United Food & Commercial Workers 8 Golden State

Dear/Sir Madam:
We are writing in response to the above-referenced complaint filed with your office against UFCW 8- Golden State by Mr. [redacted].
We understand that Mr. [redacted] is very concerned about changes in his Retiree Health Coverage provided by the UEBT Retiree Health...

Plan. We also know that health plans everywhere have had to make difficult decisions regarding coverage in order to be able to continue offering the benefits on which members rely. We note, though, that the UEBT Retiree Health Plan is a separate entity and is administered through the UFCW & Employers Trust, LLC. Mr. [redacted]'s issues regarding reimbursement of his claims should not be directed to UFCW 8 - Golden State, but should be sent to the Plan's administrator, which has a clams and appeals process for this purpose.
The administrator's office closest to Mr. [redacted] is:
UEBT
2200 Professional Drive, Suite 200
Roseville, CA 95661
Main Phone: ###-###-####
Main Fax: ###-###-####
Thank you for your attention to this matter.
Sincerely,
[redacted]
Director of Office Operations

Review: I have UFCW & Employers Benefit Trust health insurance plan for retirees which is Blue Cross/Blue Shield as my secondary health insurance and Medicare as my primary insurance. Of course Medicare pays 80% and Blue Cross/Blue Shield pays the remaining 20%. It has been that way for many years. I have been receiving medical bills in the mail and noticed that Medicare paid their portion of the 80% and noticed that Blue Cross/Blue Shield wasn't paying their portion of the 20% after all of my deductibles were met 100%. As my medical bills have been coming in I have been noticing that Medicare has been doing there part and my secondary hasn't even paid a penny. I called UFCW and Blue Cross/Blue Shield and tried talking to them about what was going on and I got a really strange answer to my question I asked the rep. [redacted] why they weren't picking up the 20%after Medicare paid their portion of the 80%. She told me that if Medicare paid more then they would they didn't have to pay anything. I have a daughter who has worked in the medical field for more than 20 years and has done medical billing and she said that made no since at all. So I called back again and I told [redacted] the rep. that I still didn't understand what she was saying and it made no since to me at all. Finally I got an answer that shocked me she told me that the "BOARD OF DIRECTORS" voted and passed a bill that they were no longer going to cover the retiree's and were not going to pay the 20% for us anymore. I told her that was not right and that I have been paying for my medical and vision of $120.00/month and that I never received nothing by mail nor by phone saying that this was going to happen and she really didn't care. I told her that I really needed my secondary insurance. I am very deep in medical bills and I thought that I had my secondary insurance this whole time supposedly this was just passed in January 2014 and none of the retiree's were notified. It is very illegal for them not to notify us.Desired Settlement: I am needing them to pay all of the 20% of my outstanding medical bills that are now going to collections due to me being on a fixed income and I am in need of a "termination letter" from them and they are refusing to write the "termination letter" there stating that I am opting out of the insurance plan when I am not I need them to write the letter because I had to find a new secondary insurance company AARP and they need the letter so I can have them as my new secondary insurance.

Business

Response:

Dear/Sir Madam:

We are writing in response to the above-referenced complaint filed with your office against UFCW 8- Golden State by Mr. [redacted].

We understand that Mr. [redacted] is very concerned about changes in his Retiree Health Coverage provided by the UEBT Retiree Health Plan. We also know that health plans everywhere have had to make difficult decisions regarding coverage in order to be able to continue offering the benefits on which members rely. We note, though, that the UEBT Retiree Health Plan is a separate entity and is administered through the UFCW & Employers Trust, LLC. Mr. [redacted]'s issues regarding reimbursement of his claims should not be directed to UFCW 8 - Golden State, but should be sent to the Plan's administrator, which has a clams and appeals process for this purpose.

The administrator's office closest to Mr. [redacted] is:

UEBT

2200 Professional Drive, Suite 200

Roseville, CA 95661

Main Phone: ###-###-####

Main Fax: ###-###-####

Thank you for your attention to this matter.

Sincerely,

Director of Office Operations