|
|
|
  |
|
|
UFCW LOCAL 1776 and
PARTICIPATING EMPLOYERS HEALTH and WELFARE FUND |
|
|
| Physical Well-Being Program |
The Physical Well-Being Program is part of the Fund's effort to improve your
general health. The benefits described
below are designed to reduce your risk of medical problems by assisting you to
stop smoking or lose excess weight, and enabling you to improve your
cardiovascular health through exercise.
If you are covered for physical well-being benefits under any other
plan, please check the section titled "Coordination of Benefits" to see how to
submit your claims. Please note: Benefits described in this section are separate from the "Healthy Lifestyles Programs" (described in the Personal Choice and Keystone Point of Service Program sections of this booklet). You may participate in a Healthy Lifestyles Program and the Physical Well-Being Program simultaneously. Remember, if you would like to enroll in a Healthy Lifestyles Program, call the Health Resource Center at 1-800-ASK-BLUE (in Philadelphia call 215-241-3367). What is Covered The Physical Well-Being Program provides an allowance for membership in the following programs: Covered: membership fees, charges for classes Not Covered: equipment, apparel, individual instruction Covered: fees, instruction, annual charges Not Covered: equipment, medication, vitamins Covered: membership fees, meeting charges, manuals Not Covered: food supplements, vitamins, medication Covered: membership fees Not Covered: greens fees, apparel, cart rentals, equipment Covered: membership fees Not Covered: daily usage fees, lessons, equipment Covered: membership fees, lessons, instruction Not Covered: equipment, apparel, instructional aids How Much is Covered The maximum amount of your benefit depends on whether you join a facility that is under contract with the Fund (participating) or a facility that is not under contract with the Fund (non-participating). If you purchase a single membership for yourself or for a dependent at a facility that participates in the Physical Well-Being Program through the Fund, you will receive a maximum allowance of $300 per calendar year. If you purchase a family at a participating facility, you will receive a maximum allowance of $500 per calendar year. If you purchase membership at a non-participating facility or program, you will receive a maximum reimbursement of $250 per calendar year. This $250 maximum applies whether you purchase a single or family membership. Using the Physical Well-Being Program Participating facility If you wish to join a participating facility, simply notify the facility that you are a participant of the UFCW Local 1776 and Participating Employers Health and Welfare Fund. You will be given an eligibility form which both you and the center will complete. The participating center will then verify your eligibility with the Fund office. Once your eligibility is verified, you will be able to use that facility on a regular basis. If the participating facility requires that you make additional payments, you will be made aware of the specific amount and conditions of any additional co-payments at the time you join the facility. Non-participating facility If you join a non-participating facility, call the Fund office to request a reimbursement form.In order to receive reimbursement, you must submit the following items to the Fund office for verification: If you sign up for an annual membership, both you and the facility must complete the reimbursement form and submit these items twice each calendar year (June 30 and December 31).If you join a program that is not utilized throughout the entire year (e.g. smoke cessation, weight loss, swim clubs, etc.), the reimbursement form and other information may be submitted when the program is completed rather than each June and December. Call the Fund office to request a reimbursement form approximately three weeks before the end of the calendar semester or the completion of the program. Rules Whether you use a participating facility or a non-participating facility, the Physical Well-Being Program is contingent upon the following terms: Participating Facility - at least 10 usages per calendar quarter (Jan 1 - Mar 31, Apr 1 - Jun 30, Jul 1 - Sep 30, Oct 1 - Dec 31) with single memberships, or at least 17 usages per calendar quarter with family memberships. Non-Participating Facility - at least 20 usages in each calendar semester (Jan 1 - Jun 30, Jul 1 - Dec 31) All claims for reimbursement must be submitted within 90 days of the end of the calendar year in which your membership or participation in a program occurred. Claims submitted after this period will not be reimbursed. |