Flex Plan FAQ

 Flex Plan Frequently Asked Questions

1. Why was it decided to eliminate the 30% per hour and institute the Flex Plan $50 per day in lieu of?

The amount that comes into the Flex Plan is done through collective bargaining between the Company and the Union. The Flex Plan does not set the amount per day to be contributed.

2. Why am I forced to join?

In order for the health plan to be effective everyone must join. Otherwise it would be just the sick joining and the plan would not be effective. And because the payments made to the plan are earmarked for health benefits, employees who have $600 or more dollars in their account are required to have some form of medical insurance. However, the insurance does not need to be provided through the Flex Plan. In addition, all of the Flex Plan insurance contracts are "guaranteed issue" which means that employees may enroll regardless of a pre-existing medical condition. Therefore, the insurance providers require that all eligible participants have some sort of insurance coverage and that participation may not be on a voluntary basis.

3. Why does the employer contribution come out of my pocket?

The $10 per day is shown as a deduction however it is part of the $50 per day in lieu of benefits. Currently $10 is earmarked for benefits. This is not a deduction from the hourly rate,and the $10 per day is not subject to taxes. It is the only way the plan can insure participation.

4. When do I become eligible?

Members have the option to enroll once the plan receives $100 in contributions (which includes any additional pre-tax money the member has opted to contribute through payroll). Eligibility for insurance coverage takes place when there is a sufficient account balance to pay for the cost of the insurance options elected. Once the $100 is received members will have the opportunity to pay the difference between their account balance and the cost of insurance coverage.

5. Once eligible, how am I notified and what should I receive in the form of information?

Upon reaching the $100 balance level, the member will receive a New Member Package from the Flex Plan. It will include a SPD - Summary Plan Document explaining the Plan rules in detail, a summary of insurance benefits available as well as their monthly rates. This same information is available at our web site at 
www.flexplan.com, for members that are anxious to enroll and want to review the options before they receive their New Member Package from the Plan.

6. What is the time frame as it relates to when the company contributions are available to my account?

All employers agree to remit no later than the 15th of the month following the month in which the work was performed. NBC makes weekly payments whereas ABC makes one payment a month for the preceding month. Funds are posted at the end of each calendar month.

7. Will I be able to access my account via the Internet?

We are currently working on providing our members with full account access through the Internet. We had hoped to have this in place in the 4th quarter of 2001, but is more likely to be in place sometime during the 1st quarter of 2002.


8. If I have my own health care provider, why am I charged an administration fee?

An administration fee is charged quarterly for collecting and reporting contributions, answering questions, sending out statements and various other mailings periodically. If we are paying the member's individual policy we are also charging a check fee for this service. This fee offsets the cost of maintaining the information in the system, updating semi-annual increases, sending out a check, etc. (Individual policies actually require more labor than our group contracts).

9. Is it true that I can be reimbursed for those administration fees? If so, How?

Yes, whenever a member turns in a claim for out-of-pocket medical expenses they may also include the administration fees. Reimbursement of administration fees are only accepted after the close of a calendar year.

10. Once accepted, how many days a year do I need to work to remain in good standing?

Once a members account balance goes to zero, a member must work at least 1 day per 18 months to continue coverage under the Flex Plans COBRA provision.

11. If I choose the Flex Plan as my health care provider, how can I insure that there will never be a lapse in my health care?

The Flex Plan recommends that a member be set up for automatic bank debits (at no cost) to assure that their coverage selected through the Plan never lapses. Credit card payments are also accepted, but the Plan charges a $4 processing fee. If automatic payment information is not on file with the Flex Plan, you will receive a Self-Payment Billing. The bills are mailed approximately 14 days before they are due. Members may call in payments over the phone as well up until 3:00pm of the payment due date.

12. If I dont choose a Flex Plan program do I have access to my accrued funds?

Since the payments received are made on a pre-tax basis there are strict guidelines on how they may be spent. However, the contributions may be used for payment of insurance premiums or reimbursement of out of pocket medical expenses in accordance with Flex Plan and IRS guidelines. In addition, these funds may be used for reimbursement of Child Care expenses, please refer to the Summary Plan Description for more information on this benefit.

13. How does my pre-existing condition affect my chances of being accepted in the Flex Plan?

With respect to the Flex Plan group medical insurance contracts, if a person has a pre-existing condition and has had insurance coverage for six months or more, there will be no restrictions imposed. If a member has had insurance for less than 6 months they will be given credit for the duration of their prior coverage months until the 6 months have been reached. Participants with pre-existing conditions and no prior insurance will only be excluded for treatment of that specific condition. Example: A member has hypertension as a pre-existing condition but needs to see a physician for a sinus infection; the sinus infection would be covered.

14. What happens to my employer contribution if I have my own coverage, and it pays everything?

Very rarely does the member have everything covered at 100% from another employer, spouse's employer, or other Plan, usually there are out of pocket expenses: copays, deductibles, prescription co-pays. In addition there are benefits that are generally limited such as chiropractic, which may be reimbursed. Any unused balance from employer contributions will roll over until the next calendar year or until it is feasable to use for medicare.

If the source of the prior insurance terminates, you would be eligible to enroll under the Flex Plan group contracts or elect reimbursement of the COBRA premiums for the prior insurance.

15. Is the disability program mandatory, or do I have a choice not to participate?

The disability policy is only mandatory if you do not have a disability contract (not including state disability programs) from another source.
The only way to have "guaranteed issue" disability benefits available at such low rates is to require that all eligible participants have coverage.

16. Can I opt out of Flex disability if I have my own disability?

Yes.

17. If disability occurs, how soon do I collect and for how long?

Effective 1/1/2002 there are 2 options available: a 90 day waiting period and a 60 day waiting period (after the date of disability). Benefits will be paid to age 65, however you should refer to the detailed Evidence of Coverage information for more detailed information. Participants over age 65 will have a minimum payment period of 1 year.

18. If I choose to participate in the disability program, how can I be sure I never lose it?

This is a group disability plan and does require that you receive employer and pre-tax contributions in the amount of $100 at least 1 time every six months. If you secure an individual policy, they are generally portable and the premiums may be reimbursed from the Flex Plan. However, if you pay disability premiums with pre-tax dollars, the benefit (if disabled) is taxable