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Effective April 1, 2023
Elimination of out of network lab coverage

Effective April 1, 2023, any services rendered at an out-of-network lab will not be covered. Network labs only will be eligible for covered expenses under all Plan Levels.

You should make your provider aware of this Plan change, in order to make sure they submit any lab work ordered or performed to a Network lab. To obtain a list of Network labs or find a lab near you, you can go to following Horizon website: https://www.horizonblue.com/ or you can call them at 800-355-2583.

Effective April 2023
END OF COVID-19 EMERGENCIES

As you may be aware, due to the COVlD-19 National Emergency, the federal government extended certain deadlines for participants, dependents, and beneficiaries during the "Outbreak Period," which began March 1, 2020, and ends on June 9, 2023. The extensions applied to the following deadlines:

  • filing an initial claim for benefits
  • filing an appeal of a claim denial
  • requesting and perfecting an external review of an appeal denial, if applicable
  • electing COBRA continuation coverage
  • making payments for COBRA continuation coverage
  • notifying the plan of qualifying events or disability
  • filing for HIPAA special enrollment

The extended deadlines will continue to apply if you experienced either a qualifying life event or became eligible to take any of the foregoing actions under the Plan on or before June 9, 2023. Thus, you continue to have up to the earlier of: (1) one year from your original deadline; or (2) the end of the Outbreak Period plus the original deadline in which to take the action in question. For events after June 9, 2023, all deacllines will run as normal, with no forther COVlD-19 extensions.

COVID-19 SERVICES AFTER THE END OF THE PUBLIC HEALTH EMERGENCY

During the Public Health Emergency, the Plan covered COVID-19 testing expenses, preventive services, and vaccinations without any participant cost-sharing for in-network only.

After May 11, 2023, the Plan ,vill no longer cover items and services related to testing and preventive treatment of COVlD-19 without participant cost-sharing (i.e., deductibles, copaymcnts, or coinsurance), prior authorization or other 1nedical n1anagen1ent require111ents, and COVID-19 vaccinations, (with the exception of out of network of laboratory services); regardless of whether the service was furnished in-network or out-of-network. Over the counter COVID-19 tests ,:vill no longer be covered at all. Services rendered to participants prior to May 11, 2023, will not be subject to these changes.

Further reminder effective, April 1st, 2023, the Plan is no longer covering any services pcrfOrn1cd in an out-of-network laboratory.

Additionally, after May 11, 2023, the Plan will no longer cover vaccines for COVID-19 without costsharing, if the services are provided out-of-network. Coverage for in-network vaccines for COVID-19 will continue to be covered as all covered vaccines are currently done so.

Has your address changed? It's important to update your address in order to ensure you receive any and all important notices sent to members. Please call the Fund office with your new address: 973-423-4565.

No Surprises Act

The "No Surprises Act" is a new federal law that protects you from "Surprise Medical Bills." We encourage you to learn more by viewing the Notices posted below, and to contact us at 973-423-4565 with any questions about these changes.

  • Find out...
    • What is "balance" or "surprise" billing?
    • What are your rights and protections?
    • Who can you call for help?

    View No Surprises Act Notice

    View Machine Readable Files - Available 7/1/2022

The Benefit Plan Office is Open

While our office and phone line are open during normal business hours (8am to 4pm Monday to Friday). If you need to come into the office please sechedule an appointment. Our office number is 973-423-4565. If you need any assistance, please contact us via phone - do not come to the Plan Office.

  • Coverage of Telehealth Visits - Effective January 1, 2022

    Effective January 1, 2022, telehealth visits (for medical or mental health services) will be covered by the Northern New Jersey Teamsters Benefit Plan as follows:

    • If the telehealth provider is a Network provider, coverage will be provided at the same level as any other in-person in-network office visit, including applicable copayments and network deductibles and a limit of one office visit per day. Please refer to your Northern Plan summary plan description for additional information regarding coverage for office visits.
    • If the telehealth provider is a Non-Network provider, coverage will be provided at the Plan's Out-of-Network maximum allowance for telemedicine visits, which is approximately $115 based on the current network rate with Horizon Blue Cross Blue Shield (this rate is subject to change). The Non-Network deductibles will also be applied to telehealth visits, and coverage is limited to one telehealth visit per day, as is the case for in-person office visits.

    As with all benefits, telehealth visits will be covered only if “medically necessary” as defined in the Northern Plan summary plan description and are subject to all other terms and limitations set forth therein. Telehealth services are covered services that would have normally been performed in an office visit setting. Telehealth services are not covered for services that would have been performed in an out-patient hospital setting or for clinic or hospital visits.

    If you have any questions about telehealth visits or your other benefits under the Northern Plan, please contact the Plan Office.

  • TELEDOC COVERAGE HAS ENDED
    Teledoc Services terminated on 3/31/21.
BCBSNJ logo

Members of this Plan have recently been enrolled in Horizon Blue Cross Blue Shield. Click here to read the newsletter describing this change in detail.. To locate a doctor using the Horizon website, follow this link below and click Provider Directory in the upper right-hand corner of the Horizon home page.

Horizon Blue Cross Blue Shield
Teamster Center Services logo

Teamster Center Services (TCS), the employee assistance program for the NNJTBP, continues to be open from 8:00am to 4:00pm Monday through Friday. We are here to assist participants seeking referrals for behavioral health services (mental health and substance abuse related).

We can be reached at 800-433-4827.

teamstercenter.com
OptumRx logo

Get the most out of your OptumRx prescription benefits. Visit OptumRx's website.

OptumRx
NVA logo

High Quality Vision Benefits. Visit National Vision Administrators' website.

National Vision Administrators