Benefits Bulletins Old

HB Bulletin #48-15


HB Bulletin #48-15


July 2, 2015





Wednesday, July 15, 2015

10:00 a.m. to 2:00 p.m.




Monday, August 3, 2015

10:00 a.m. to 2:00 p.m.



ILWU Memorial Hall

231 West “C” Street

Wilmington, CA  90744




Coastwise Zenith Representative; David Bisuano continues to be available at Local 13, to assist you with any problematic claim(s), please take advantage of this service.  


This service is available for Members and their family only, NO PROVIDERS.  


David Bisuano may be reached Monday through Friday, 8:30 a.m. to 4:30 p.m. at (310) 830-6116 ext. 122 or if you’d like to come into ILWU Local 13 – 630 South Centre Street, San Pedro, CA 90731 please sign in at Receptionist’s desk and patiently wait to be seen.  While you wait make sure to have your claims/bills ready and out of the envelope.




Claims from “in network” providers have the least difficulty getting processed and paid, DO NOT assume that your “in network” provider will refer you to “in network” providers for other services.  If they refer you for anything outside their office; such as blood work, diagnostic testing (MRI’s, CT Scans, X-rays, etc.), to see a specialist, or for other treatment such as; surgery, physical therapy etc. your very first question to them should be: “Is that provider in network?”  If they are not, you may request a referral that is “in network” or use that provider knowing that it will be paid at the 80/20 of Maximum Allowable Charges (MAC) rate.  





(About Tetanus)

Tetanus is different from other vaccine-preventable diseases because it does not spread from person to person.  The bacteria are usually found in soil, dust and manure and enter the body through breaks in the skin usually cuts or puncture wounds caused by contaminated objects.


Today, Tetanus is uncommon in the United States, with an average of 29 reported cases per year from 1996 through 2009.  Nearly all cases of tetanus are among people who have never received a tetanus vaccine, or adults who don’t stay up to date on their 10-year booster shots.


For additional information or if you have any questions, please consult your primary care physician.



(SECTION 6 Duties of Employees and General Safety Rules)


Rule 605: No employee shall be present on the job while under the influence of intoxicating liquor, or drugs of a stimulating or depressive nature which affect his/her ability to carry out his/her obligations as required under the Pacific Coast Longshore and Clerks’ Agreement.




As a member of the ILWU-PMA Welfare Plan-CIP (“Plan”), your coverage qualifies as a minimum essential coverage.  The CIP also meets the minimum value standard of benefits of a health plan, meaning you will not have to pay any fees with your federal income tax return.


Before February 1, 2016, the Plan will send you a form (Form 1095) that lists the individuals (you and all your dependents) who have coverage under the Plan for 2015; you may use this form to document that you are covered under the CIP.  This is a requirement of the Affordable Care Act that the ILWU-PMA Welfare Plan must comply with.


In addition, under the Minimum Essential Coverage Reporting Requirements of the Affordable Care Act, health plans including the ILWU-PMA Welfare Plan, must provide reports to the IRS in March 2016 of all individuals covered under the CIP and your Social Security Number is required by the government for the report. To comply with this requirement, the Plan must request social security numbers (the primary identifier used by the IRS) of every individual, including all dependents, covered under the Plan.


Every member is offered the opportunity to provide SSNs when enrolling in the Plan.  However, if you did not provide that information, the Plan is required to follow-up on every individual with missing or invalid SSN.  If you have any questions, please contact the Benefit Plans Office at (415) 673-8500.



(American Disability Act)

ADA JPLRC meetings are scheduled the 1st and 3rd Tuesday of each month at 9:00 a.m. at Pacific Maritime Association, 300 Oceangate, 12th Floor, Long Beach, CA 90802 (no parking validation).



The Health Benefits Officer maintains an open door policy, however, if you need special assistance, (i.e. retirement, disability or personal matter) we recommend that you schedule an appointment with Jerry Avila at (310) 830-6116.


In Solidarity,

Jerry Avila,

Health Benefits Officer

ILWU Local 13


HB Bulletin #48-15  



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