IMPORTANT INFORMATION REGARDING YOUR HEALTH BENEFITS

It has been brought to JNESO’s attention that members are having difficulty using Tier 2 benefits for their medical care. Through the authorization process, members have been denied physicians and told that they are approved for a Tier 1 (PRIME) physician only. Some members have been told that there are no Tier 2 benefits and it is a “strict EPO.”

THIS IS NOT WHAT WAS AGREED TO OR WHAT YOUR CONTRACT PROVIDES FOR!

Your Local has currently filed a grievance against Prime for this unilateral change and may file further legal action with the National Labor Relations Board (NLRB).   While we await the outcome of the grievance, there are several things that can be done if you are denied coverage for a Tier 2 provider:

ASK YOUR HEALTH CARE PROVIDER TO IMMEDIATELY APPEAL THE DENIAL    IMMEDIATELY CONTACT YOUR LABOR REPRESENTATIVE AND PROVIDE DETAILS OF YOUR DENIAL

JNESO cannot promise to prevail in our grievance or other legal action, however, please remember that your health and wellbeing are of the utmost importance. If the care you need is denied, and your health will suffer, please consider getting the care and let us fight to recoup your expenses after. It is of course a risk, but one that may be well worth taking.

Labor Representative Aisha Harrison: [email protected] or (800) 292-0542 x127

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