Open Enrollment for Furloughed & Retired Employees

Open Enrollment for
Furloughed & Retired Railroad Employees

United HealthCare Group Policy GA-23111 holds an open enrollment period in December of every even calendar year. The next open enrollment period will be in December, 1998.

Coverage for individuals enrolling in December, 1998 will be effective January 1, 1999. No proof of insurability is required. There are no preexisting condition limitations.

The following individuals may enroll in December, 1998:

Employees and dependents whose coverage under GA-23000 ended because of furlough or retirement.

Amtrak employees and dependents whose coverage under Amplan ended because of furlough or retirement.

Employees currently covered under GA-23000, GA-23111, GA-107300 or Amplan may enroll any parent or parent-in-law who is eligible for Medicare.

There are three GA-23111 plans available:

Plan E covers individuals who are also eligible under GA-46000, or Amplan Early Retirement Benefits.

Plan D covers individuals who are eligible for Medicare

Plan C covers individuals who are not eligible for GA-46000, Amplan Early Retirement Benefits or Medicare.

Complete details of the GA-23111 eligibility and benefit provisions can be found in the booklet titled Group Health Insurance Plans for Furloughed and Retired Railroad Employees and their Dependents. You may obtain this booklet, and an enrollment form, from the United Transportation Union headquarters, or by calling United HealthCare toll-free at 1-800-842-5252.

Following is a brief summary of the current coverage under each GA-23111 plan. Benefits under any of these plans may change in the future.

Plan C
For individuals not eligible for GA-46000,
Amplan early retirement benefits or Medicare

Major Medical Benefits:

Maximum amount per lifetime - $150,000

Cash deductible per calendar year - $500

Out-of-pocket maximum per calendar year - $5,000

Percentage of covered expenses payable - 75% (65% if Medical Management is not called when required)

Percentage of covered expenses payable after out-of-pocket maximum is reached - 100%

Plan D
For individuals eligible for Medicare

Hospital Benefits reimburse the Plan A Medicare deductible and coinsurance amounts in full for hospital confinements up to 90 days, and for the 60 Medicare lifetime reserve days.

Skilled Nursing Facility Benefits reimburse the Part A Medicare coinsurance amounts in full for skilled nursing facility confinements up to 100 days.

Treatment Center Benefits cover Treatment Center confinements, up to $55 per day, for up to 30 days per lifetime.

Major Medical Benefits:

Maximum amount per lifetime - $300,000

Cash deductible per calendar year - $100

Percentage of covered expenses payable:

all expenses other than out-patient treatment of mental and nervous disorders - 80%

out-patient treatment of mental and nervous disorders - 65%.

Pharmacy Benefits:

Card Program - up to a 21-day supply for a $5 co-payment for generic drugs and $10 for brand name drugs

Mail Order Program - up to a 120-day supply for a $10 co-payment for generic drugs and a $20 co-payment for brand name drugs

Maximum amount per calendar year - $3,000.

Plan E
For individuals eligible for GA-46000
or Amplan early retirement benefits

Major Medical Benefits:

Maximum amount per lifetime - $200,000

Cash deductible per calendar year - $100

Out of-pocket maximum per calendar year - $5,000

Percentage of covered expenses payable:

all expenses other than out-patient treatment of mental and nervous disorders - 70%

out-patient treatment of mental and nervous disorders - 50%

Percentage of covered expenses payable after the out-of-pocket maximum is reached - 100%

Treatment Center benefits cover Treatment Center confinements up $55 per day, for up to 30 days per lifetime.

For more information, including payment rates or to obtain an enrollment form, call United HealthCare toll-free at 1-800-842-5252.