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ctww.org |
phone
(206) 441-6514 |
administrative fax
(206) 728-5648 |
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(206) 441-5839
2200 Sixth Avenue, Suite 300, Seattle, WA 98121-1839
| PO Box 1929, Seattle, WA 98111-1929
Health and Security Retirement Vacation Industry Fund
Carpenters Health and Security Plan
of Western Washington
Summary of Material Modification
Purpose of Notice
The purpose of this notice is to advise you the Board of Trustees amended the Carpenters
Health and Security Plan of Western Washington as follows:
§The preferred provider network is changing from Aetna to Regence eective September 1,
2021.
§Alternative care will be covered in lieu of regular plan benefits for dates of service beginning
September 1, 2021 and vasectomies will be covered at 100% for dates of service beginning
September 1, 2021.
§The Oregon-Washington Carpenters-Employers Health and Welfare Plan merged with the
Carpenters Health and Security Plan eective July 1, 2021 for September 1, 2021 coverage.
New Provider Network September 1, 2021
Background
A very important change is being made to the Carpenters Health and Security Plan of Western
Washington eective September 1, 2021. On that day, the plan will move from its current
preferred provider network, Aetna, to its new preferred provider network, Regence. As you may
recall, a preferred provider network is a group of providers – hospitals, urgent care centers, clinics,
physicians, specialists, chiropractors, and many others – that provide services at a contractually
discounted rate in exchange for the plan’s participation in the network. No action is required by
you at this time.
Important: This change does not apply to Medicare-eligible retirees and dependents who
elected Retiree Coverage.
What’s Changing On September 1?
The September 1, 2021 change from Aetna to Regence should be seamless for the vast majority
of participants, retirees and dependents but here are a few of the more important issues related
to this plan change:
1. The Regence network extends to all fifty states through the BlueCard network which
makes finding a network provider a lot easier when working or traveling outside the Pacific
Northwest. Remember, using a network provider usually means less out-of-pocket expense
for you and lower claims costs for the plan.
2. Regence will provide the following additional services for participants and dependents:
§Preauthorization for inpatient admissions. With Regence, your provider is responsible
for precertifying inpatient admissions.
§Preauthorization for bariatric surgery.
§Case management services.
§Preauthorization for other services and supplies such as, but not limited to, durable
medical equipment, home health care, home phototherapy, hospice care, infusion
therapy, neurodevelopmental therapy, neuropsychological or psychological assessments
or tests.
More details about these program changes will be provided to you in August. Carpenters Trusts
will also provide updates on the web: www.ctww.org. This change does not aect Medicare-
eligible retirees or dependents unless the retiree regains dollar bank eligibility through post-
retirement service.
What to Look For
Here’s how the change in network will be introduced in advance of the September 1, 2021
eective date:
1. Participants will receive a new Regence/Carpenters Trusts ID Card in late August. The
projected mail date for the new card is August 25, 2021. The new ID Card will replace the
Aetna/Carpenters Trusts ID Card currently in use. When you or a dependent receive services
or supplies from any provider, please present your new ID Card to the provider.
2. Eective for services beginning September 1, 2021, your provider is responsible for contacting
Regence to verify eligibility and benefits and to obtain authorization for any service that
requires prior approval.
3. Your Delta Dental card and your dental and orthodontia benefits, in general, are unaected
by this change.
The Board of Trustees is making this change to help slow the rise in healthcare inflation across
the carpenter population. Preliminary studies suggest the new preferred provider network will
save the plan a significant amount of money while improving services. Carpenters Trusts will
continue to update you on the progress of this project with follow-up communications in July
and August. No action is required by you at this time.
New Plan Benefits Eective September 1, 2021
The Board of Trustees approved three benefit changes to the Carpenters Health and Security
Plan eective September 1, 2021 as described below:
§Alternative care may be covered in lieu of regular plan benefits for dates of service beginning
September 1, 2021 if certain conditions are met. Alternative care must be approved in writing,
medically necessary and must meet accepted medical community standards and result in no
additional cost to the plan. For example, alternative care could be coverage for home care or
a skilled nursing facility in lieu of hospitalization.
§Vasectomies will be covered at 100% for dates of service beginning September 1, 2021.
§The Plan is implementing a specialty pharmacy copay assistance program, SaveOnSP
administered by Express Scripts, to help you save money on certain specialty medications. If
your specialty medication is noted on the SaveOnSP Drug List, you must participate in the
SaveOnSP program to receive your medications free of charge ($0). Specialty medications
are filled through Accredo specialty pharmacy. You will be contacted by Express Scripts if
your specialty medication is on the SaveOnSP Drug List.
Please contact Claims at Carpenters Trusts if you have questions about these benefit changes.
Washington and Oregon Plans Joining Forces!
After much discussion, the Trustors and Board of Trustees of the Oregon-Southwest Washington
Carpenters Trusts and the Board of Trustees of the Western Washington Carpenters Trusts agreed
to merge their trusts and fringe benefit plans. This important change is eective July 1, 2021
with changes phased in through the end of the year. With these mergers, the Board of Trustees
intend to take advantage of lower administrative expenses due to increased negotiating power
with plan vendors and improved portability of benefits for participants working in multiple
jurisdictions (money follows). If you work in Oregon, you will continue to participant in this
Trust and Plan without the need for reciprocity. No action is required by you with this change.
Questions?
If you have questions about these important changes, please contact Participants Services at
Carpenters Trusts: (800) 552-0635.
