| Q: |
Is the International trying to take over our Fund?
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| A: |
This answer is a simple NO. Local Trust Funds maintain full control of benefit design, eligibility (including appeals), plan assets and investment.
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| Q: |
My Fund is already self-funded and we have negotiated great deals to make the operating cost super-efficient. Why would we want to join? |
| A: |
For a Fund that is already self-funded, the big advantage is economies of scale and collective resources ability to teach clinical and financial data; allowing BAC members to make better informed health care decisions. Economies of scale means that it will cost less on a per-member or per-hour basis to provide similar or better healthcare benefits.
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| Q: |
How is it that my Fund gets to hang on to its reserves? |
| A: |
Your Local Fund will pay the negotiated fees and claims to UHC on a per-employee per-month basis at fees determined by the number of participants (larger number the lower the fees). Other than those monthly fees, and no up-front payment deposit, your Local Fund will retain all of its assets and invest and use those reserves as the Local Fund Trustees determine is consistent with your Trust. Your Local Fund Trustees may, for example, use reserves to purchase prescription drug, vision or dental coverage. Depending on the eligibility rules that your Local Fund establishes, it will also need to maintain some reserves to pay for members who are eligible but not currently working because it will pay fees/claims on a per-employee per-month basis for each eligible employee, regardless of whether or not that employee is actually working. This is similar to how most Local Funds currently use reserves.
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| Q: |
How are my Fund’s employer and member contributions determined? |
| A: |
The Local Fund is responsible for setting its contribution at a level that will cover the monthly contributions needed to provide the selected health coverage for all eligible members. They will need to determine what level is needed to build up a reserve sufficient to cover the monthly contribution during times of low working hours.
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| Q: |
Who picks the benefits? |
| A: |
The Local Fund will select from a range of benefit plans.
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| Q: |
Who picks the eligibility? |
| A: |
The Local Fund will be able to set the eligibility requirements.
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| Q: |
How do appeals and retro-adds and terms get handled? |
| A: |
Eligibility appeals are handled by the LTF.
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| Q: |
Why should I switch when our fund already receives great discounts? |
| A: |
In addition to the savings from discounts, through the HCPC your fund also has the potential to have lower access fees and stop-loss premium. As participation grows the fund anticipates the potential for savings will grow.
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| Q: |
Why should we do this? Our fund just went through an RFP process. |
| A: |
You have a fiduciary responsibility to your fund; besides the HCPC premium calculation comes at no cost to the fund.
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| Q: |
I’ve been told by my administrator/consultant that it’s not a good idea – who should I believe? |
| A: |
Remember, you (the Fund) are the client and as such the administrator/consultant needs to take direction from the Trustees. You are also the one with the fiduciary duty to determine what is best for your fund and its participants.
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| Q: |
Will my members be able to keep their Doctors? |
| A: |
Every effort is being made to limit member disruption and match your existing network with one offered through the HCPC, and changing to a larger network would result in less disruption since more providers exist. In addition, the HCPC can do a network match and run a disruption report based on your member census.
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| Q: |
Since this is such a new program, chances are there will be service issues and I would rather wait a year or so and not be the first to jump on board. |
| A: |
The HCPC has implemented two service safe guards -- provider performance guarantees and a general administrator to make sure that the members receive excellent service. Taking a “wait and see” attitude only lengthens the time your fund and members will not realize the savings and medical management benefits.
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