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MBA Trust - Frequently Asked Questions
Plan Design
Question: Do I have to enroll all my employees on one plan?
Answer: Companies with 10 or more full-time, eligible employees may elect to offer two medical plans. Under this “Dual-Choice” option, employees may choose between one Preferred or Traditional medical plan and one Point-of-Service medical plan selected by the company.
Question: Are dental and/or vision plans available through the MBA Trust?
Answer: Yes, for companies with 4 or more enrolled employees/subscribers, group dental and/or vision plans may be added to the company’s MBA benefit package. Dental and/or vision plan enrollment must match medical plan enrollment.
Question: Does the MBA Trust offer my employees the opportunity to buy more Life Insurance than the company provides?
Answer: You can allow your employees to apply for up to $500,000 (in $10,000 increments; $30,000 minimum) of Additional Term Life Insurance for very reasonable rates. For companies of 10 or more employees, individuals can apply for Additional Term Life insurance within the first 30 days of the company’s effective date with the MBA Trust and would be guaranteed a minimum of $50,000 of coverage regardless of their health condition. See the Life Insurance summary in the Plan Designs section of this proposal for more details.
Question: Does the MBA Trust offer a Health Savings Account (HSA) Plan?
Answer: Yes, the MBA Trust offers a High Deductible Health Plan (HDHP) that is qualified to be used with Health Savings Accounts (HSAs). Companies with 25 or more enrolled employees can offer the HDHP plan in conjunction with another MBA Trust plan. See the Plan Designs section for more details.
Question: How can I obtain a list of doctors covered by the medical plan I choose?
Answer: There are several ways to obtain this information. Although printed directories are available upon request, the most up-to-date list of providers is available through the MBA Trust insurance carriers’ websites. In addition, you may contact the carriers’ customer service department to verify that a provider has a contract under a particular plan. See below for contact information:
Asuris Northwest Health www.asurisnorthwesthealth.com 1-888-344-5587
Group Health Options www.ghc.org 1-888-901-4636
Regence Blue Shield www.regence.com 1-800-330-7206
Magellan Behavioral Health www.magellanhealth.com 1-800-523-5668
Question: Are my employees covered if they work or travel outside of Washington?
Answer: Yes, all MBA Trust plans provide worldwide coverage for employees and their covered dependents.
- Employees covered by Asuris Northwest Health are covered worldwide. Contact Asuris Northwest Health or access the Plan Summaries at our website for more details.
- Employees covered by Group Health Options are covered worldwide. Contact Group Health or access the Plan Summaries at our website for more details.
- Employees covered by a Regence Blue Shield plan are able to obtain the highest level of benefits and are protected from “balance billing” from providers by accessing the services of a Blue Cross or Blue Shield provider in other states. When traveling, check the web site (www.bluecares.com) or simply call 800-810-BLUE (2583) to find a doctor in that area.
- Employees covered by the Magellan Employee Assistance Program have 24-hour access to the call center and online services. In addition, Magellan contracts with providers in all markets to assure your employees get the assistance they need. Contact Magellan Health Services via the 800 number or website listed above for more details.
Question: Are there waiting periods on MBA medical plans?
Answer: MBA medical plans include a three-month waiting period for pre-existing conditions and a 12-month waiting period for transplant-related expenses. However, full portability (i.e., crediting of time covered under a previous plan) for pre-existing conditions is available through the MBA Trust in accordance with State and Federal insurance regulations. Waiting periods for transplant-related expenses are not portable; therefore, all participants will be subject to the 12-month waiting period regardless of the length of time on a prior plan.
Question: Are there waiting periods on MBA dental plans?
Answer: Yes, there is a six-month waiting period for major dentistry only. Major dentistry includes treatment for crowns, bridges and dentures, etc. Preventive and basic dentistry are not subject to this waiting period. Groups enrolling in the MBA Trust that previously had a “group” dental plan may receive credit towards this waiting period upon the company’s initial enrollment. Contact the MBA Trust Consultants for more information.
Question: Are benefits provided by Alternative Providers, such as naturopaths or acupuncturists, included on MBA plans?
Answer: Yes, coverage for treatment by alternative providers is included on all MBA Trust medical plans. Benefits for services such as acupuncture, massage therapy, nutritional, chiropractic and naturopathy may be limited to a specific number of visits annually. Contact the MBA Trust Consultants for more information.
Question: Are prescription drugs covered on the MBA Trust benefit plans?
Answer: Prescription drug benefits are included on all Trust medical plans. All plans include copay drug cards, meaning that the employee pays a flat copay or percentage amount at the pharmacy when filling a prescription. Please see the Plan Designs section for more details.
All plans also include a Mail Order Drug benefit that allows employees to obtain a 90-day supply of a prescription. Please see the Plan Designs section for more details.
Question: Can I receive credit for Annual Deductible accumulated under my prior group plan?
Answer: Companies transferring directly from a group medical plan to the MBA Trust program are eligible to receive full credit of deductible (year-to-date) satisfied under that plan for each covered participant. Documentation from the previous insurance carrier is required to obtain these credits.
Companies can request a group listing of deductible credits from most carriers. A fee may be charged.
OR
Each employee may submit a copy of his or her most recent Explanation of Benefits (EOB) indicating deductible satisfied for each family member.
This information must be provided to the MBA Trust Administrator within 30-days of the company’s effective date of coverage to obtain the deductible credit.
Please Note: Stoploss or Coinsurance amounts accumulated under a prior group or individual plan cannot be credited toward this plan’s maximums
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Program Overview
Question: Do I have to be a member of the Master Builders Association of King & Snohomish Counties to participate in the MBA Health Insurance Trust?
Answer: Participation in the MBA Trust requires the company to be a current member of a sponsoring or endorsing trade association or organization (Master Builders Association of King & Snohomish Counties; Associated Builders & Contractors of Western Washington; Associated Builders & Contractors – Inland Pacific Chapter; Northwest Marine Trade Association; Safety Management Advocacy Resources Training; and Washington Chapter of the Painting & Decorating Council of America). Annual Membership Dues and Access Fees (if applicable) must be maintained each year to continue participation in the MBA Trust.
Question: Are we required to cover all employees?
Answer: Employee/Subscriber participation levels are required on the MBA Trust program. For details, please see the Minimum Employee/Subscriber Participation Requirements included on the General Information page of this proposal.
Question: How am I billed for coverage through the MBA Trust?
Answer: Detailed monthly billing statements are sent to each participating company 1 to 2 weeks in advance of the billed month. Payments are due on the first day of the billed month and become “delinquent” if not received before the 15th day of the billed month. Program cancellation will result if full payment is not received within 45-days of the payment due date.
Question: What is COBRA and how is it handled?
Answer: COBRA is a federal law affecting continuation of employer-based health coverage beyond the point when termination of coverage would normally occur. MBA Trust companies subject to federal COBRA Continuation Coverage regulations (generally, companies with 20 or more full and part-time employees) are provided with COBRA services at no extra charge. The MBA Administrator provides COBRA services with the exception of the company’s Notification Requirements.
Question: Does the MBA Trust offer coverage for Domestic Partners?
Answer: The MBA Trust offers, on a group-by-group basis, Domestic Partner Benefits. This benefit will be available only to those groups with:
20 or more covered employees
OR;
groups who have a “qualifying” contract with a governmental entity (city, county or state) that requires that this benefit be offered as part of its contracting process
If you have any questions about the availability and requirements needed to offer this benefit, contact the MBA Trust Consultants for more information.
Question: If I cancel or terminate my coverage through the MBA Trust, can I enroll again at a later date?
Answer: Any company terminating or cancelling coverage from the MBA Trust for any reason is not eligible to reapply for a minimum of 24-months following their termination date.
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