Health Trust Changes

Daniel Coyne

With a new year, comes new changes to the Health Trust. For those of you who don’t know what the Health Trust is, here is some information on what it is and what it does. The LVMPD Employee Health and Welfare Trust was formed in 2001 and is made up of eight trustees. The trustees are composed of four members from management, Jackson Wong, Jamie Frost, James Kilber and Jamie Prosser; two from the PMSA, William Gethoefer and Troyce Krumme; and two from the LVPPA, John Abel and Myron Hamm.

This group maintains and oversees your health-care benefits. The health plan director is Linda Lester and she works directly for the Trust and its participants. The Trust is constantly working hard to increase your benefits, and every year they continue to improve upon the last. From everything that I have seen, the eight trustees and Linda are all very passionate about improving our benefits and educating members on those benefits. Some of you are familiar with these new benefits, but many of you are not, so I’d like to remind you of some of the important changes for 2022 and 2023.

2022 Plan Improvements

  • $500 deductible removed with contracted providers for outpatient labs.
  • $500 deductible removed for most outpatient radiology (X-rays, CTs, MRIs, etc.).
  • $500 deductible removed for custom shoe inserts/orthotics.
  • If the employee dies, 30 days of free coverage for any covered dependents.
  • Hearing aids are a covered benefit, deductible waived, prior authorization required, $2,000 maximum per ear, eligible every three years.
  • MedImpact became Pharmacy Benefit Manager, which allowed more access to other large pharmacy chains (Walgreens, Smith’s, Sav-on, Walmart, etc.).

2023 Plan Improvements

  • Annual wellness benefit increased from $250 to $300 per year.
  • Annual wellness benefit includes up to two $50 incentive payments for certain preventative tests (annual physical, mammogram, colonoscopy, etc.).
  • New annual physical exclusive to LVMPD Metro Health Trust participants now includes full preventative coverage for EKG Basic, echocardiogram, treadmill stress test or cardiopulmonary treadmill stress test.
  • Now included in the 2023 wellness benefits — employee, retiree, spouse and domestic partners can also submit for up to a maximum $300 gym membership reimbursement per year. Reimbursement includes “in-home gym subscriptions.” Note: Requires completed reimbursement form, proof of amount paid and proof of eight gym visits per month.
  • With contracted free-standing radiology facilities (SDMI, Desert Radiology, Pueblo Medical Imaging, etc.), no prior authorization is required for CT, CTA, MRI, MRA or PET scans.
  • Bariatric program — lower $3,000 surgery copay and up to three $1,000 annual reimbursements post-surgery (when weight is kept off).
  • Travel benefit — maximum lifetime reimbursement increased to $15,000. Restrictions apply: must be in outpatient case management, treatment cannot be performed locally, treatment must be a covered service, etc.

One change that I get asked about the most is the gym membership reimbursement. This is a great benefit that has a lot of people excited. The process to get a reimbursement is a fairly easy: fill out a one-page form and send it to UMR. If you have any questions about the Health Trust or your benefits, please feel free to reach out to Director Linda Lester at (702) 641-2165.