Article III - Benefits
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UMWA Health and Retirement Funds

Article III - Benefits

A. HEALTH BENEFITS
(8) CO‑PAYMENTS AND DEDUCTIBLES
 
· Allergy desensitization therapy, 204
 
· Anesthesiologists’ services, Q&A 81‑55
 
· Coordination of benefits/copayment, Q&A 81‑62, 60
 
· Deductible and Annual Health Benefit elimination07-000207-000307-0004, 07-0005 
 
· Definition of physician visit, Q&A 81‑50
 
· Employer charges co-payment for all services except inpatient hospital servicesCA-062 
 
· Formulary drug program with surcharge, 98-013, 98-014, 02-002 CA-056, CA-072 
 
· HMO enrollees, Q&A 81‑63
 
· Home health nurse visits, Q&A 81‑56
 
· Individuals changing status, Q&A 81‑58
 
· Insulin, Q&A 81‑64
 
· Laboratory and x‑ray services, Q&A 81‑52, CA-062 
 
· Lump sum health care payment, 93-031, 02-017 
 
· Mail-order, 88-613
     --maintenance prescription drugs, CA-066, 02-001
 
· Medicare‑eligible beneficiaries (Part B deductible), 102, 02-026,CA-074
 
· Obstetrical delivery services, Q&A 81‑51
 
· Pernicious anemia injections, 197
 
· Pharmacy, network, 88-613
 
· Physician visits during hospitalization, Q&A 81‑50, 61, 81‑085, 88‑493
 
· PPL‑employer does not establish, 93‑035
 
· Prescription drugs, Q&A 81‑53, Q&A 81‑54, 88‑322, CA-097 
 
· Primaries, two under same plan, Q&A 81‑59
 
· Reimbursement procedures, 28, 132, 84‑042CA-074 
 
· Responsibility of employee, 81‑573, 84‑413, 88‑440
 
· Schedule of 12‑month periods, 81‑087
 
 
· Surgery, Q&A 81‑57
 
· Transfer of copayment between employers during plan year, 231, 81‑538, 88‑354, 88‑733