PLAN OUTLINE
Eligible Retiring Employees and/or Dependents
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**LIFETIME MAXIMUM INCREASED UNDER GA46000** As of January 1, 2008, the lifetime maximum benefit for each individual covered under the Railroad Employees National Early Retirement Major Medical Benefit Plan (United Healthcare's GA46000) will increase from $101,200 to $107,7200.
The $6,500 in additional benefits payable applies to expenses incurred on or after January 1, 2008. The lifetime maximum benefit is adjusted each year based on the medical cost component of the Consumer Price Index. |
The CARE Health Plan offers a secondary plan for Early Retirement Major Medical retired employees & spouses whose primary coverage is through United Healthcare Plan GA46000 only.
For Precertification and Utilization Review, members in the Plan MUST follow the criteria established by United Healthcare GA46000.
Plan #5000 will pay the Primary Plan’s deductible, as well as, copayments and/or coinsurance on Allowable charges. This plan will also reimburse the member for the difference between the Amount Allowed* and the Amount Paid by your primary carrier until you reach the Lifetime Maximum under United Healthcare GA46000.
* The Amount Allowed must have been considered for payment by the Primary Plan in order for CARE to consider for secondary payment.
(If you meet the Lifetime Maximum under United Healthcare GA46000, your coverage would then transfer to Plan #5500).
CLASSIFICATION OF MEMBERSHIP
For Pre-Certification and Utilization Review, members in
this Plan MUST follow the criteria established by their Primary Carrier (the
Comprehensive Plan administered by United Healthcare 46000).
Eligible Retiring Employees
To qualify for coverage under the Early Retirement Plus Plan, the eligible retiring union employee must retire at age 60 or over, (but not yet 65), with thirty years or more service. Eligible retiring employees should follow the guidelines set by the Comprehensive Plan administered by United Healthcare for coverage under GA46000 prior to applying for membership in this CARE Health Plan.
Eligible retiring employees are eligible for benefits under this Plan only until he or she reaches 65 years of age. At that time, eligible retiring employees may transfer coverage over to a Medicare supplement (Plan #4000 or Plan #4100).
If you qualify for coverage under the Retirement Plus Plan, you should contact the CARE office for an application.
Eligible Dependents
Eligible dependents of early retirees are eligible for coverage under this Plan. In order for dependents to qualify for GA46000, the eligible retiring employee must apply for his/her annuity within 30 days after leaving railway company employment.
Spouses enrolled in the Early Retirement Plus Plan are eligible for benefits under that plan ONLY until the eligible retiree reaches, or in the case of a widow (er), would have reached 65 years of age, or until the spouse becomes 65 years of age, whichever comes first. Spouses of eligible retirees who are not yet eligible for Medicare, may apply for membership in the Plan #2000 when the eligible retiree becomes 65.