| Documents |
Brief Description |
| Annual Audits |
Financial statements and the independent auditor's report for the period noted. |
| 07/01/2013 to 6/30/2014 Annual Audit |
|
| Appeals |
| Appeal of a Denial of Medical, Dental, Vision or Audio Benefits |
If you submit a medical, dental, vision or audio claim for payment and the claim is denied in whole or partially, you also have the right to appeal the denial. This document explains the appeals process. |
| Appeal of a Denial of Prior Authorization of Prescription Drug Benefits by the Prescription Drug Manager |
Preauthorization may be required for some prescription medication. If your request for prior authorization is denied, you can make your appeal to the Prescription Benefits manager using the process outlined here. |
| Appeal of Non-Certification of a Procedure or Hospital Stay |
Preauthorization may be required for a procedure or inpatient hospital stay. If the treatment is not certified, you have the right to appeal to the Utilization Review Provider using the process explained in this document. |
| Policy on Appeal of Denied Claims Involving Medical Necessity |
This policy outlines the Trust's process of requesting a second independent review of the original claim. |
| Benefit Plan Documents |
Financial statements and the independent auditor's report for the period noted. |
| HCRA Plan Document |
This document provides details about the Health Care Reimbursement Account (HCRA) which allows you to pay for qualified health care expenses with pre-tax dollars. |
| HRA Plan Document |
This document provides details about the Health Reimbursement Arrangement (HRA) which is included in Plan D – Low Option Plan for Employees and Families. |
| Trust |
| Trust Agreement |
This detailed document outlines the purpose and operational requirements of the ASEA/AFSCME Local 52 Health Benefits Trust. |
| Trustee Election Policy |
This policy establishes guidelines for the election of Trustees in accordance with the provisions of Article III of the ASEA Health Trust Agreement. |
| Health Benefit Plan (HBP) Governance Document |
This is the governance document which establishes the Trustees’ powers and obligations as the fiduciaries charged with the administration of the Trust and the Plans offered through the Trust. |
