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Please note new phone number  769-257-5270
N.E.C.A.-I.B.E.W. Local 480/917 Benefit Plans, Logo

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NECA-IBEW LOCAL 480 HEALTH & WELFARE FUND
 No Surprises Act (Effective January 1, 2022)
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance and/or deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
Out-of-network air ambulance services
Out-of-network air ambulance services can’t balance bill you if your Plan covers in-network air ambulance services.

 You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:
·         You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

· Your health plan generally must:
o   Cover emergency services without requiring you to get approval for services in advance (prior authorization).
o   Cover emergency services by out-of-network providers.
o   Base what you owe the provider or facility (cost-sharing) on what it would pay an in? Network provider or facility and show that amount in your explanation of benefits.
o   Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you have any questions regarding your rights, you may contact the Plan at NECA-IBEW Local 480 Health & Welfare Fund, P.O. Box 721119, Byram, MS 39272; phone: (769-257-5270) or 1-800-424-8434; email: jhill@ibew480.org.

If you believe you’ve been wrongly billed, you may contact:

The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law; or

IMPORTANT NOTICE REGARDING GRANDFATHERED STATUS

The NECA-IBEW LOCAL 480 HEALTH AND WELFARE FUND is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (“PPACA”).  As permitted by PPACA, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered plan means that your plan may not include certain consumer protections of PPACA that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in PPACA, for example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the Plan at NECA-IBEW Local 480 Health & Welfare Fund, P.O. Box 721119, Byram, MS 39272; phone: (769)257-5270 or 1-800-424-8434; email: jhill@ibew480.org. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform.  This website has a table summarizing which protections do and do not apply to the grandfathered health plan.

Insurance & Benefits from Local 480/917

Get all the information you need to access and administer your benefits through N.E.C.A.-I.B.E.W. Local 480/917 Benefit Plans. We make it easy to download all the important forms and sign up for additional voluntary insurance. The Mortuary Fund and Sickness & Accident Fund are in need to new members, so please look into these great opportunities. Just contact us if you have any questions.

Forms & Links


Members can visit www.groupvisionservice.com for details about Vision benefits - Effective date January 1, 2022

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   Please visit www.Principal.com to register and view your retirement

 Visit American Benefit Corporation™ and Create a Login to View EOBs


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About Us

On December 23, 1975, Local Union 480 of the International Brotherhood of Electrical Workers and the Jackson Division, Central Mississippi Chapter of the National Electrical Contractors Association, Inc., established a jointly administered employee benefit trust to provide health and welfare benefits for eligible employees engaged in employment under the collective bargaining agreement. Today, we continue to provide benefits, retirement coverage, and optional benefit plans to electrical workers and their families throughout the Jackson area. If you have any questions about your union benefits, please get in touch. We're always happy to help.


Contact

Thank you for your interest. For questions or comments, please use the information listed here. We look forward to hearing from you soon.

Phone
(769)257-5270

Hours of Operation
Monday – Friday: 8:00 a.m. – 5:00 p.m.

Address
4767 I-55 S Frontage Road
Jackson, MS 39212
P.O. BOX 721119
Byram, MS 39272

Service Area
Jackson, Mississippi, and the Surrounding Areas

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