Dear ATPAM Member:

In an effort to better serve health plan participants, the Trustees have agreed to implement new procedures for the reimbursement of self-insured medical benefits (Dental, Optical, Psych, etc.) These new procedures are designed to both speed up the reimbursement and also to protect the confidentiality of the claimant’s private health information (“PHI”).

There will be no reduction to the current benefits offered to eligible participants.

As you may know, the Union Trustees recently took the position that it was inappropriate for employers and their representatives to have access to Union members’ PHI. Conversely, the Employer Trustees took the position that they had the right to view all the back-up to each claim before co-signing reimbursement checks. After protracted discussions between the Union and Employer Trustees it has been agreed that the claims backup will be presented in manifest form without identifying the claimant by either name or social security number. Once the manifest has been approved by a Union Trustee and an Employer Trustee, the Fund Office will issue the reimbursements directly into the bank accounts of each participant via ACH deposit. Each participant will also receive a written explanation of benefits (“EOB”) under separate cover.

In order to put this new system in place, it will be necessary for each participant to complete a “direct deposit authorization form” when they initially become eligible for benefits. This will only need to be done again if the participant changes bank accounts. This is the same system already in use to transmit the monthly checks to our pensioners. It is very simple and very efficient. For already eligible participants, the Fund Office will be contacting you shortly to arrange completion of the form.

Please be aware that if, for any reason, you decline to provide the direct deposit authorization, it may cause a delay in receiving your reimbursements and also make it much more likely that your PHI will be viewed by any Trustee co-signing a paper check payable to you.

We are very pleased that we have been able to resolve this matter in a positive manner.

Union Trustees, League-ATPAM Welfare Fund

Allen Brawer
Gordon Forbes
Kevin O’Connor
Richard Seader
Maria Somma