Benefits
Teamsters Local 995 is extremely proud of the quality benefits we negotiate and manage for our members with benefits provided through the Teamsters Security Fund for Southern Nevada, Locals 995 and 14. When health issues or emergencies arise, our members know there are quality services available at an affordable cost.
The Trust Fund offers a choice of two medical benefit plans; an Indemnity Medical Plan, and an HMO for those who live in the HMO service area. The Indemnity Plan and HMO Plan are described in separate booklets provided to participants at the time of active enrollment.
Choose from the following list to locate the specific information you are interested in or start here to read all available information.
Prepaid Health Plan Option or Indemnity Plan Option
When you become eligible for coverage for the first time, you must complete enrollment designating the Health Plan Option of your choice:A. Prepaid Health Plan Option, or
B. Indemnity Plan Option
A. PREPAID HEALTH PLAN OPTION
If you select the Prepaid Health Plan Option, you and your eligible dependents will be provided hospital-medical care and prescription drug benefits under an agreement with Health Plan Nevada. Under this plan, you are required to use the doctors, medical clinics and hospitals which are a part of the Health Plan Nevada.
- Election to be Covered Under the Prepaid Health Plan
(Health Plan of Nevada)
If you live within the service area of Health Plan of Nevada, and you are otherwise eligible for coverage under the active Eligible Member Plan, you may elect to be covered under Health Plan of Nevada in lieu of being eligible for the Medical Expense Benefits described in this booklet. Even if you elect the prepaid health plan option, you will still be eligible for the Life, Accidental Death and Dismemberment, Dental, and Vision benefits, your dependents will still be eligible for Life, Dental and Vision benefits. - Rules for Electing and Revoking Election of Prepaid Health Plan Coverage
If you live within the service area of Health Plan of Nevada, you will have an opportunity annually to elect or revoke the prepaid health plan coverage.
B. INDEMNITY PLAN OPTION
The Indemnity Plan provides you with the greatest flexibility of provider selection. When you obtain covered medical services from a PPO Provider, you will receive greater benefits with lower out-of-pocket costs. In addition, you can obtain covered medical services from a Non-PPO Provider of your choice, but you will have higher out-of-pocket costs, and will be responsible for any changes in excess of what the Plan considers Usual, Customary and Reasonable (UCR).
PPO PROVIDER
PPO or contract providers are paid at a contracted rate schedule (CRS), which is the negotiated rate for Contract Providers. You will not be responsible for charges in excess of the discounted negotiated rate for medical services provided by a PPO Provider.
NON-PPO PROVIDER
Non-PPO or NON-Contract Providers are paid at USUAL, CUSTOMARY AND REASONABLE (UCR) rates, which are based on the fees most frequently made to the majority of patients for the same service or procedure. The charge must be within the range of charges most frequently made in the same or similar medical service area for the service or procedure as billed by other physicians. You will be responsible for charges in excess of what the Plan considers in excess of UCR.