DEMYSTIFYING ILA BENEFITS FOR LONGSHORE WORKERS AND THE IMPACT OF WORKERS COMPENSATION CLAIMS
Part 3. The MILA Managed Health Care Trust Fund – An Overview.
What is the MILA Managed Health Care Trust Fund?
The Managed International Longshoremen’s Association (MILA) Managed Health Care Trust Fund was established to provide medical, behavioral health and prescription drug benefits to active and retired Longshore workers and their qualifying dependents. This comprehensive Fund consists of
4 plans with varying eligibility requirements:
- The MILA Core Plan;
- The MILA Basic Plan;
- The MILA Premier Plan;
- and The MILA Medicare Wrap-Around Plan.
The MILA Managed Health Care Trust Fund is a single unified program that covers medical, behavioral health and prescription drug expenses evenly in all four Plans. Unless the Plan specifically states otherwise, uniform coverage applies to all expenses. The main variation between Plans is the member’s portion of the benefit expense when they incur a covered charge.
For example, in the Basic and Core Plans, only benefits for In-Network medical and behavioral health are covered; whereas in the Premier Plan and MILA Wrap-Around Plans, medical and behavioral health benefits are covered both In- and Out-of-Network. Plus, deductibles, co-pays, and coinsurance will differ between the Plans. Please visit http://www.milamhctf.com for more detailed information and comparisons on all Plan features and costs.
Eligibility for Benefits by Active Longshore Workers Under The MILA Managed Health Care Trust Fund.
Benefits under the MILA Managed Health Care Trust Fund are contingent upon the number of credited hours worked by the active employee during a contract year. A contract year begins on October 1st and ends the following year on September 30th. Active Longshore workers who have received the required number of credit hours in the prior contract year will be covered starting December 30th of that year. To learn how credit hours are calculated, please refer to Part 1 of our blog series on our website: Demystifying ILA Benefits for Longshore Workers and the Impact of Workers Compensation Claims
If the Longshore worker accrues between:
- 700 and 999 hours in the last contract year, the worker qualifies for the MILA Core Plan;
- 1000 and 1299 hours in the last contract year, the worker qualifies for the MILA Basic Plan;
- 1300 or more hours in the last contract year, the worker qualifies for the MILA Premier Plan.
Retirees and their eligible dependents who qualify for benefits will be covered in the Premier or the Basic Plan until they are eligible to enroll in Medicare benefits. Once enrolled in Medicare, they will be covered by the MILA Medicare Wrap-Around Plan. Retirees who immediately receive a pension based on years of service must meet the minimum age requirement for plan coverage and be credited with the years of service as follows:
- Age 62 with 25 or more years of credited service to qualify for the MILA Premier Plan;
- Age 58 with 25 or more years of credited service to qualify for the MILA Basic Plan; or
- Age 65 with the number of years of credited service required by the local Port to qualify for the MILA Medicare Wrap-Around Plan.
In certain circumstances, MILA benefits are also extended to retirees receiving a disability pension, the surviving spouse of an active Longshore worker, the surviving spouse of a retired Longshore worker, other former bargaining and non-bargaining unit Members, as well as Members of other organizations acknowledged by the Fund Trustees. For more information on participation and eligibility requirements, visit http://www.milamhctf.com.
What are the Workers’ Compensation Limits for Active Longshore Workers Under The MILA Managed Health Care Trust Fund?
There is a twenty-four (24) month limit per illness or injury for MILA disability credited hours based on the receipt of Workers Compensation benefits or non-occupational disability benefits provided by a local port plan. When an active Longshore worker has reached the 24-month limit, an application to MILA must be submitted on an annual basis to receive additional years of credited service. Those active workers participating in the MILA Managed Health Care Trust Fund who are also receiving Social Security Disability Income (SSDI) cannot accrue credited hours based on the receipt of accident and health benefits, Workers Compensation benefits, or non-occupational disability benefits.
How is Workers’ Compensation Impacted for Retirees Under The MILA Managed Health Care Trust Fund?
When a disabled retiree receiving a disability pension from a local port applies for MILA disability retiree benefits, proof that an application was submitted to the Social Security Administration to receive Social Security Disability Income (SSDI) benefits must be presented to MILA. Any correspondence received from the Social Security Administration related to the application for SSDI benefits must also be submitted to MILA within one week of receipt. In accordance with the agreements between MILA and the local port, MILA will continue to provide benefits to the disabled retiree while their SSDI application is pending. Unless the disabled retiree has enough credited hours to receive a better MILA plan, coverage will fall under the existing MILA plan.
In addition to medical, behavioral health and prescription drug benefits, dental and vision plan benefits are also available under the MILA Managed Health Care Trust Fund. For more information regarding workers’ compensation claims and the impact on Longshore benefits under the MILA Managed Health Care Trust Fund, contact RITE law via their website at www.ritelaw.com or call their office at 904-500-7483.