PG&E Tentative Agreement: Q & A

Why are we bringing our members a medical package with so much change?

PG&E proposed to increase the portion of the premiums we pay from 7.5% up to 15%. (Please review the Union Summary on Benefits for other comparisons.) This proposal was similar to past proposals from PG&E and also similar to what other companies have been doing. IBEW Local 1245 has been looking for a new approach that could help us avoid the usual fight over premium cost-sharing. PG&E agreed to collaborate in searching for a win-win scenario by containing cost and improving our members’ health over the long term.

I know I pay 7.5% of the medical premium but how much is my 2012 cost for the family plan if I have Kaiser or Anthem Blue Cross?

For Kaiser family coverage, the 2012 annual premium portion you pay is $1,466.16. For Anthem Blue Cross family coverage, the 2012 annual premium portion you pay is 1,672.08 and these costs will double if we pay 15% of the annual premium. If we continue to argue over how much of the premium cost we pay and medical costs continue to rise as they have in the past 10 years, this problem will never go away.

 

HRA

1. What is an HRA?

An HRA is a Healthcare Reimbursement Account. It is made up of notional money that is put in by PG&E.

2. What does notional money mean?

Notional money is money that is guaranteed for the employee’s use but controlled by the Company. The money can’t be used for any purpose not specified in IRS section 213(d), and does not become part of the employee’s estate.

3. What can I use HRA funds for?

HRA money can be used for eligible dental, vision or medical expenses (see Question #4 below for IRS section 213(d) item list). In addition, HRA funds can be used by retirees if eligible for a PG&E retiree medical plan.

4. What items are included within IRS section 213(d)?

A list is available at //www.benefittaxlink.com/pdfs/Section213.pdf

5. How much HRA money will I get?

The amount of HRA money that will automatically be credited into your account on Jan. 1, 2014 will be $750 individual/$1500 family. On Jan. 1, 2015 through Jan. 1, 2020, $500 individual/$1000 family will be automatically credited. Additional money will be put into your HRA by PG&E if you take a health screening, and/or pass a tobacco screening or complete a tobacco cessation program. Please see chart below.

	2014 Single/Family	2015 thru 2020 Single/Family
HRA Contribution	$750/$1500	$500 / $1,000
Health Screening	$250 / $500	$250/$500
Tobacco Free or Cessation	$250 / $500	$250/$500
Yearly total max HRA	$1250 / $2,500	$1000 / $2000

 

6. Will unused HRA funds disappear at the end of the year?

No. Any unused HRA funds will rollover to the following year and can accumulate.

7. Will the PG&E stop funding the HRA once this contract is over?

No, IBEW 1245 negotiated an agreement with PG&E to lock in the amounts of the HRA automatic contributions and incentive amounts through the year 2020.

8. Is there any chance to qualify for additional HRA funds?

Yes, there are 2 ways. Employees who earn equal or less than the 18 month step of the Service Rep 1 rate (currently $22.95/hour) will receive an additional $500 in their HRA on January 1 of that calendar year. There will also be an appeals process for employees who are experiencing a financial hardship and have reached the out-of-pocket maximum 2 years in a row.

9. What happens to HRA money when I retire? How does HRA money work with the RMSA money when I retire?

Any HRA money left in your account when you retire rolls over. It still can be used for any medical expenses covered under IRS section 213(d) as long as you are eligible for a PG&E-sponsored medical plan. In addition, once you are Medicare eligible, the HRA money can be used for premiums and medical expenses.  HRA money and RMSA money are separate. The RMSA money can only be used for retiree medical plan premiums.

10. Do HRA funds earn interest?

HRA money is notional and does not earn interest; however it will accrue and roll over each year if there is money in the account and you stay enrolled in the plan or retire from PG&E and are eligible for retiree medical.

11. Are HRA funds taxable?

No, since the HRA money is notional it is not taxable.

12. What happens to HRA money if an employee terminates employment (including resignation, retirement, lay-off, termination or death) For example, if you have dependents and pass away while active or retired, can the dependents still use the HRA funds?

The answer is “yes” if the dependents continue coverage in a PGE medical plan under COBRA – the HRA funds in the account at the time of the member’s death remain with the dependents.  At the beginning of each plan year, the dependents also get whatever additional HRA money active employees get added into their accounts as long as they remain covered by COBRA. HRA funds can’t be used for COBRA premiums but can be used for deductibles and out-of-pocket medical expenses. If an employee leaves PG&E and does not elect COBRA, the HRA money is no longer available.

13.  I know I can use my HRA funds for services that are not free but what if only one person in my family has a medical bill that is, for example, $100,000. How does the deductible and out-of-pocket maximum work for this one family member?

Since only one person in the family has a high medical bill, the maximum amount would be $2400 for this family member. ($1000 deductible + $1400 = $2400 out-of-pocket maximum per person)  All other cost for this one family member would be free for the rest of the year. The employee can use up to $2400 from their HRA fund to pay this cost.

14. Can we still use HCRA (Health Care Reimbursement Account) and DCRA (Dependent Care Reimbursement Account)?

YES, all employees can still use the HCRA and DCRA. In fact, members who have advance knowledge of their upcoming medical costs can save money on taxes by using an HCRA.

15. How do the HRA funds/contributions work if both member and spouse work for PG&E? Do you get two accounts? Can you get double the contributions in one account?

No, if one union member is covering another union member as a dependent, they are treated as one family unit and get one family HRA contribution.  If both union members enroll in separate plans as employees, they will each get an HRA. (Example, he covers himself in Kaiser, she covers herself and the children in Anthem and both get the incentives) He gets the single HRA amount of $1000 and she gets the family HRA amount of $2000. Combined they collect $3000 in HRA funds.

16. What is in a Health Screening?

Health screenings will consist of: measurements for Body Mass Index (BMI), blood pressure check and a finger prick blood test to check glucose and cholesterol levels.

17. Do I have to “pass” the Health Screening to get HRA money?

No.  There is no “pass or fail” for the health screenings. Just taking the screening is all that is required to receive the HRA account money.

18. Where are the health screenings?

Health screenings can be conducted on-site at many PG&E work locations, a network of contracted labs, or with your primary care provider.

19. What are the tobacco screenings?

Tobacco screenings will be a test for nicotine in your body. Commonly a saliva swab technique is used for this test; however, the specific methodology for this screening will be determined later between the Union and PG&E.

20. Do I have to pass my tobacco screening to get HRA money?

You do not have to pass the tobacco screening to get HRA money but if you test positive for nicotine, you will need to take a free tobacco cessation program in order to get the HRA money.

21. Will they test me for drugs during health or tobacco screening?

No.

22. Will my spouse or dependents have to take a health screening?

No, spouses and dependents are not eligible for health screenings.

23. Will my screening info remain private?

Individual results are provided only to the enrolled employee and are kept completely confidential.

24. Are the specific results from a person’s health screening automatically given to their primary care provider or are they just given to the employee with advice to pass it along to the employee’s primary care provider?

No, PG&E doesn’t know who a person’s primary care provider is.  Results are given to the employee to take to their primary care provider, hopefully with some informed questions. If the employee takes the screening at a PG&E facility, health educators will be available to discuss the meaning of results and explore options with your doctor.

25. Where will all this medical data go and what will be done with it?

No individual results will be shared with PG&E, which would violate Federal HIPPA compliance standards. Results will be collected in aggregate (total population health,) sent to a third party data warehouse and later the aggregate data will be shared with a joint Union and Company committee to assist with on-going health and wellness program planning.

 

Medical Plans and Plan Designs

26. What medical plans will be removed?

Health Net and Blue Shield HMO’s will no longer be offered as of 1/1/2013. The HSA plan administered by Anthem Blue Cross will no longer be offered after 12/31/13.

27. Will I still have my same doctor?

It is possible that a few members will need to change doctors; however, Anthem Blue Cross and Kaiser will ensure 97% access to physicians that currently enrolled employees and dependents use. If a member’s doctor is not currently with Anthem, they can nominate their doctor to become part of the Anthem network.

28. Is this medical change all because of the national Affordable Care Act?

No, this change was a collaboration between IBEW 1245 and PG&E to end the usual practice of simply shifting the cost of medical premiums from corporations to employees. The free preventive care, incentives and even the increased out-of-pocket amounts are designed to lower the constant 8-10% yearly premium increases that are ultimately taken out of wages.

29. What is the worst-case scenario/what is the most I would have to pay “out of pocket”?

In any single calendar year, the most any employee would have to pay in any “worst case scenario” is $2400 individual/$4800 family, but these out of pocket amounts can be offset or significantly reduced by using the funds in your HRA account.

30. What is coinsurance?

Coinsurance is a percentage of the service charge that your health plan calculates for you, after you’ve met your deductible. Example; once your deductible is met, if a doctor’s visit is $100 and you have a 20% coinsurance, you will pay the doctor $20 and your health plan will pay the doctor $80. Starting in 2014 both Kaiser and Anthem Blue Cross will have a coinsurance plan design.

31. Will PG&E just raise the deductibles, coinsurance percentages or out-of-pocket maximums after this contract?

IBEW 1245 negotiated with PG&E to lock in the amounts of the deductibles, coinsurance percentages and out-of-pocket maximums through the year 2020.

32. How many free visits to the doctor do I get?

Each covered member will receive 4 free visits to their primary care provider (General or Family Practice, Internal Medicine, Pediatrics, Family Nurse Practitioner, OBGYN). If a member goes to an Urgent Care clinic for one or more of his or her first 4 visits, that visit would also be free.

33. If I have 4 people in my family do we each get 1 free visit each?

NO. Each covered member will receive 4 free visits to their primary care provider

34. What medications and routine lab tests are free?

There is a large list of free medications and lab tests. The list includes immunizations (except for flu shots which are available at no cost on-site at PG&E, using your Medco card at a pharmacy or through Kaiser).

35. Have there been any added medicines since the 1st contract vote?

Yes, there have been seven free medications for mental health added. Also, IBEW 1245 and PG&E have a commitment to meet and discuss adding medications in the future.

36. Are flu shots/immunizations free?

Yes. See free medications.

37. Are contraceptives free?

Yes. See free medications.

38. Are medications not on the free list still covered?

Yes, all the medications that are currently covered by Anthem Blue Cross and Kaiser will still be covered by them; only those on Attachment B1 are free.

39. What do we have to pay for medications?

For medications that are not on the list of free medications, the coverage is: Retail drugs (up to three 30-day fills) 85% for generics/75% for brand, subject to deductible. Mail order drugs– 90% generic/80% for brand, subject to deductible. Employees would pay the difference, but no more than the annual out-of-pocket maximum.

40. If I get a physical does that count as one of my free visits?

Yes. It would count as one of your 4 free visits.

41. What happens if we have a baby?

All maternity and well baby visits (up to age 2) are free. The delivery would be covered at 80% and be subject to deductible. As always, members can use any of the HRA funds to pay these out-of-pocket costs.

42. Are chiropractic care & acupuncture still covered?

Yes. Both chiropractic care and acupuncture are still covered. After the deductible is met, the first 5 visits will be covered at 90% and all visits over 5 will be covered at 80%.

43. Are OBGYN visits covered at 10%/primary care or 20%/specialist?

The OBGYN is considered primary care, so if your OBGYN visit is one of your first 4 visits then it is free. After that it would be covered at 90%. OBGYN is not considered a specialist in the new plan design.

44. Do they cover test strips for diabetics for free?

Yes. Test strips for diabetics are covered at no cost.

45. How much will the dollar amount of the employee’s portion of the medical premium increase in 2014?

The dollar amount of the employee’s portion of medical premiums for Anthem Blue Cross and Kaiser Plans will be the same (or lower) than they were in 2013. In 2014 any increase in the actual cost of the premium will be covered by PG&E

46. What if I have a dependent on my medical plan that lives in another state?

There is no difference from the current Plans for Anthem Blue Cross or Kaiser. If an employee has eligible dependents out of state, they are fully covered under Anthem Blue Cross, they just use the local state’s Blue Cross network and it’s still considered in-network.  (Blue Cross is available in all 50 states). If an employee has Kaiser, the dependent is covered for emergency services only while out of state.  Regular doctor visits and prescriptions must still be done through Kaiser (North or South, depending on which one the employee’s location.)  (Kaiser mail-order pharmacy is also available)

47. What if I’m on vacation in Hawaii and get hurt. Is that out of network?

In Anthem Blue Cross, the out of network provisions are the same as the network provisions. If you end up in the hospital, you would pay 20% (subject to deductible) up to the out-of-pocket maximum. For Kaiser it is the same coverage you would have in-network but they only cover Emergency, Post-Stabilization and Out-of-Area Urgent Care.

48. How will the Company reimburse individuals who utilize their Primary Care Physicians for DOT medical exams?

Employees who are required to maintain a CDL are required to obtain a medical certification every two years. California law requires the employer to pay for this exam. Employees should make prior arrangements with the Company if they plan to use their primary care physicians for these exams.

49. What does “subject to deductible” or “not subject to deductible” mean?

If the service is “subject to deductible” then the member will have to pay the charge with either their HRA funds or out-of pocket funds until the deductible is met. If a service is “not subject to deductible” the claim is paid as if the deductible does not exist.

50. What visits are not subject to the deductible?

Visits to Primary Care Doctors (after the 1st 4 which are free), Urgent care clinics, and outpatient behavioral health visits would have no deductible and only be subject to a 10% coinsurance, while the plan pays 90%.

51. How can I find out how much Anthem or Kaiser charges for typical doctor visits?

Anthem Blue Cross members can log onto www.anthem.com/ca/pge and look for Compare Facility Cost and Quality. Kaiser members can check the Kaiser Sample Fee List or check with Kaiser at www.kaiserpermanente.org.

53. Do we still have our defined benefit pension?

YES, the Cash Balance Pension is simply a new benefit formula added to the existing Retirement Plan. The Cash Balance Pension would only be for new hires after 1/1/2013 and people who volunteer to freeze their current pension and move to the new Cash Balance Pension.

54. Who would be on the new Cash Balance Pension?

New employees hired after 1/1/2013 and those existing employees who elected (in 2013) to participate in the Cash Balance Pension beginning 2014.

55. Will PG&E convert all existing employees to the Cash Balance Pension after this contract is over?

IBEW 1245 negotiated with PG&E a commitment to NOT involuntarily convert any existing member (hired prior to 1/1/2013) to the Cash Balance Pension.

56. How will employees in the new Cash Balance Pension earn credits?

An employee will earn credits based on a combination of years of service and age. Credits are a percentage of base wages earned in a year. See table below.

Annual pay credits based on points (age + service):
Fewer than 40 points	5.00%
40-49 points	6.00%
50-59 points	7.00%
60-69 points	8.00%
70-79 points	9.00%
80 or more points	10.00%

57. How long will it take to become 100% vested in the Cash Balance Pension Benefit?

Employees will be 100% vested after 3 years of service.  Under the current Final Pay Pension formula, 100% vesting comes after 5 years of service.

58. What is changing in the 401k plan?

For existing employees who are staying in the current Final Pay Pension formula there will be no change to the 401k plan. Employees who are hired after 1/1/2013, or existing employees who elect to move over to the Cash Balance Pension, will receive a PG&E match of $.75 on each dollar they contribute to the Retirement Savings Plan up to 8% of their pay. Cash Balance participants will also be automatically enrolled in the RSP at the 8% eligible match level. Employees can change or stop this 401(k) contribution at any time.

59. When do existing employees need to decide if they want to change to the Cash Balance Pension?

They would have a one-time choice in 2013 to join the Cash Balance Pension, which will be effective 1/1/2014. PG&E expects to offer education, communications and a calculator before any current employee has to make a choice.

60. Under the Cash Balance Pension does it make a difference what date in the calendar year a new employee is hired?

Yes, the Cash Balance Pension credits are based on a percentage of the pay youearn in a year. So, assume two employees are hired in 2014, one in January and the other in July. Both employees earn the same hourly wage and both work full time. The employee hired in January will have twice as much “pay” as the employee hired in July and would get twice the contribution if they are the same age. This is just like the current plan where employees bgin to earn service credit when they are hired.

61. What happens with my “cash balance” money if I die before I retire?

In the Cash Balance Pension, if you die before you retire, and your account has vested, your spouse or named beneficiary would receive the entire balance of the account.

62. What happens with my cash balance money if I die after I retire?

It depends on if you elected an annuity or if you elected to take a lump sum. If you elected an annuity, you would have made survivor benefit elections for your spouse or other named beneficiary at retirement. Cash balance participants will have the same survivor benefit options available at retirement that are available to employees in the current Final Pay Pension. If you elected to take a lump sum, the funds are a part of your estate.

63. What happens with my cash balance money if I leave PG&E before I retire?

Under the Cash Balance Pension, you can elect to receive the full balance paid to you in a lump sum, or to receive an actuarially equivalent monthly lifetime benefit, as long as you are fully vested in the plan. A lump sum or the monthly benefit amount would be subject to income tax. Any withdrawals before age 59 ½ could involve federal or state penalties unless you roll your account balance to an IRA or some other tax-sheltered plan.

64. In 2013 a current employee elects to freeze his/her current Final Pay Pension and elects to transition in 2014 to the new Cash Balance Pension. Will the employee’s final pay benefit be reduced if the employee works until 55 years of age and has at least 30 years of service?

No, for the purposes of the Early Retirement Reduction Factor, total service will be recognized.  In other words, as long as the employee is at least 55 years old with at least 30 years of service or more there is no reduction for early retirement.

65. When would an existing employee electing the Cash Balance Pension have a vested right to a benefit if he has only 3 years service as of 12/31/2013?

Currently an employee must have 5 years of credited service to vest in the Final Pay Pension benefit. However, since only a total of 3 years of service is required to vest in the Cash Balance Pension, an existing employee who elects to move to the Cash Balance Pension will vest in both the frozen final pay benefit and the Cash Balance Pension with three years of credited service.

66. How would a leave of absence affect yearly cash balance earnings?

A full-time employee on an approved leave of absence would still earn contributions based on the last wage rate they held in their base classification when they began their leave. A part-time employee would not receive cedit during a leave of absence since part-time benefit accruals are based on hours worked. This treatment is the same under the current Final Pay Pension and the new Cash Balance Pension.

 

67. Will dental implants be covered?

Implants will now be covered as a Major Care item in the dental plan at 85% coinsurance.

68. What are dental implants?

A dental implant is a “root” device, usually made of titanium, used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.

69. What is the difference between VSP Signature (our current VSP plan) and VSP Choice (our plan for 2014 and beyond)?

VSP Plan benefits are not changing; however, there will be  fewer access points (40,000 vs. 42,500) and  a lower discount on non-covered lens options (20-25% vs. 35-40%) The new benefit will be better than the current benefit if you go to a non-VSP provider. (i.e. Costco).

70. Is there any coverage for hearing aids?

Hearing aids will be covered at 80% under active and retiree medical effective 2014. Members are eligible for one hearing aid for each ear at a three year frequency.

 

73. I have Supplemental Life Insurance coverage now, what happens in 2014?

In 2014, optional supplemental life insurance amounts will vary between 1x and up to 6x yearly base wage. If you currently have 1.5x yearly base wage you can choose to move to 1x or 2x without a “statement of health”. If an employee wants to go above 2x base yearly wage coverage, they will need to fill out a health questionnaire. Employees who currently have 1.5x their yearly base wage in supplemental life insurance who do nothing during the open enrollment period in 2013 for 2014 will automatically be moved to 2x yearly base wage rate in supplemental life.

 

Questions Submitted by Members

Question: Somewhere I saw some sort of 10% bonus for employees retiring with 90+ points (age + years of service). Could you explain how that works. Haven’t been able to locate that statement on the website.

In negotiations after the NO vote, an additional band was added to the Cash Balance Pension. At 80 points and above (years service + age), an employee would earn 10% of their base wage into their account. See Q/A # 56 for the table with all the bands. Also see the summary on benefits or the text of theTentative Agreement for more information about the Cash Balance Pension.

Question:   What is covered with an emergency like a broken bone or a cut or a heart attack or cancer. Do we pay for these services?

Emergency room visits are still covered with a 20% coinsurance and are subject to the deductible.  Hospitalization is covered with a 20% coinsurance and subject to deductible. Urgent Care visits are covered with 10% coinsurance and are NOT subject to deductible. Click on the links on Q/A #41 or #42 above, which will take you to the specific insurance coverage for different services.

Question: Concerning raises for T300 Electrical Tech (4.1%) and Electrical Tech Crew Lead (5% above Tech) (LOA 11-46). There is currently an Electrical Tech Crew Lead A and B. Who gets what raise?

The original letter of agreement did not address the Title 300 Tech Crew Leader B (1607-not Gas), however this oversight was corrected by the following:

Title 300 Electrical Technician (2387) will receive a 4.1% wage increase as stated in the summary and letter of agreement.

The Title 300 Tech Crew Leader B (1607) wage increase will be above the new Electrical Tech wage by 2.5% (start) and 3.5% (end of 6 months)

The Title 300 Tech Crew Leader A (1606) increase will be above the new Electrical Tech wage by 5% as stated in the summary and letter of agreement.

Question: The free medicines attachment lists medicines associated with certain conditions. What if you are on the medicine but for a different condition than what is listed? Is the drug itself covered regardless of condition or can it only be for that specific purpose?

The free drugs or lab tests listed on Q/A #34 are free if they were prescribed to you by your doctor, regardless of what condition you have. For example, if you have a condition that is unrelated to blood pressure problems but a doctor has prescribed a medication that is on the free list under the blood pressure category, it is still free.

Question: Can you provide a comparison of the current Blue Cross PPO medical out-of-pocket maximum to the proposed medical Blue Cross out-of-pocket to see how close the current plan and new proposed plan are?

The current Anthem Blue Cross PPO out-of-pocket maximum is $750 individual/$1500 family for in-network medical; $1000/$2000 for out-of-network medical; and $500 individual/$1000 family for prescription drugs. In total, the out-of-pocket max currently is $1250 individual/$2500 family for in-network Anthem Blue Cross in 2012, $1500 individual/$3000 for out-of-network Anthem Blue Cross in total. There are no HRA funds to offset any of this total.

From 2014 through 2020 the out-of-pocket max would total $2400 individual/$4800 family. (There would be no in-network or out-of-network or separate medical or prescription out-of-pocket max.) There would be HRA funds to offset some or all of this total.

Every year single employees can earn up to $1000 in their HRA to offset the out-of-pocket maximum, and employees covering family members can earn up to $2000 in their HRA to offset the out-of-pocket maximum. Employees who roll over HRA money from previous years would further offset any out-of-pocket maximum.

Question:   The proposed changes to the Commercial Driver’s License states the following:

8. Upon ratification, all new hires, bidders and transfers from outside the lines of progression to Gas and Electric T&D, General Construction Gas and Line Departments or other Departments as described herein will be required to have and maintain a CDL as part of their job duties and will not receive additional compensation. Employees must obtain a Class A permit by month 3 and a Class A drivers license within 12 months unless Company is unable to provide timely training.
9. For departments such as Fleet, new hires, bidders and transfers shall be treated the same as above. The Company and Union will address other departments if needed, consistent with this agreement.

If I understand this correctly, does this mean that if I bid into another garage, I will no longer receive the CDLA premium?

The section that you quote applies to new hires and to bidders from outside the lines of progression. If you are currently in the line of progression (department) you remain eligible for the CDL premium if you bid to another garage.

Question: What are the major changes in this offer versus the contract we voted down? I don’t see any major changes, especially the 2 issues that convinced me to vote no last time. Not many changes that I see yet the union is strongly recommending a yes vote! Please explain why it’s so much better.

In the physical agreement there are major improvements in the hourly CDL premium coverage and the company’s overtime meal proposals are off the table.

The pension plan includes two major improvements. First, the Company will never attempt to transition current employees into the cash balance pension plan. Second, the Company agreed to add a 10% band to the contribution bands for employees with age plus service of 80 or greater.

The medical plan is simplified and improved. The HRA amount is increased to an amount that can effectively make this a no-deductible plan. We negotiated four nine-year guarantees – the deductible will not increase, the coinsurance percentage will not increase, the out of pocket maximum will not increase, and the health account contribution will not decrease. We included additional free medication, improved handling of mental health therapy, extra health account money for lower wage employees, and an appeals process for employees who reach the out of pocket maximum two years in a row.

There were significant improvements.

Question: I saw where the HRA starts on Jan 1, 2014. What about an HRA for those of us who are forced into Anthem Blue Cross on Jan 1, 2013? I currently have Health Net.

None of the plan design changes (HRA, deductible, out-of-pocket max etc.) will go into effect on January 1, 2013. Any existing member of Health Net or Blue Shield can choose to go into Kaiser or Blue Cross during the open enrollment period in the fall.  With these 2 vendors, we have 97% access to physicians currently-enrolled members use.

Question: Under the new medical for prescriptions will we have to use Medco mail in or can we still use our regular pharmacy and get the same covered prescriptions at no cost?

Anthem Blue Cross members will still have prescriptions filled through Medco. Kaiser members will use Kaiser. There will still be a greater coinsurance benefit for prescriptions that are filled through mail order. See below for specifics taken directly from the full text of the TA:

Preventive Drugs:

• No cost if listed on Attachment B1. Anthem/Blue Cross members need to get through mail-order

Retail Drugs:

• Subject to deductible

30-day prescriptions supplied at a participating pharmacy — plan pays:

• 85% for generic
• 75% for brand

Maintenance medications: – after three prescription fills at retail pharmacy, plan pays $0 – maintenance drugs must be obtained from Mail Order Pharmacy.

Mail Order Drugs:

• Subject to deductible

Plan pays:

• 90% for generic
• 80% for brand

Question:   What year will the 9-year commitment start if the contract is passed?

If the contract is passed, the 9-year commitment takes effect at the same date as the TA, January 1, 2012. The intent of the commitment to lock in HRA, Deductible, out-of-pocket maximums, and coinsurance levels was to alleviate concerns that these items would change after this 3-year contract. The commitment on these items locks in the amounts set forth in the TA through the year 2020, or three contract cycles.

Question:   Why are you taking Promotion-Demotion system wide protection only areas for the GC Field Clerk, You will have a separate negotiation on the need for additional Physical Clerks, why not negotiate the Promo-Demo at that time?

There is only one bid code for the First Field Clerk and currently a First Field Clerk is unable to bid to desired locations if there is a vacancy. The proposed change would enable First Field Clerks to bid desired locations in other promo-demo areas, etc. The Company indicated they wished to continue discussions regarding Physical Clerical positions and this issue among others will be discussed; however, we are not sure if an agreement will be reached.

For a more detailed explanation please contact the GC Business Representative in your area. You will find a list of contacts on our website.

Question:   It says chiropractic is covered. Is that true for Kaiser members ?

Yes, that is true. Both Kaiser and Anthem Blue Cross members will have access to a network of chiropractic and acupuncture care providers. The network of providers will be the same one that is currently being offered through Anthem Blue Cross: the American Specialty Health Network (ASHN). When the new plan is implemented in 2014, both Anthem and Kaiser will offer chiropractors and acupuncturists through ASHN so members can self-refer to chiropractors and acupuncturists by contacting ASHN directly.  Kaiser members will not need a referral from their primary care physician to use these services. This will be an added benefit for Kaiser members. The first 5 visits will be covered at 90% and all visits over 5 will be covered at 80%. This benefit is subject to deductible.

Question: Could we get the actual fee list that PG&E has contracted for with Kaiser? The Kaiser 2012 Sample fee list you linked to does not appear to be for our EPO plan that PG&E has, it is for PPOs. These are also estimated charges as of 1-1-2012 and may change without notice.

What is posted on the link to Q/A #51 is the fee schedule that is currently used to pay Kaiser members’ claims. Kaiser has only one fee list for its self-funded plans. PG&E does not negotiate with Kaiser on the fees charged, as Kaiser uses the same charges across all of its book of business. Like any medical provider, Kaiser has the right to increase its costs to members as its own costs increase.

Question:   If member is off on workers comp will he get retro wages?

Yes, employees who are off on Worker’s Compensation would be eligible for retroactive pay subject to the provisions of Title 108 of the Collective Bargaining Agreement.

Question:   Why are Towermen not part of a climbing classification when they climb more than any other work group?

The 2011 Union bargaining committee received a number of proposals from GC Tower department and made a proposal to address this issue with the Company. The Company committee said they were not interested in this proposal at this time. As always, IBEW 1245 will continue to engage the Company to consider ad hoc negotiations on this issue as well as other matters for other departments.

Question:   I have 32 years’ service with PG&E, and I will not ever want to change to the new cash balance plan. Can the company force me to change plans in the future, and what would happen to my old pension.

See Q/A #55 with this answer. IBEW 1245 negotiated with PG&E a commitment to NOT involuntarily convert any existing member (hired prior to 1/1/2013) to the Cash Balance Pension.

Question:   What medical plans are offered when you retire after 1-1-13 if passed ? Or, if not passed?

There were no changes made to any of the retiree medical plans during these negotiation. Retiree medical plan choices will not be affected, whether or not the TA is ratified.

Question:   I don’t understand what it means by the Company agreeing to add a 10% band to the contribution bands for employees with age-plus-service of 80 or greater. Exactly what does this mean for us?  Does this equate to better and higher monthly pension benefits to us at retirement than otherwise?  Please clarify and thanks again!

This addition provides annual pay credits to the Cash Balance Pension account equal to 10% of pay for an employee whose age + service time = 80 or more. This band is higher than was offered previously and would allow more money to accrue for those employees who reached the 80 point total. The Cash Balance Pension is only for existing employees who voluntarily elect to freeze their current pension in 2013 and begin on the Cash Balance Pension in 2014 or for new employees hired on or after 1/1/2013.  See Q/A #54 and #56.

Question:   Family of 4. Son needs braces. It costs 6K. My current plan covers 2K, out-of- pocket 4k. With the new plan how much out-of- pocket and what happens if someone else gets sick during the course of the rest of the year?

There has been no change to orthodontia coverage during negotiations. The $2000 max that is in the current dental plan has no connection with changes to the medical plan. The only cross over between medical and dental would be in where members can use their HRA funds. These funds could be used for dental, medical, orthodontia or vision costs or any other eligible expenses on IRS213(d). (See Q/A #4 for link.)

Question:   What about if a person is in the middle of an on-going health care issue? Like cancer or something that is requiring many visits. How does that transfer over?

PG&E has no pre-existing conditions exclusions in any of its medical plans.  Members who need on-going treatment would be covered according to the cost matrix that is linked in Q/A #41, 42, 43.  For employees who have serious or chronic conditions, once the out-of-pocket maximum is reached for any calendar year, all other covered services are free.

Question:   Currently I have Anthem NAP, Family deductible is $320. And a 90/10 split plus a 10 and 20 dollar co-pay. How do these compare to the new plan?

In the new plan design, the deductible would be $1000 per individual up to $2000 maximum for 2 or more people. The cost matrix link in Q/A # 41, 42, or 43 answers the coinsurance comparisons. The new plan does not have co-pays. There are currently no HRA funds in the current Anthem plans.

Question:   Who determines the description of Durable Medical Equipment? Is there a list somewhere? Does Durable Medical Equipment include Ostomy supplies?

There was no change made during negotiations that affect the list of items that are or are not considered Durable Medical Equipment (DME). The plan vendor (i.e. Anthem Blue Cross or Kaiser) would be the one to contact for an exact list of DME.

Question:   I am not clear on the medication coverage.  I have already found 3 common medications that are used in my household that are not on the Free list.  Can the deductible be used to pay for the difference?

HRA funds can be used for deductibles or other costs incurred from the purchase of medications that are not on the free list. Here is the coverage (taken from text of the TA):

Retail Drugs:

• Subject to deductible

30-day prescriptions supplied at a participating pharmacy — plan pays:

• 85% for generic
• 75% for brand

Maintenance medications: – after three prescription fills at retail pharmacy, plan pays $0 – maintenance drugs must be obtained from Mail Order Pharmacy.

Mail Order Drugs:

• Subject to deductible

Plan pays:

• 90% for generic
• 80% for brand

Question:   My Blue Cross prescription out-of-pocket has a $500 max which I reach after 3 months. Does the new medical plan have separate out of pocket maximums for prescription and medical or will I now have to pay the $2400 (max) deductible for non-covered/not-on-list prescriptions?

The new plan design for both Anthem Blue Cross and Kaiser will have a combined medical and prescription out-of-pocket max of $2400/individual or $4800/for 2 or more people. There is a list of free medications (see Q/A #35). If your medication is not on that list but is still currently covered by Anthem Blue Cross, then you would be responsible to pay up to the deductible amount of $1000. In any year an individual can receive/earn at least $1000 in HRA funds that could be used to pay the deductible and reduce the out-of-pocket to $1400 or less. If you reach your out-of-pocket maximum on prescription drug expenses, both covered medical and prescription costs for you, the rest of the year, would cost you nothing. Follow the matrix below to determine level of coinsurance:

Preventive Drugs:

• No cost if listed on Attachment B1. Anthem/Blue Cross members need to get through mail-order

Retail Drugs:

• Subject to deductible

30-day prescriptions supplied at a participating pharmacy — plan pays:

• 85% for generic
• 75% for brand

Maintenance medications: – after three prescription fills at retail pharmacy, plan pays $0 – maintenance drugs must be obtained from Mail Order Pharmacy.

Mail Order Drugs:

• Subject to deductible

Plan pays:

• 90% for generic
• 80% for brand

Question:   We were told, (during verbal presentations), that a visit to a specialist would be counted as one of our 4 free visits; but this is not what is in the written tentative text – what’s up?

In nearly all cases, visits to specialists would not count as one of your 4 free visits, as these were intended for primary care visits. However, in an instance where you saw a specialist who was also trained as a generalist and who billed you as a primary care doctor, it could be counted as one of the 4 free visits.

Question:   What is the appeals process for employees who reach the out-of-pocket maximum two years in a row and what would be appealed?

The appeal would be for an additional $1000 individual/$2000 family in HRA funds. The process, taken from the full text of the agreement, is as follows:

8. HRA Appeals Process due to Financial Hardship: The company and union agree that employees may appeal to request additional funding in their Health Reimbursement Account (HRA) due to a financial hardship. The decision to grant or deny the additional funding is non-grievable.

a. Employee must have reached the out-of-pocket maximum for a minimum of two years in a row to be eligible to appeal.

b. Employees must submit their appeal in writing to:

Pacific Gas and Electric Company
Benefits Department Appeals
1850 Gateway Blvd. 7th Floor
Concord, CA 94520

c. Within 60 calendar days of the date the appeal is received, the employee will receive a written response. There may be special circumstances where an extension of up to 90 calendar days may be required. The employee will be notified if such an issue occurs. If the Benefit Department denies the claim, the employee will receive a written response that will include the reason for the denial and an explanation of additional appeals procedure. The employee may then have the appeal reviewed by the Employee Benefits Appeals Committee (EBAC). The employee must submit a new appeal in writing stating the reasons for the appeal and enclosing all relevant documentation and information that supports the appeal. Employees will receive EBAC’s decision within 90 calendar days of EBAC’s receipt of the appeal unless there are special circumstances where an extension of up to an additional 90 calendar days may be required.

d. No special form is needed – employees must describe their financial hardship and supply supporting documentation demonstrating their financial hardship.

e. Each appeal will be considered separately.

f. If the appeal is granted, the employee will be given a one-time deposit into their Health Reimbursement Account of $1000 if they have single coverage and $2000 if they have family coverage.

g. Employees may be eligible to appeal once every two years provided they have reached the out-of-pocket maximum in each of the previous two years.

Question: Let’s say an existing employee, one with over 30 yrs of service, elects to freeze their retirement in 2013 and join the Cash Balance Plan and then retires in 2014, can that employee elect the Lump Sum payment method?

That employee could elect to take only what he/she earned in 2014 (before retirement) as a lump sum. The pension amount earned prior to 2014 would be in the form of annuity as it is currently.

Question: How much do employees have to contribute into the Cash Balance Pension Plan?

The Cash Balance Pension is noncontributory, meaning employees do not need to (nor can they) add funds to this account. Each year PG&E will credit a percentage of the employee’s base wage earned that year, based on age + years of service. This account earns interest each year based on the average of the 30-year Treasury. See Q/A #52 through #66 for more Cash Balance Pension Plan information.

Question: On the Health Plan, Emergency room visits / Ambulance services does not say if it’s subject to the deductible, coinsurance or the cost per visit. Can you please clarify?

Emergency Room Visits and Ambulance services are subject to the deductible and have a 20% coinsurance. They are listed at the top of page 24 on the full text of the TA. They were intended to be shown with the Specialty and Hospital Care items at the bottom of page 23, but were inadvertently cropped on the links on Q/A #41-#43. In the TA it reads:

Specialty/Hospital Care

• Subject to deductible
• 20% coinsurance up to maximum annual out-of-pocket · Includes specialty office visits, inpatient hospital care, outpatient hospital care, Emergency Room visits/Ambulance Services, skilled nursing facility, home health care, substance abuse centers, mental health centers, ambulance services and emergency room visits.

Question: How much per month will Anthem Blue Cross be?

The rates for Anthem Blue Cross or Kaiser for the following year are known around November of each year. Although we do not know what the rates will be in 2014, IBEW 1245 and PG&E negotiated an agreement that keeps the rates in 2014 for Anthem Blue Cross and Kaiser the same (or lower) than they were in 2013.

Question:   According to Attachment A -Title 3 Continuity of Service: If an anti-union ballot measure was to pass in the future would we be expected to cross a picket line if another union was to strike? Could we be fired for not crossing the picket line? Or am I misreading the attachment?

The current contract language contains an agreement that our members will not strike during the term of the contract.  This means that we cannot strike and that we cannot refuse to cross picket lines unless we fear for our safety.  Courts have interpreted this as applying to picket lines at customers’ facilities as well as picket lines at the signatory employer’s facilities.  The new language reflects court decisions. Discipline is possible today, and would still be possible under the new language.

Question:   Kaiser sometimes offers phone appointments with a doctor. Would that be counted as one of your 4 free visits?

Phone and e-mail contacts with doctors at Kaiser will remain free and not count as one of your 4 free doctor visits.

Question: My spouse and I both work for the company and have one child left on our plan. On the medical what happens to the HRA if the spouse carrying the family plan dies? Does the other inherit the money for their use on the new medical or does it just disappear? Would one of us have to take out a family plan and one of us take out a single plan?

The HRA always stays with the medical plan. If the child and surviving spouse continue the plan of the deceased parent, they keep the HRA. If the spouse then enrolls in their own plan they would start as a new enrollee with no carryover HRA funds.

Question:   If contract does not pass, and you retire first part of 2013 will raise be retro back to 1-1-13?

If the contract is not ratified by the membership we expect to return to the bargaining table in September so at this point it is difficult to give you a definite answer to your question. Many factors will determine the outcome of any future negotiations.

Question:   Will the proposed 4.1% raise for Title 300 Electrical Technicians- Not Gas (2387)- be in addition to the company proposed 2.75%  cost of living increase or will it be in lieu of the 2.75%?

The 4.1% wage increase for the Electrical Technician positions (Title 200 and Title 300) is in addition to the General Wage Increase of 2.75%

Question:   I am on a drug which is on the free drug list, but my doctor specifically wants me taking the name brand, not the generic.  To be free does it have to be generic?  There are also different versions of the drug (different dosages, extended release versus twice a day).  Can it be any version I request or only a pre-determined type?

If the drug is on the free medication list as written, the drug is free. The list contains many generic drugs and also brand names as well. If your doctor is prescribing a drug that has the generic version on the free list but not the branded version, then the drug would be still covered but not as a free medicine. The free drug list does include different versions of the same drugs (i.e. extended release). The list is predetermined but is a “living” list that will be updated in the future in a cooperative committee made up of  IBEW 1245 members and PG&E. See the links to the free medicine list on Q/A #34-38.

Question:   What is out of pocket and what is deductible? Can you give me a list? How do I identify what service is deductible or out of pocket?

“Out of Pocket” is any amount of money you pay toward your medical costs (beyond the premium). This includes using funds from the HRA, HCRA or from your own wallet. The deductible is the amount of money needed to be paid by you though an HRA, HCRA or your own wallet, before the medical insurance begins paying. Funds paid toward the deductible also count toward your Out of Pocket maximum. A list of visit types and whether a deductible is needed can be found by looking at the matrix linked on QA #41,42 or 43. Visits and procedures which are subject to the deductible are labeled by showing the terms “subject to deductible” in the box coinciding with each visit type. If the box for a specific visit type says “not subject to deductible” or “covered at no cost” then no deductible needs to be paid. Also see QA#49 and 50 for information about deductibles.

Question:   What is the 10% band to the contribution bands for employees with age-plus service of 80 or greater? How is that applied?

This addition provides annual pay credits to the Cash Balance Pension account equal to 10% of pay for an employee whose age + service time = 80 or more. This band is higher than was offered previously and would allow more money to accrue for those employees who reached the 80 point total. The Cash Balance Pension is only for existing employees who voluntarily elect to freeze their current pension in 2013 and begin on the Cash Balance Pension in 2014 or for new employees hired on or after 1/1/2013. See Q/A #54 and #56.

Question:   If the contract is passed….Will the insurance companies offer pay plans to pay off the maximum out of pocket expenses?

Yes, health care providers are used to arranging pay plans for patients who have expenses their insurance doesn’t cover.  At Kaiser, it would be Kaiser making the arrangements, but if you are an Anthem member, it’s the physician’s office that would make the payment arrangements because they are the ones the money is owed – not Anthem.  Payment arrangements will vary based on the size of the debt and the individual’s personal circumstances – there is no “set” formula. The Benefits Advocacy Service provided by Aon/Hewitt will be available to help employees make needed payment arrangements for either Kaiser or Anthem doctors.  Many of the advocates have worked in doctors’ offices themselves, so they know how these arrangements typically work. They can advise the employee or have a 3-way phone conversation with the employee and the physician’s office to advocate for the employee directly with the doctor’s office.

Question:   I plan on retiring in early 2013, how far into 2013 will I need to work in order to receive the 2.75% pay raise for that year?

You will need to be on the payroll at least one day in January 2013.  If your retirement date is February 1st 2013 or later, the 2013 pay rates will be used to calculate your pension.

Question:   I am on Long term Disability, am 58 years old, and am eligible to retire in 7 years. If I went to the Cash Balance Pension Plan, would my 10% be based on my 66% LTD pay, or my last yearly full salary?

The Cash Balance Pension pay credits would be based on your last base wage rate. The percentage band would be based on your age + years of service (including the time you have been on LTD).  If that total is 80 or more then that band would be 10%.

Question:   When will the back pay take place?

PG&E has advised the Union that they expect to have the retro checks to our members by Oct 1, 2012 pay period. As of now they haven’t confirmed whether it will be a separate check or not. The retro will be 2.75% for physical members beginning on 1/1/12, and as always is based on your hourly wage.

Question:   Why are telecommunication techs not part of a climbing classification when they climb frequently for microwave antenna/dish work?

Answer–  For both Telecommunication techs and Towermen, with lack of any Company interest we were unable to add  them to the climbing classification.

Question:   Has the Recognition amounts been increased?

During negotiations there was no changes made to the current rewards and recognition program.

Question:   RE: Dental.  If implants will be covered at 85%_will the maximum amount of coverage, $2000.00 per year, also be increased?

The maximum amount paid by the dental plan in any calendar year is $2,500 per member. Orthodontia has a separate lifetime max of $2000 per member.

Question:   I am retired and with Kaiser what if I move to an area that Kaiser does not service and there is no health net with the new contract what plan will be provided tor me if new contract passes.

There are numerous Anthem Blue Cross retiree plans that have a nationwide network. Health Net also has a retiree plan. There were no changes to retiree medical plans during these negotiations.

Question:   I have found 2 drugs for my daughter and 3 drugs for myself
which are not on the free list.  Is there some way to petition these drugs be covered?  All of the medications are for conditions which will be life long.  Also, are there any antibiotics (used for maintenance) on the free list?

Answer-The free preventive list is not intended to cover all maintenance drugs.  If a drug is not free, it is covered at 85% for generics and 75% brand name once the deductible is met.  If you get them from mail-order, the plan covers 90% for generic drugs and 80% for Brand Name drugs.  The free drug list was developed in conjunction with outside medical consultants and pharmacy providers.  The free drug list is a group of generic and preferred brand drugs that targets conditions PG&E employees have and removes any financial barrier to taking these drugs if they are obtained from mail order.  IBEW 1245 always welcomes our member’s feedback that we can use for future negotiations, but there is no formal procedure for the joint Union/Management committee to add new drugs to the list.  It is recommended that if you currently take drugs that are contained within the free drug list, that you discuss with your doctor if any of them might be acceptable for you to take. That would be for you and your doctor to decide. Typically, antibiotics are not prescribed for maintenance/long term purposes.