Changes to the ARTA Retiree Benefits Plan Effective November 1, 2019
Every year the ARTA Health Benefits Committee reviews possible changes to the ARTA Retiree Benefits Plan. These potential changes arise primarily via covered members submitting change requests to the Health Benefits Committee for consideration. Each of these requests is reviewed to determine if a group benefit plan such as ARTA is allowed to cover the service or device (for more information refer to the article titled “Why Doesn’t the ARTA Retiree Benefits Plan Cover My Gym Membership?” in news&views Summer 2019) to make certain a significant number of members would benefit from the coverage change. Additional changes are then considered to ensure that the plan continues to provide the best retiree benefits available to ARTA members.
Once a potential plan design change is approved by the Health Benefits Committee, the committee makes a recommendation to the Board of Directors to implement the change. The potential changes are reviewed and voted on by the board during their spring meeting.
The following changes will become effective on November 1, 2019, for all members covered by the Extended Health Care plan.
- Covered members who are insulin-dependent are going to be able to claim flash blood glucose monitor expenses, including sensors and readers.
◊ Flash blood glucose monitors allow diabetics to electronically scan a sensor embedded in their arm instead of having to use a finger prick and a blood glucose test strip to check their blood glucose level.
◊ A number of covered members have expressed interest in these devices, which would permit them to monitor their blood glucose levels more closely on a continuous basis.
◊ An annual maximum of $1,750 for all diabetic supplies, including flash blood glucose monitors, will be implemented coincident with this change.
- The accidental dental maximum is increasing from $1,000 per year to $3,500 per year.
◊ This change is in response to this coverage not being updated in some time; it is now in line with other health plans available in the group benefits marketplace.
- The private duty nursing maximum is increasing from $3,000 every three (3) years to $3,000 per year.
- Hearing aid accessories are being added under the current hearing aids benefit.
◊ Allowable accessories may connect directly to an existing hearing aid (either with a wire or wirelessly), including microphones, television connectivity, and remote controls.
◊ Other allowable expenses include hearing aid dehumidifiers and cleaning tools.
◊ The current hearing aid maximums allowed do not change.
- Low-dose Cialis (Tadalafil) coverage is being added for the treatment of prostate gland enlargement (benign prostatic hyperplasia).
◊ Special authorization is required for coverage of this medication when used for this indication.
◊ Only low-dose (2.5mg or 5mg) versions are covered for this treatment regimen.
- Knee scooters (also known as knee walkers) and hands-free crutches are being added to the list of covered medical aids and devices available for purchase or rental, to a maximum of $200 every five (5) years.
◊ These mobility aids are used for people who must keep their knee in a bent position and are generally easier to use than crutches.
◊ Knee crutches also allow a person to continue to be mobile and keep their hands free while protecting an injured leg or knee.
- CPAP machine cleaners and sanitizers are going to be covered by the plan.
◊ These devices are being added under the current maximum allowed for CPAP machine purchases of $2,000 every five (5) years.
◊ People who use a CPAP machine should ensure that their machine and equipment are cleaned regularly to reduce the risk of infection when using CPAP therapy to treat sleep apnea.
- Usual and customary charges are being updated to reflect the marketplace charges for certain medical aids, devices, and service claims submitted over the past year.
◊ The usual and customary fees continue to ensure that most of the claims will be covered.
◊ However, claims that are significantly higher than marketplace standards are not introducing excess costs into the plan.
Due to the positive plan experience over the past year, ARTA is proud to be able to implement these plan enhancements with no rate changes.
Detailed information on these coverage changes is included in the plan booklets or available online at arta.net by clicking on Forms and Documents, located within the Member Services section of the website.
ARTA will continue to review potential plan enhancements on an ongoing basis while keeping the plan affordable for our covered members. Please continue to submit suggestions you think may be suitable for the Health Benefits Committee’s consideration. Suggestions may be mailed to the ARTA office or via email to firstname.lastname@example.org.