FREQUENTLY ASKED QUESTIONS

Participation in the HRA begins on the first day of the month after your Dollar Bank exceeds six months of the Required Contribution amount.

For example, if you have the maximum Dollar Bank balance and have contributions for the current month’s coverage which
exceed the Required Contribution amount, the contributions in excess of the Required Contribution amount will be posted to
your HRA balance. (If the Required Contribution amount is $1,200, the maximum Dollar Bank balance is $7,200, and your
contributions for the current month’s coverage are $1,500; then $300 will be posted to your HRA balance.)

The Fund will automatically reimburse you for deductible and coinsurance amounts. Other Qualified Medical Care Expenses must be submitted for reimbursement with an HRA Claim Form. If you do not want to receive automatic reimbursement, you should complete the HRA Election Change Form (Off). All Qualified Medical Care Expenses must be submitted for reimbursement with an HRA Claim Form if automatic reimbursement is turned off.

You may use the contributions deposited into the HRA for the payment of Allowable Medical Care Expenses incurred by you, your spouse as defined in Internal Revenue Code Section 213(d)(8), and/or your eligible, non-spouse dependents. Benefits will not be provided in the form of cash or any other taxable or non-taxable benefit other than reimbursement of Allowable Medical Care Expenses. The following contains only a partial list of medical Expenses considered Allowable Medical Care Expenses under this HRA. Contact the Fund Office for questions about a particular Expense.

• Amounts exceeding payments made by insurance companies for eligible Expenses in connection with dental, vision care, and hearing benefits
• Laser eye surgery
• Braille books and magazines
• Nursing services in connection with dental, vision care, and hearing benefits
• Contact lenses and solutions
• Physicians fees for dental, vision care, and hearing benefits
• Deductibles for medical insurance only
• Radial Keratotomy
• Dental fees
• Seeing-eye dog and its upkeep
• Dentures
• Self-payments to the Heartland Healthcare Fund
• Eyeglasses, including the examination fee
• Surgical fees in connection with dental, vision care, and hearing benefits
• Special telephone for the hearing impaired
• Hearing devices
• Television audio display equipment for the deaf
• Home improvements/modifications motivated by medical considerations in connection with dental, vision care, and hearing benefits
• X-rays in connection with dental, vision care, and hearing benefits
• Hospital bills in connection with dental, vision care, and hearing benefits

Contact the Fund Office and ask to speak with an Accounts Receivable Specialist. They will verify eligibility and order new ID cards. Your new ID cards will arrive within 7-10 business days from the date you notify the Fund Office that you need a new card.

The Service Providers page provides links to the service provider websites where you can find BlueCross BlueShield and Delta Dental network providers.

Please visit bluecrossmnonline.com and login to view your EOB.

If you receive services from a non-participating provider you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider, then complete an Initial Report of Claim Form. Forward the bill and completed form to the address as it appears on the claim form.

Request a Beneficiary Designation Form and mail to the Fund Office.

In order to change your mailing address, you must complete a Change of Address Form. You may print and complete the form, or you may contact the Fund Office and a form will be mailed to you.

To enroll your spouse for coverage under the Plan, submit a completed Family Update Form along with a copy of the certified marriage certificate to the Fund Office.

To enroll your dependent child for coverage under the Plan, submit a completed Family Update Form along with a copy of the certified birth certificate or adoption papers to the Fund Office.

Submit a completed Disability Claim Form to the Fund Office.

You will receive your ID cards 10-15 business days after you become eligible.

You can review the Summary Plan Description electronically or you can call the Fund Office to request a hardcopy of the SPD booklet.

You or your spouse must notify the Plan and mail a fully executed copy of your divorce decree to the Fund Office. Once the Plan receives the divorce decree, your former spouse’s coverage will be terminated as of the date of your divorce.

If you exhaust your Active eligibility, you may become eligible for coverage as a Retired Employee by meeting the following requirements:

• You must be at least age 55 and have at least 10 Years of Service. For this purpose, a Year of Service means a calendar year in which you have at least 500 hours of work for which Employer contributions are made to the Fund or a Predecessor Fund.
• You must have at least 60 months of continuous eligibility immediately preceding the commencement of retiree coverage under this Fund or a Predecessor Fund. For the purpose of this provision, eligibility continued through self-contributions will be included.
• You must waive your right to COBRA Continuation Coverage.

If you are a Retired Employee, your coverage will commence on the first day of the month following the month in which your Dollar Bank is exhausted, provided you make the required self-contribution charged by the Trustees. As a Retired Employee, coverage for you and your Eligible Dependents is based on age, as follows:

• You and any Eligible Dependent under age 65 may continue coverage under the Regular Plan or the Reduced Plan.
• You and any Eligible Dependent age 65 or older will be covered under the Medicare Supplement Plan.

Please contact the Fund Office for your retiree options for continuing health coverage.

The transition from active employment to retired status can present challenges. One of these challenges is deciding when to enroll for Medicare Part B coverage. This discussion is intended to assist participants as they transition from an active employee covered by the Heartland Healthcare Fund, to an early retiree covered under the Retiree benefits of the Fund, and finally, to a Medicare enrollee also covered by the supplemental plan offered through the Fund.

In general, you should enroll in Medicare Part B when you are first entitled to do so. Why? Even if you don’t enroll, the Heartland Healthcare Fund will treat you as though you have. The 2018 Summary Plan Description states on page 44, “The Plan automatically considers you to be insured under both Part A and Part B whether or not you have actually enrolled. Therefore, it is very important that you enroll in Medicare as soon as you become eligible.” Some participants may intentionally or inadvertently decline to enroll in Medicare Part B coverage at the time they first became eligible to do so. As a result, those individuals may have to wait to become enrolled for that coverage and may also have to pay a higher monthly premium.

What happens if you don’t enroll in Part B? If you decline enrollment, you will be insufficiently covered and unable to enroll in the Medicare supplemental coverage offered by the Fund through BlueCross BlueShield. Additionally, those who decline Part B coverage when initially available may need to wait to enroll in that coverage in the future, and that coverage could be more expensive due to certain penalties assessed by Medicare.

The Heartland Healthcare Fund recommends accepting Medicare Part B coverage as soon as you are Medicare eligible either as a result of becoming age eligible or as a result of a disability.

If you have any questions about your eligibility, benefits or claims, contact the Fund Office at (952) 854-0795 or (800) 535-6373.