End of COVID-19 National Emergency – Impact on Certain Funds’ Deadlines

As previously explained in Funds’ notices, early during the COVID-19 pandemic the federal government announced that employee benefit plans (like the Funds) were required to extend the usual deadlines for requesting special enrollment in health plans, filing claims and appeals (under all of the Funds), and making COBRA elections and payments. Specifically, the applicable periods were “tolled” until 60 days after the end of the COVID-19 National Emergency, for a period of up to one year.

The National Emergency ended on April 10, 2023, and in accordance with government guidance, the above deadlines will no longer be extended as of July 11, 2023. Please click on this link to a notice that describes this in more detail (on page 3).

Please click on the link for two important Notices regarding the Annuity Fund’s rules. The first Notice explains changes to the Fund’s spousal consent rules. The second Notice describes a few updates and clarifications to the Fund’s Hardship Withdrawal rules, and also includes a reminder about the different types of Withdrawals available from the Annuity Fund.

EFFECTIVE JULY 1, 2022, - UPDATED INFORMATION REGARDING COVERAGE FOR AT-HOME COVID-19 TESTS THROUGH THE WELFARE FUND

As previously announced, the Welfare Fund has been covering over-the-counter (OTC) at-home COVID-19 tests purchased by participants on or after January 15, 2022, limited to 8 tests per 30-day period per covered individual, without participant cost-sharing, preauthorization, or medical management. The Fund’s prescription drug benefit manager (AetnaRx) provides this coverage for the Fund’s participants.

As of July 1, 2022, you can order at-home COVID-19 tests at CVS.com or with the CVS pharmacy App and have the tests shipped to your home, office or other location, at no cost to you. You may also continue to obtain tests at participating CVS pharmacies at no cost to you. You can either order the tests online for pick-up at your local CVS, or you can visit a CVS pharmacy in-person. (See the CVS flyer for details). This option is available only at CVS pharmacies (not including those at Target and Schnucks stores). You may also continue to submit claims to AetnaRx for reimbursement (for tests already purchased). Just keep your receipt, and then complete and mail your COVID-19 test kit reimbursement claim form to AetnaRx. Once your claim is processed, a check will be mailed to you. As of July 1, 2022, reimbursement is limited to $12 per test (or usual and customary charge, if lower).

Note that at-home COVID-19 tests used for return to work or school, or recreational purposes, are not covered unless required by state law. Lab-based PCR home collection kits also are not covered.

Also, as a reminder, you can order free at-home COVID-19 tests from the federal government at https://www.covidtests.gov/

UPDATED AETNA ID CARDS

Updated Aetna ID cards will be available next week. The new cards include deductible and out-of-pocket cost information for both in-network and out-of-network medical services. You can print a copy of the new card by signing into Aetna’s member portal at aetna.com. You also can request a new card by calling the phone number on your ID card. If you don’t print or obtain an updated ID card, your current ID card will still work.

As a reminder, you can register on the member portal on aetna.com to stay up-to-date. It only takes a few minutes and all you need is your Aetna ID number.

TRANSPARENCY IN COVERAGE

The Fund is required to post certain information on a public website pursuant to the Federal Transparency in Coverage Final Rule published in the Federal Register on November 12, 2020.

The Transparency Rule is intended to make information about the prices charged for health care available to the general public, particularly researchers. These experts can use pricing information from the Fund and other health plans to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending.

The Transparency Rule requires that the Fund post links to machine-readable files that contain information about the price of health care services. A machine-readable file is written in computer code and is an extremely large file. It is not intended to be downloaded or read by participants but to be used in research studies. The files do not contain Protected Health Information (PHI) about you or your family. Below is a link to the required machine-readable files.

https://Health1.Aetna.com/app/public/#/one/insurerCode=AETNACVS_I&brandCode=ALICSI/machine-readable-transparency-in-coverage?searchTerm=276125&lock=true

Links on this website provide machine-readable files for the Fund’s in-network negotiated rate and historical allowed amounts for out-of-network charges. The files attached to the links are maintained by the Fund’s third party claims administrator, Aetna. Aetna will update the file attached to the links automatically each month.

If you have any questions about the Transparency Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f

Please click on the link for a directory of Health Care Professionals who are participating in the Aetna network under the Welfare Fund.

Please click on the link for information about the prescription drugs covered under the Welfare Fund prescription drug plan.

Please Click On This Link For Important Information Effective January 1, 2022 Regarding Your Rights and Protections Against Surprise Medical Bills.

NY PAID FAMILY LEAVE BENEFITS PROVIDED BY THE FUND

As a reminder, the Mason Tenders’ District Council Welfare Fund (the “Fund”) has been providing New York Paid Family Leave (PFL) benefits to eligible members covered under the Fund since January 1, 2018 (the effective date of the NYPFL requirement). Accordingly, contributing employers do not need to collect, nor should they collect, PFL premiums from collectively-bargained employees who are participants in the Fund. Note that an employee who has contributions reciprocated from the Fund to another welfare fund pursuant to a reciprocal agreement is not a participant in the Fund and, therefore, is not eligible for PFL coverage from the Fund.

IMPORTANT INFORMATION REGARDING THE FUND OFFICE

Good news! Members can now drop off benefit applications and other documents at the Fund Office without an appointment. Documents may be given to the receptionist. If you would like to meet with one of the Fund’s employees, please make an appointment. You can request an appointment by sending an email to:

pensionannuity@mtdctrustfunds.org - for an appointment with the Pension/Annuity Department
eligibility@mtdctrustfunds.org - for an appointment with the Eligibility Department
contributions@mtdctrustfunds.org - for an appointment with the Contribution Department
accounting@mtdctrustfunds.org - for an appointment with the Accounting Department
memberadvocate@mtdctrustfunds.org - for an appointment with the Member Advocate

Please include the following information in your appointment request email:

Name and Book Number
Date and Time you would like your appointment (please provide a few possible dates)
Phone number
Reason for appointment

We will try to accommodate your requested appointment date and time as best as we can.

After we receive your email request, we will send you an email letting you know the date and time of your appointment. Please do not arrive at the Fund Office more than 5 minutes prior to your appointment. Members are required to wear masks and, to the greatest extent possible, maintain a distance of at least six feet from others at all times while in the office and while entering/exiting. No individuals may visit the Fund Office if they are experiencing symptoms consistent with COVID-19, such as fever, cough, difficulty breathing, or congestion/runny nose. A Visitor Health Screening Questionnaire will be sent to you with your appointment confirmation email. You will need to complete the Questionnaire immediately prior to coming to your appointment and give it to the Fund employee you are meeting with. The Questionnaire can also be obtained by clicking this link.

Please Click On This Link Link For Important Information Regarding Plan Deadlines (For COBRA Election, Payment and Notice of Qualifying Events, Special Enrollment, and Filing of Claims and Appeals).

Please Click On This Link For Important Information Regarding Behavioral Health Televideo Counseling Services.

INFORMATION FOR NEW JERSEY RESIDENT WELFARE FUND PARTICIPANTS

New Jersey residents who participate in the Welfare Fund will soon be receiving new Identification Cards from Aetna. The new card (which you should start using July 1) includes a note showing that the Fund is enrolled in a program that is provided in accordance with a New Jersey law, which protects New Jersey residents from being balance billed by out-of-network health care providers in New Jersey for covered healthcare services under certain circumstances. You will receive a notice from the Fund Office with more information about the program and the types of claims it applies to. If you have questions about balance billing or the program, please contact Aetna at the number on the back of your Identification Card.

IMPORTANT MESSAGE ABOUT CORONAVIRUS (COVID-19)

The Funds' Board of Trustees understands that you and your family may have questions about your health, pension and annuity benefits during this uncertain time. As you know, the situation and the public health response is continuing to evolve and change on a daily basis. Please be aware that the Board of Trustees and the Funds' Office is taking steps to ensure that the Funds' operations continue without interruption as best as possible during this difficult time for all. Please continue to check the Funds' website periodically for new information and updates.

Please also be advised that the Welfare Fund is waiving participant out-of-pocket costs/cost-sharing for COVID-19 diagnostic testing. In addition, Aetna has introduced Healing Better care packages for members diagnosed with COVID-19, supporting our participants and helping to keep others in the home protected from potential exposure. Aetna also is offering resources to help address any associated anxiety and stress related to COVID-19, including opening Crisis Response Lines and expanding access 24/7 to the Aetna Nurse Medical Line, among others. You can find more information about these resources on Aetna's website aetna.com or contact Aetna at:

• Aetna Crisis Resource line Number: (833) 327-2386
• Aetna Informed Health Line (Nurse Line) number is: (800) 556-1555