May 12, 2015
APFA National Health Department Email Contacts:
Out of Network Reimbursement Policy Changes, June 1, 2015
The company has chosen to disregard APFA’s objections that changing out-of-network reimbursement policy is a violation of our contract. Beginning June 1, 2015, if you use an out-of-network provider, the company will limit the “allowed amount” they pay for those services. Their plan is to allow 140 percent of Medicare’s published rates for any service the employee obtains at an out-of-network provider. AA will pay 60 percent of the “allowed amount” because the out-of-network provider is not contractually prohibited from billing the employee for the difference between their charges and the lower ”allowed amount.” Therefore you may end up paying the 40 percent of the “allowed amount” PLUS that difference.
For Example an MRI charge of $2000 that has a Medicare 140 percent “allowed amount” of $1000, AA will pay $600 (60%) you will pay $400 (40%) PLUS the difference of $1000 = $1400.
So, if you go to your in-network Doctor and he sends you for an MRI at an out-of-network facility, possibly in the same building, you will end up paying more. Please make sure that any Doctor or facility/provider is in network. You can contact your insurance provider to verify if you are using an in network provider.
APFA views this as a JCBA contract violation and has met with legal regarding this mid-year imposed change. We will be noticing the company of our issue with their blatant contractual violation and will demand a cease and desist. If the company continues with their June 1, 2015 Out-of Network changes, we will immediately file a Presidential Grievance and seek expedited Arbitration.
LUS – This will change go into effect January 1, 2016.
LAA / LUS
Benefit Direct Bill Drops
There are approximately 147 LAA and 132 LUS Flight Attendants that should have received a letter from HR as a result of being in jeopardy of having their benefit coverage cancelled retroactively for the period that has not been paid.
Direct Bill balances are no longer sent back to payroll once an employee returns to work, so you have to pay the balance for the coverage during the absence for the benefits to remain intact. If you have any questions please feel free to contact us.
LAA / LUS
Verifying Benefit Coverage
It is a good idea to verify your benefit elections and deductions on your paycheck with your benefit enrollment selections in the Benefit Service Center. If you find that there is an error, please contact Aon 888-860-6178 to open a case for you. Also, please call the APFA Health department so that we can assist you in getting this corrected.
APFA has been notified by AA that it will no longer provide light duty accommodations. We do not agree to this change and will continue to address this with the company. In the meantime, it is our recommendation that if you are able to perform light duty that you should apply for unemployment. Each state has different laws governing if you will be eligible for unemployment, we recommend you contact your state unemployment office or visit your state unemployment website.
LUS – Status Quo
APFA National Health Chair
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