Archive for the ‘Healthcare’ Category

Reminder: Open enrollment underway for SMART TD long-term voluntary disability plan

Open enrollment for the new SMART Transportation Division Long-Term Voluntary Disability Plan (VDP) is underway. Enrollment started in May and runs through Nov. 30, 2019. All dues-paying members of SMART TD living in the United States and working at least 20 hours per week can apply for coverage. Members can enroll online by visiting www.smart-vltd.com, contacting their local field supervisor or by calling the SMART TD VDP Enrollment Center at 224-770-5328.

Since May 2019, SMART TD members have had a new disability benefit available to them. Enrollment for the new Long-Term Voluntary Disability Plan (VDP) ends November 30, 2019. Members can apply for coverage if they are a dues-paying member of SMART TD living in the United States and working at least 20 hours per week.

Previously, SMART TD members had long-term disability insurance available to them through MetLife, but the MetLife plan ended April 1, 2019. The new plan is underwritten by Amalgamated Life Insurance Company. Members who were enrolled in the previous MetLife plan are guaranteed approved for a monthly benefit of up to $1,000 per month (2 or 5 years’ duration).

“Applying for the new Long-Term Voluntary Disability Plan (VDP) is easy, because Amalgamated Life Insurance Company uses simplified medical underwriting,” stated Carl Galdine, the VDP enrollment director. “With simplified underwriting, there is no medical exam, only a few medical questions on the application.”

Enrollment packets including a letter, a summary of benefits, and information on how to enroll were mailed to SMART TD members in May and June. Members can enroll online by visiting www.smart-vltd.com contacting their local field supervisor or by calling the SMART TD VDP Enrollment Center at 224-770-5328 and speaking with a benefit specialist.

Below are highlights of the new Long-Term Voluntary Disability Plan (VDP):

  • Members can choose between a 2- or 5-year option
  • Members can enroll in a monthly benefit ranging from $300 to $5,000 ($100 benefit increments) (monthly benefit may not exceed 60% of gross earnings)
  • Previous MetLife participants are guaranteed approved for a monthly benefit of up to $1,000
  • Benefit does not offset and pays in addition to all other benefits
  • Benefit starts paying after 180 days (6 months)
  • Pre-existing conditions are covered after 12 months on the plan
  • Benefit covers members on and off the job (24-hour coverage)
  • Benefit is not subject to repayment upon receipt of a FELA or personal injury settlement
  • Members can retain coverage even if they are furloughed or suspended (portable)

“This new plan was designed to work well with the benefits that SMART TD members already have available to them,” Galdine said. “It stacks on top of all other benefits including the Voluntary Short-Term Disability Plan and RRB benefits. Also, this plan starts after a 6-month waiting period when RRB Sickness Benefits typically end.”

Open enrollment ends Nov. 30, 2019.

For more information or to enroll, contact your local field supervisor, visit www.smart-vltd.com or call the SMART TD VDP Enrollment Center at 224-770-5328.

Railroad unemployment and sickness benefits reduced again due to sequestration

Starting October 1, 2019, the U.S. Railroad Retirement Board (RRB) will reduce railroad unemployment and sickness insurance benefits by 5.9%, down from the current 6.2% reduction, as required by law.

The adjusted reduction is based on revised projections of benefit claims and payments under the Railroad Unemployment Insurance Act. It will remain in effect through September 30, 2020, the end of the fiscal year. Reductions in future fiscal years, should they occur, will be calculated based on applicable law.

The current daily benefit rate is $78.00, so the 5.9% reduction in railroad unemployment and sickness benefits will reduce the maximum amount payable in a two-week period with 10 days of unemployment from $780.00 to $733.98.

Certain railroad sickness benefits are also subject to regular tier I railroad retirement taxes, resulting in a further reduction of 7.65%. Applying the 5.9% reduction to these sickness benefits will result in a maximum two-week total of $677.83.

Under the Budget Control Act of 2011, and a subsequent sequestration order to implement mandated cuts, railroad unemployment and sickness insurance benefits are reduced by a set percentage, which is subject to revision at the beginning of each fiscal year.

When sequestration first took effect in March 2013, railroad unemployment and sickness benefits were subject to a 9.2% reduction. This amount was then adjusted to 7.2% in October 2013, 7.3% in October 2014, 6.8% in October 2015, 6.9% in October 2016, 6.6% in October 2017, and 6.2% in October 2018, as required by law.

In fiscal year 2018, the RRB paid about $12.7 billion in retirement and survivor benefits to about 540,000 beneficiaries, and net unemployment-sickness benefits of about $92.6 million to approximately 24,000 claimants.

Rail members: Online open enrollment in national health plans begins Oct. 1

Railroad employees covered under the National Railway Carriers/UTU Health and Welfare Plan or the Railroad Employees’ National Health and Welfare Plan are being mailed a notification of the online open enrollment period that begins Oct. 1, 2019, and ends Oct. 31, 2019, at midnight. The enrollment site is available 24/7 during the period. The information should be specific to the current enrollment for you and your eligible dependents.

The online enrollment capability provides the ability to view your personal information, add, delete and update dependent information, view enrollment materials, enroll in benefits for next year, and receive an immediate confirmation statement. There is no need to mail in a paper enrollment form. However, if you need assistance, have questions or require a paper enrollment kit, call Railroad Enrollment Services at 800-753-2692.

The enrollment website can be found at https://www.yourtracktohealth.com.

You are encouraged to visit the site and review all the information available. Use the login instructions at the end of this article to access and review your personal information and spend some time learning about the benefits and resources available on the site.

You will also be able to search medical provider networks.

It is required that covered dependent Social Security numbers (SSN) be provided to the Centers for Medicare and Medicaid Services (CMS). Please supply any missing Social Security numbers on the Dependent Information screen.

If you are currently enrolled in the Health Flexible Spending Account, the election and yearly contribution will not rollover to the new plan year. You must enroll in your Health Flexible Spending Account every year.

Instructions to log in to the site:

  • Click “Login” at the upper right of the screen.
  • If you have already registered, enter your username and password.
  • If you have not yet registered, select “New User?” to complete your registration.

Once logged in, select the option to “Enroll Now for 2020,” located in the upper left corner of the screen.

Follow this link to view more information on the flexible spending account.

Palmetto: Medicare ready to serve during disasters

When a severe weather event happens (such as a hurricane, typhoon, earthquake or wildfire), the last thing you or your healthcare provider are thinking about is Medicare. Concerns are about staying alive and what kind of home and property damage you will have. Your situation may be the most-stressful event in your life. When a disaster like the California wildfires or Hurricane Dorian hits, your survival is most important.

Medicare understands this.

For some disasters, like a hurricane or wildfires, the Secretary of Health and Human Services may declare a Public Health Emergency (PHE), which provides waivers for 90 days. In Hurricane Dorian, Medicare made accommodations in the states of Florida, Georgia, North Carolina, South Carolina, and the Commonwealth of Puerto Rico. In those states, providers have an extension on the time allowed to enroll providers or request appeals.

As a patient, you may wonder if Medicare will pay if you see another doctor outside of the disaster area or another sate to receive the care you need. Medicare/Railroad Medicare beneficiaries can receive services anywhere in the United States. The services must be medically necessary and a covered Medicare benefit.

Another concern when a disaster hits is what happens if you lose your Medicare card. If you’ve lost your card (and can’t remember the number) but need to see a doctor or other healthcare provider in an affected area before you receive a replacement card, Medicare advises providers to hold their claims until you receive your new card. It is your responsibility to inform the provider of your new Medicare number. If you need emergency care and do not have your Medicare card or know the number, providers should try to obtain your Medicare number from you or your family. If that fails to be successful, your provider can call Railroad Medicare to request the Medicare number. This should be a rare incidence.

If you have questions or need to obtain a replacement Medicare card, you can call our Beneficiary Customer Service Center at 800-833-4455, Monday through Friday, 8:30 a.m. until 7 p.m. ET to order a new one. For the hearing impaired, call TTY/TDD at 877-566-3572. You may also call the Railroad Retirement Board at 877-772-5772.

We encourage you to visit our website at www.PalmettoGBA.com/RR/Me and visit our Facebook page at www.Facebook.com/MyRRMedicare.

Reminder: Section 6 proposals due by Sept. 30

ATTENTION: All SMART Transportation Division members employed by rail carriers negotiating under the umbrella of the National Carriers’ Conference Committee (NCCC).

As you are likely aware, on August 16, 2019, the SMART Transportation Division began the process of formulating Section 6 notices to be served on rail carriers represented by the NCCC, which will include proposals to increase wages, benefits and improve working conditions. In our communications, all officers and members were invited to submit proposals for the Section 6 notices to the SMART TD headquarters.

For those members who have already submitted proposals, we thank you for providing your invaluable input.

Members who have not yet responded are reminded that proposals are being cataloged through the month of September, and in October a committee of general chairpersons from the Association of General Chairpersons, District No. 1, will review the proposals and begin to fine-tune those suggestions into the notices to be served on the carriers.

In order for your proposal to be cataloged and considered by the Section 6 review committee, your proposal must be received in the Transportation Division office by September 30, 2019.

As a reminder, members may submit their proposals by email (preferred), fax or U.S. Mail:

Email – Section6@smart-union.org
Fax – (216) 228-5755,

or by writing to the attention of the SMART Transportation Division President at

24950 Country Club Blvd. Suite 340
North Olmsted OH 44070

Following this review process, the full Association of General Chairpersons, District No. 1, will be convened to review and finalize the union’s Section 6 notices. Soon thereafter, the Section 6 notices will be reproduced and mailed to all U.S. general chairpersons for serving on the affected railroads on or about Nov. 1, 2019, with changes to become effective no earlier than Jan. 1, 2020.

In addition to membership submitted proposals, SMART Transportation Division will conduct a membership survey to help define the issues for prioritization during negotiations.

“All affected members will be kept informed regarding the Section 6 notices and developments in negotiations, when possible, through the SMART Transportation Division News and the SMART TD website,” said Transportation Division President John Previsich.

The serving of the Section 6 notices is the first step in reaching a new national agreement with railroads represented by the NCCC. The carriers represented by the NCCC also have been working on their own wage and rule notices that they will serve at or about the same time the SMART-TD notices are served.

Under the Railway Labor Act, the current national agreement between SMART TD and NCCC will remain in effect until a new agreement is reached.

Seeking proposals for Section 6 notices

The SMART Transportation Division is beginning the process of formulating Section 6 notices to be served on rail carriers negotiating under the umbrella of the National Carriers’ Conference Committee (NCCC), which will include proposals to increase wages, benefits and improve working conditions.

As mandated by the Railway Labor Act and the current national agreement, these Section 6 notices will be served on most of the nation’s rail carriers on or about Nov. 1, 2019, with changes to become effective no earlier than Jan. 1, 2020.

The serving of the Section 6 notices is the first step in reaching a new national agreement with railroads represented by the NCCC. The carriers represented by the NCCC also have been working on their own wage and rule notices that they will serve at or about the same time the SMART TD notices are served.

All officers and members are invited to submit proposals for the Section 6 notices to the SMART TD headquarters. In addition, SMART Transportation Division will conduct a membership survey to help define the issues for prioritization during negotiations.

Members may submit their proposals by email (preferred), fax or U.S. Mail:

Email – Section6@smart-union.org

Fax – (216) 228-5755

or by writing to the attention of the SMART Transportation Division President at:

24950 Country Club Blvd., Suite 340
North Olmsted OH 44070

The proposals submitted by members will be catalogued during the months of August and September. In October, a committee of general chairpersons from the Association of General Chairpersons, District No. 1, will review the proposals submitted and begin to fine-tune those suggestions into the notices to be served on the carriers.

The full Association of General Chairpersons, District No. 1, will then be convened to review and finalize the union’s Section 6 notices. Soon thereafter, the Section 6 notices will be reproduced and mailed to all U.S. general chairpersons for serving on the affected railroads on or about Nov. 1.

“All affected members will be kept informed regarding the Section 6 notices and developments in negotiations, when possible, through the SMART Transportation Division News and the SMART TD website,” said Transportation Division President John Previsich.

Under the Railway Labor Act, the current national agreement between SMART TD and NCCC will remain in effect until a new agreement is reached.

RRB: unemployment and sickness benefits for railroad employees

The Railroad Retirement Board (RRB) administers the Railroad Unemployment Insurance Act, which provides two kinds of benefits for qualified railroaders: unemployment benefits for those who become unemployed but are ready, willing and able to work; and sickness benefits for those who are unable to work because of sickness or injury. Sickness benefits are also payable to female rail workers for periods of time when they are unable to work because of health conditions related to pregnancy, miscarriage or childbirth. A new benefit year begins each July 1.

The following questions and answers describe these benefits, their eligibility requirements and how to claim them.

1. What are the eligibility requirements for railroad unemployment and sickness benefits in July 2019?

To qualify for normal railroad unemployment or sickness benefits, an employee must have had railroad earnings of at least $3,900 in the calendar year 2018, counting no more than $1,560 for any month. Those who were first employed in the rail industry in 2018 must also have at least five months of creditable railroad service in 2018.

Under certain conditions, employees who do not qualify on the basis of their 2018 earnings may still be able to receive benefits in the new benefit year. Employees with at least 10 years of service (120 or more months of service) who received normal benefits in the benefit year ending June 30, 2019, may be eligible for extended benefits, and employees with at least 10 years of service (120 or more months of service) might qualify for accelerated benefits if they have rail earnings of at least $4,012.50 in 2019, not counting earnings of more than $1,605 a month.

In order to qualify for extended unemployment benefits, a claimant must not have voluntarily quit work without good cause and not have voluntarily retired. To qualify for extended sickness benefits, a claimant must not have voluntarily retired and must be under age 65.

To be eligible for accelerated benefits, a claimant must have 14 or more consecutive days of unemployment or sickness; not have voluntarily retired or, if claiming unemployment benefits, quit work without good cause; and, when claiming sickness benefits, be under age 65.

2. What is the daily benefit rate payable in the new benefit year beginning July 1, 2019?

Almost all employees will qualify for the maximum daily benefit rate of $78. Benefits are generally payable for the number of days of unemployment or sickness over four in 14-day claim periods, which yields $780 for each two full weeks of unemployment or sickness. Sickness benefits payable for the first 6 months after the month the employee last worked are subject to tier I railroad retirement payroll taxes, unless benefits are being paid for an on-the-job injury. (Claimants should be aware that as a result of a sequestration order under the Budget Control Act of 2011, the RRB will reduce unemployment and sickness benefits by 6.2 percent through September 30, 2019. As a result, the total maximum amount payable in a 2-week period covering 10 days of unemployment or sickness will be $731.64. The maximum amount payable for sickness benefits subject to tier I payroll taxes of 7.65 percent will be $675.67 over two weeks. Future reductions, should they occur, will be calculated based on applicable law.)

3. How long are these benefits payable?

Normal unemployment or sickness benefits are each payable for up to 130 days (26 weeks) in a benefit year. The total amount of each kind of benefit which may be paid in the new benefit year cannot exceed the employee’s railroad earnings in calendar year 2018, counting earnings up to $2,015 per month.

If normal benefits are exhausted, extended benefits are payable for up to 65 days (during seven consecutive 14-day claim periods) to employees with at least 10 years of service (120 or more cumulative service months).

4. What is the waiting-period requirement for unemployment and sickness benefits?

Benefits are normally paid for the number of days of unemployment or sickness over four in 14-day registration periods. Initial sickness claims must also begin with four consecutive days of sickness. However, during the first 14-day claim period in a benefit year, benefits are only payable for each day of unemployment or sickness in excess of seven which, in effect, provides a one-week waiting period. (If an employee has at least five days of unemployment or five days of sickness in a 14-day period, he or she should still file for benefits.) Separate waiting periods are required for unemployment and sickness benefits. However, only one seven-day waiting period is generally required during any period of continuing unemployment or sickness, even if that period continues into a subsequent benefit year.

5. Are there special waiting-period requirements if unemployment is due to a strike?

If a worker is unemployed because of a strike conducted in accordance with the Railway Labor Act, benefits are not payable for days of unemployment during the first 14 days of the strike, but benefits are payable during subsequent 14-day periods.

If a strike is in violation of the Railway Labor Act, unemployment benefits are not payable to employees participating in the strike. However, employees not among those participating in such an illegal strike, but who are unemployed on account of the strike, may receive benefits after the first two weeks of the strike.

While a benefit year waiting period cannot count toward a strike waiting period, the 14-day strike waiting period may count as the benefit year waiting period if a worker subsequently becomes unemployed for reasons other than a strike later in the benefit year.

6. Can employees in train and engine service receive unemployment benefits for days when they are standing by or laying over between scheduled runs?

No, not if they are standing by or laying over between regularly assigned trips or they missed a turn in pool service.

7. Can extra-board employees receive unemployment benefits between jobs?

Yes, but only if the miles and/or hours they actually worked were less than the equivalent of normal full-time work in their class of service during the 14-day claim period. Entitlement to benefits would also depend on the employee’s earnings.

8. How would an employee’s earnings in a claim period affect his or her eligibility for unemployment benefits?

If a claimant’s earnings for days worked, and/or days of vacation, paid leave or other leave in a 14-day registration period are more than a certain indexed amount, no benefits are payable for any days of unemployment in that period. That registration period, however, can be used to satisfy the waiting period.

Earnings include pay from railroad and nonrailroad work, as well as part-time work and self-employment. Earnings also include pay that an employee would have earned except for failure to mark up or report for duty on time, or because he or she missed a turn in pool service or was otherwise not ready or willing to work. For the benefit year that begins July 2019, the amount is $1,560, which corresponds to the base year monthly compensation amount used in determining eligibility for benefits in each year. Also, even if an earnings test applies on the first claim in a benefit year, this will not prevent the first claim from satisfying the waiting period in a benefit year.

On the other hand, earnings of no more than $15 a day from work which is substantially less than full-time and not inconsistent with the holding of normal full-time employment may be considered subsidiary remuneration and may not prevent payment of any days in a claim. However, a claimant must be sure to report all full and part-time work on each claim, regardless of the amount of earnings, so the RRB can determine if the work affects benefits.

9. How does a person apply for and claim unemployment benefits?

Employees can apply for and claim unemployment benefits online or by mail.

Individuals who have established an account at RRB.gov can log in to conveniently file their applications and their biweekly claims online. Employees are encouraged to establish their accounts while still working to expedite the filing process for future unemployment benefits, and for access to other online services.

To apply by mail, claimants must obtain an Application for Unemployment Benefits (Form UI-1) from RRB.gov, any RRB field office, their labor organization or employer. The completed application should be mailed to the local RRB office as soon as possible and, in any case, must be filed within 30 days from the date the claimant became unemployed or the first day for which he or she wishes to claim benefits. Benefits may be lost if the application is filed late. Claimants who know in advance that they will be filing an unemployment application or claim late should include a signed statement explaining why they are unable to meet the required time frame.

The local RRB field office reviews the completed application, whether it was submitted online or by mail, and notifies the claimant’s current railroad employer, and base-year employer, if different. The employer has the right to provide information about the benefit application.

After processing the application, biweekly claim forms are made available on the RRB’s website and are mailed to the claimant, as long as he or she remains unemployed and eligible for benefits. Claim forms should be signed and sent on or after the last day of the claim. This can be done online or by mail. The completed claim must be received by the RRB within 15 days of the end of the claim period, or within 15 days of the date the claim form was made available online or mailed to the claimant, whichever is later. Claimants must not file both an online and a paper claim form for the same period(s). Once an individual submits a claim online, all subsequent claim forms will be made available online only, and will no longer be mailed.

Only one application needs to be filed during a benefit year, even if a claimant becomes unemployed more than once. However, a claimant must, in such a case, request a claim form from the RRB within 30 days of the first day for which he or she wants to resume claiming benefits. These claims may then be filed online or by mail.

10. How does a person apply for and claim sickness benefits?

An Application for Sickness Benefits (SI-1a) can be obtained from RRB.gov, any RRB field office, railroad labor organizations or railroad employers. An application including a doctor’s statement of sickness is required at the beginning of each period of continuing sickness for which benefits are claimed. Claimants should make a special effort to have the doctor’s statement of sickness completed promptly since claims cannot be paid without it.

The RRB suggests that employees keep an application for sickness benefits on hand, and that family members know where the form is kept and how to use it. If an employee becomes unable to work because of sickness or injury, the employee should complete the application and then have his or her doctor complete the Statement of Sickness (SI-1b). If a claimant receives sickness benefits for an injury or illness for which he or she is paid damages, it is important to be aware that the RRB is entitled to reimbursement of either the amount of the benefits paid for the injury or illness, or the net amount of the settlement, after deducting the claimant’s gross medical, hospital and legal expenses, whichever is less.

If the employee is too sick to complete the application, someone else may do so. In such cases, a family member should also complete a Statement of Authority to Act for Employee (Form SI-10), which accompanies the statement of sickness.

After completion, the forms should be mailed to the RRB’s headquarters in Chicago within 10 days from when the employee became sick or injured. However, applications received after 10 days but within 30 days of the first day for which an employee wishes to claim benefits are generally considered timely filed if there is a good reason for the delay. Upon receipt, the RRB will process the application and determine if the employee is eligible for sickness benefits.

After processing the application, the RRB provides biweekly claims to the qualified employee as long as he or she is eligible for benefits and remains unable to work due to illness or injury. Biweekly claims are made available for completion online (by those with an account at RRB.gov) and mailed to the claimant. Completed claim forms must be received at the RRB within 30 days of the last day of the claim period, or within 30 days of the date the claim form was made available online or mailed to the claimant, whichever is later. Benefits may be lost if an application or claim is filed late. Claimants who know in advance that they will be filing a sickness application or claim late should include a signed statement explaining why they are unable to meet the required time frame.

As with claims for unemployment benefits, once a claim for sickness benefits is submitted online, all subsequent claims will be made available online only, and will no longer be mailed.

Claimants are reminded that while claim forms for sickness benefits can be submitted online, applications must be mailed to the RRB. Statements of sickness may be mailed with the sickness application or faxed directly from the doctor’s office to the RRB at 312-751-7185. Faxes must include a cover sheet from the doctor’s office.

11. Is a claimant’s employer notified each time a biweekly claim for unemployment or sickness benefits is filed?

The Railroad Unemployment Insurance Act requires the RRB to notify the claimant’s base-year employer each time a claim for benefits is filed. That employer has the right to submit information relevant to the claim before the RRB makes an initial determination on the claim. In addition, if a claimant’s base-year employer is not his or her current employer, the claimant’s current employer is also notified. The RRB must also notify the claimant’s base-year employer each time benefits are paid to a claimant. The base-year employer may protest the decision to pay benefits. Such a protest does not prevent the timely payment of benefits. However, a claimant may be required to repay benefits if the employer’s protest is ultimately successful. The employer also has the right to appeal an unfavorable decision to the RRB’s Bureau of Hearings and Appeals.

The RRB also conducts checks with other Federal agencies and all 50 states, as well as the District of Columbia and Puerto Rico, to detect fraudulent benefit claims, and it checks with physicians to verify the accuracy of medical statements supporting sickness benefit claims.

12. How long does it take to receive payment?

Under the RRB’s Customer Service Plan, if a claimant files an application for unemployment or sickness benefits, the RRB will release a claim form or a denial letter within 10 days of receiving his or her application. If a claim for subsequent biweekly unemployment or sickness benefits is filed, the RRB will certify a payment or release a denial letter within 10 days of the date the RRB receives the claim form. If the claimant is entitled to benefits, his or her benefits will generally be paid within one week of that decision.

However, some claims for benefits may take longer to handle than others if they are more complex, or if an RRB office has to get information from other people or organizations. If a claimant does not receive a decision notice or payment within the specified time period, he or she may expect an explanation for the delay and an estimate of the time required to make a decision.

Claimants who think an RRB office made the wrong decision about their benefits have the right to ask for a review and to appeal. They will be notified of these rights each time an unfavorable decision is made on their claims.

13. How are payments made?

Railroad unemployment and sickness insurance benefits are paid by direct deposit. With direct deposit, benefit payments are made electronically to an employee’s bank, savings and loan, credit union or other financial institution. New applicants for unemployment and sickness benefits will be asked to provide information needed for direct deposit enrollment.

14. How can claimants get more information on their railroad unemployment or sickness claims?

Claimants with online accounts at RRB.gov can log in to view their individual railroad unemployment insurance account statement. This statement displays the type and amount of the claimant’s last five benefit payments, the claim period for which the payments were made, and the dates that the payments were approved. Individuals can also confirm the RRB’s receipt of applications and claims.

In addition, claimants can call the agency toll-free at 1-877-772-5772 to access the RRB’s automated HelpLine service which provides information about the status of unemployment and sickness claims or payments 24 hours a day, 7 days a week. Individuals with questions about unemployment or sickness benefits, or who need information about their specific claims and benefit payments, can also contact an RRB office by calling the toll-free number.

Persons can find the address of the RRB office serving their area by visiting RRB.gov and clicking on Field Office Locator, or by calling the RRB’s HelpLine service and selecting the appropriate option from the automated menu. Most RRB offices are open to the public on weekdays from 9:00 a.m. to 3:30 p.m., except on Wednesdays when offices are open from 9:00 a.m. to 12:00 p.m. All RRB offices are closed on Federal holidays.

RR Medicare: the transition to new numbers ends December 31

Last July, the Railroad Retirement Board (RRB) mailed approximately 450,000 new Railroad Medicare cards with new Medicare Numbers. The new Medicare Numbers, which are unique to each person with Railroad Medicare and do not contain Social Security Number (SSNs), replace the former Health Insurance Claim Numbers (HICNs). Providers can bill claims to Medicare with either a HICN or a new Medicare Number through December 31, 2019.

At this time, approximately 70% of the Railroad Medicare claims received are submitted with Medicare Numbers. Beginning January 1, 2020, all providers will be required to file claims with Medicare Numbers only.

When it’s time for a doctor’s appointment or other Medicare service, be sure to take your new card with you. Your provider’s office knows everyone should have a new Medicare Number, and they will need to keep a record of your Medicare Number so they can bill Railroad Medicare correctly.

If your provider does not have a copy of your card, they may be able to look up your information with their local Medicare Administrative Contractor (MAC) or with Palmetto GBA Railroad Medicare through our online provider portals. These portals give authorized providers access to claims history, eligibility and more. The portals also contain a tool that allows providers to look up a Medicare Number with the following patient information:

  • Last Name
  • First Name
  • Date of Birth
  • Social Security Number

Please note that in order to use the tool to look up your Medicare Number, a provider must have your Social Security Number. If you do not want to give a provider your SSN, allow them to have a copy of your card or verbally give them your Medicare Number. If you have not used your card yet, you are making it much more difficult for your providers to file claims timely. One of the reasons for having the new cards was to give protection from identity theft. One way to do that is to be very selective when giving your personal information to a trusted entity (your doctor, insurers, etc.).

When verbally giving your Medicare Number to a provider, or to a Customer Service Advocate when you call Railroad Medicare, make sure to read it correctly. Medicare Numbers have 11 characters and contain numbers and uppercase letters only. They do not contain the letters S, L, O, I, B or Z. Characters one, four, seven, 10 and 11 will always be a number. The second, fifth, eighth and ninth characters will always be a letter. The third and sixth characters will be a letter or a number.

Sample RRB Medicare Card:

If you are enrolled in a Medicare Advantage Plan, your new Medicare card does not replace your plan’s identification card. You will continue to use your plan’s ID card to receive your Medicare benefits.

If you did not receive your new Medicare Card with your new Medicare Number, you can call Palmetto’s Beneficiary Contact Center at 800-833-4455 or the Railroad Retirement Board at 877-772-5772.

Have questions?

If you have questions about new Medicare cards or Medicare Numbers, please call Palmetto GBA’s Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. You are encouraged to sign up for email updates. To do so, click ‘Listservs’ on the top banner on the Palmetto website at www.PalmettoGBA.com/RR/Me. You are also encouraged to use the beneficiary portal, MyRRMed, which is located at www.PalmettoGBA.com/MyRRMed.

Open enrollment underway for SMART TD’s new VDP

Open enrollment has begun for SMART Transportation Division bus and rail members in the union’s new Voluntary Disability Plan (VDP). The plan, now underwritten by Amalgamated Life Insurance Company, is available for long-term protection against a sudden loss of income due to an illness or injury. Although Open Enrollment will run through Nov. 30, 2019, members may sign up at any time during the enrollment period. Coverage will commence upon successful completion of the enrollment process.

This plan has been established to provide yet another level of financial security to members in the event that a long-term recovery from an illness or injury leaves them unable to work. Members can customize their 24-7 coverage by selecting the benefit option best suiting their individual needs and then pay for coverage through payroll deductions. VDP benefits are payable after a 180-day elimination period and are paid in addition to any other benefits such as the TD Voluntary Short-Term Disability (VSTD) plan, worker’s comp, Railroad Retirement Board (RRB) sickness benefit or others.

The new VDP has two- and five-year options with monthly benefits starting at $300 up to $5,000 available in $100 increments that can cover up to 60% of an enrollee’s earnings. Approval of benefits from Amalgamated is subject to participation requirements and/or simplified medical underwriting.

This VDP coverage is portable for all members, and it won’t be lost if an enrollee is furloughed or suspended. Benefits remain payable in addition to other disability benefits, exceed those of standard long-term disability plans and will give financial security in a time of need.

This plan is optional and voluntary. If a member does not enroll, he or she will not be covered.

Information concerning benefit options and rates for all SMART TD members is available at www.smart-vltd.com, by emailing info@smart-vltd.com or by calling the SMART TD VDP Enrollment Center at 224-770-5328.

RRB Q&A: Medicare for Railroad Retirement annuitants

The federal Medicare program provides hospital and medical insurance protection for Railroad Retirement annuitants and their families, just as it does for Social Security beneficiaries. Medicare has the following parts:

  • Medicare Part A (hospital insurance) helps pay for inpatient care in hospitals and skilled nursing facilities (following a hospital stay), some home health care services and hospice care. Part A is financed through payroll taxes paid by employees and employers.
  • Medicare Part B (medical insurance) helps pay for medically-necessary services like doctors’ services and outpatient care. Part B also helps cover some preventive services. Part B is financed by premiums paid by participants and by federal general revenue funds.
  • Medicare Part C (Medicare Advantage Plans) is another way to get Medicare benefits. It combines Part A, Part B, and sometimes, Part D (prescription drug) coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare.
  • Medicare Part D (Medicare prescription drug coverage) offers voluntary insurance coverage for prescription drugs through Medicare prescription drug plans and other health plan options.

The following questions and answers provide basic information on Medicare eligibility and coverage, as well as other information on the Medicare program.

1. Who is eligible for Medicare?

All Railroad Retirement beneficiaries age 65 or over and other persons who are directly or potentially eligible for Railroad Retirement benefits are covered by the program. Although the age requirements for some unreduced Railroad Retirement benefits have risen just like the Social Security requirements, beneficiaries are still eligible for Medicare at age 65.

Coverage before age 65 is available for disabled employee annuitants who have been entitled to monthly benefits based on total disability for at least 24 months and have a disability insured status under Social Security law. There is no 24-month waiting period for those who have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease.

If entitled to monthly benefits based on an occupational disability, and the individual has been granted a disability freeze, he or she is eligible for Medicare starting with the 30th month after the freeze date or, if later, the 25th month after he or she became entitled to monthly benefits. If receiving benefits due to occupational disability and the person has not been granted a disability freeze, he or she is generally eligible for Medicare at age 65. (The standards for a disability freeze determination follow Social Security law and are comparable to the medical criteria a person must meet to be granted a total disability.)

Under certain conditions, spouses, divorced spouses, surviving divorced spouses, widow(er)s, or a dependent parent may be eligible for Medicare hospital insurance based on an employee’s work record when the spouse, etc., turns 65. Also, disabled widow(er)s under 65, disabled surviving divorced spouses under 65, and disabled children may be eligible for Medicare, usually after a 24-month waiting period.

Medicare coverage at any age on the basis of permanent kidney failure requiring hemodialysis or receipt of a kidney transplant is also available to employee annuitants, employees who have not retired but meet certain minimum service requirements, spouses and dependent children. The Social Security Administration has jurisdiction over Medicare in these cases. Therefore, a Social Security office should be contacted for information on coverage for kidney disease.

2. How do persons enroll in Medicare?

If a retired employee or a family member is receiving a Railroad Retirement annuity, enrollment for both Medicare Part A and Part B is generally automatic and coverage begins when the person reaches age 65. For beneficiaries who are totally disabled, both Medicare Part A and Part B start automatically with the 30th month after the beneficiary became disabled or, if later, the 25th month after the beneficiary became entitled to monthly benefits. Even though enrollment is automatic, an individual may decline Part B; this does not prevent him or her from applying for Part B at a later date. However, premiums may be higher if enrollment is delayed. (See question five for more information on delayed enrollment.)

If an individual is eligible for, but not receiving an annuity, he or she should contact the nearest Railroad Retirement Board (RRB) office before attaining age 65 and apply for both Part A and Part B. (This does not mean that the individual must retire, if working.) The best time to apply is during the three months before the month in which the individual reaches age 65. He or she will then have both Part A and Part B protection beginning with the month age 65 is reached. If the individual does not enroll for Part B in the three months before attaining age 65, he or she can enroll in the month age 65 is reached, or during the three months that follow, but there will be a delay of 1 to 3 months before Part B is effective. Individuals who do not enroll during this “initial enrollment period” may sign up in any “general enrollment period” (January 1 – March 31 each year). Coverage for such individuals begins July 1 of the year of enrollment.

3. Are there costs associated with Medicare Part A (hospital insurance)?

Yes. While individuals don’t have to pay a premium to receive Medicare Part A, recipients of Part A benefits are billed by the hospital for a deductible amount ($1,364 in 2019), as well as any coinsurance amount due and any noncovered services. The remainder of the bill from the hospital, as well as bills for services in skilled nursing facilities or home health visits, is sent to Medicare to pay its share.

4. What are the costs associated with Medicare Part B (medical insurance)?

Anyone eligible for Medicare hospital insurance (Part A) can enroll in Medicare medical insurance (Part B) by paying a monthly premium. The standard premium is $135.50 in 2019. However, some Medicare beneficiaries will not pay this amount because of a provision in the law that states Part B premiums for current enrollees cannot increase by more than the amount of the cost-of-living increase for Social Security (Railroad Retirement Tier I) benefits. Since that adjustment was 2.8 percent for 2019, about 2 million Medicare beneficiaries saw an increase in their Part B premiums, but still pay less than $135.50. The standard premium amount applies to new enrollees in the program, and certain beneficiaries who pay higher premiums based on their modified adjusted gross income.

Monthly premiums for some beneficiaries are greater, depending on a beneficiary’s or married couple’s modified adjusted gross income. The income-related Part B premiums for 2019 are $189.60, $270.90, $352.20, $433.40, or $460.50, depending on how much a beneficiary’s modified adjusted gross income exceeds $85,000 ($170,000 for a married couple), with the highest premium rates only paid by beneficiaries whose modified adjusted gross incomes are over $500,000 ($750,000 for a married couple).

There is also an annual deductible ($185 in 2019) for Part B services.

Palmetto GBA, a subsidiary of Blue Cross and Blue Shield, generally processes claims for Part B benefits filed on behalf of Railroad Retirement beneficiaries in the Original Medicare Plan (the traditional fee-for-service Medicare plan). An individual in the Original Medicare Plan should have his or her hospital, doctor, or other health care provider submit Part B claims directly to:

Palmetto GBA
Railroad Medicare Part B Office
P.O. Box 10066
Augusta, GA 30999-0001
1-800-833-4455
www.palmettogba.com/medicare

Persons with questions about Part B claims under the Original Medicare Plan can contact Palmetto GBA as noted above.

5. Can Medicare Part B premiums increase for delayed enrollment?

Yes. Premiums for Part B are increased 10% for each 12-month period the individual could have been, but was not, enrolled. However, individuals age 65 or older who wait to enroll in Part B because they have group health plan coverage based on their own or their spouse’s current employment may not have to pay higher premiums because they may be eligible for “special enrollment periods.” The same special enrollment period rules apply to disabled individuals, except that the group health insurance may be based on the current employment of the individual, his or her spouse or a family member.

Individuals deciding when to enroll in Medicare Part B must consider how this will affect eligibility for health insurance policies which supplement Medicare coverage. These include “Medigap” insurance and prescription drug coverage and are explained in the answers to questions six through eight.

6. What is Medigap insurance?

Many private insurance companies sell insurance, known as “Medigap,” that helps pay for services not covered by the Original Medicare Plan. Policies may cover deductibles, coinsurance, copayments, health care outside the United States and more. Generally, individuals need Medicare Part A and Part B to enroll, and a monthly premium is charged. When someone first enrolls in Medicare Part B at age 65 or older, he or she has a one-time 6-month “Medigap open enrollment period.” During this period, an insurance company cannot deny coverage, place conditions on a policy, or charge more for a policy because of past or present health problems.

7. Do Medicare beneficiaries have choices available for receiving health care services?

Yes. Under the Original Medicare Plan, the fee-for-service Medicare plan that is available nationwide, a beneficiary can see any doctor or provider who accepts Medicare from qualified Railroad Retirement beneficiaries and is accepting new Medicare patients. Those enrolled in the Original Medicare Plan who want prescription drug coverage must join a Medicare prescription drug plan as described in question eight.

However, a beneficiary may opt to choose a Medicare Advantage Plan (Part C) instead. These plans are managed by Medicare-approved private insurance companies. Medicare Advantage Plans combine Medicare Part A and Part B coverage, and are available in most areas of the country. An individual must have Medicare Part A and Part B to join a Medicare Advantage Plan, and must live in the plan’s service area. Medicare Advantage Plan choices include regional preferred provider organizations (PPOs), health maintenance organizations (HMOs), private fee-for-service plans and others. A PPO is a plan under which a beneficiary uses doctors, hospitals and providers belonging to a network; beneficiaries can use doctors, hospitals and providers outside the network for an additional cost. Under a Medicare Advantage Plan, a beneficiary may pay lower copayments and receive extra benefits. Most plans also include Medicare prescription drug coverage (Part D).

8. How does Medicare Part D (Medicare prescription drug coverage) work?

Medicare contracts with private companies to offer beneficiaries voluntary prescription drug coverage through a variety of options, with different covered prescriptions and different costs. Beneficiaries pay a monthly premium (averaging about $33 in 2019), a yearly deductible (up to $415 in 2019) and part of the cost of prescriptions. Those with limited income and resources may qualify for help in paying some prescription drug costs.

The Affordable Care Act requires some Part D beneficiaries to also pay a monthly adjustment amount, depending on a beneficiary’s or married couple’s modified adjusted gross income. The Part D income-related monthly adjustment amounts in 2019 are $12.40, $31.90, $51.40, $70.90, or $77.40, depending on the extent to which an individual beneficiary’s modified adjusted gross income exceeds $85,000 ($170,000 for a married couple), with the highest amounts only paid by beneficiaries whose incomes are over $500,000 ($750,000 for a married couple).

To enroll, individuals must have Medicare Part A and live in the prescription drug benefit plan’s service area. Beneficiaries can join during the period that starts three months before the month their Medicare coverage starts and ends three months after that month. There may be a higher premium if an individual does not join a Medicare drug plan when first eligible. A beneficiary can generally join or change plans once each year during an enrollment period from October 15 through December 7. Drug coverage would then begin January 1 of the following year. In most cases, there is no automatic enrollment to get a Medicare prescription drug plan. Individuals enrolled in Medicare Advantage Plans will generally get their prescription drug coverage through their plan.

9. Where can I get more information about the Medicare program?

General information on Medicare coverage for Railroad Retirement beneficiaries is available on the RRB’s website, RRB.gov, under the Benefits tab (Medicare) or by contacting an RRB field office toll-free at 1-877-772-5772.

More detailed information on Medicare’s benefits, costs, and health care options are available from the Center for Medicare & Medicaid Services (CMS) publication Medicare & You, which is mailed to Medicare beneficiary households each fall and to new Medicare beneficiaries when they become eligible for coverage. Medicare & You and other publications are also available by visiting Medicare’s website, Medicare.gov, or by calling the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227).

RRB compares benefits under Railroad Retirement and Social Security

Employers and employees covered by the Railroad Retirement Act pay higher retirement taxes than those covered by the Social Security Act, so that Railroad Retirement benefits remain higher than Social Security benefits, especially for “career” employees who have 30 or more years of service.

The following questions and answers show the differences in Railroad Retirement and Social Security benefits payable at the close of the fiscal year ending Sept. 30, 2018. They also show the differences in age requirements and payroll taxes under the two systems.

1. How do the average monthly Railroad Retirement and Social Security benefits paid to retired employees and spouses compare?

The average age annuity being paid by the Railroad Retirement Board (RRB) at the end of fiscal year 2018 to career rail employees was $3,525 a month, and for all retired rail employees, the average was $2,815. The average age retirement benefit being paid under Social Security was approximately $1,415 a month. Spouse benefits averaged $1,035 a month under Railroad Retirement compared to $720 under Social Security.

The Railroad Retirement Act also provides supplemental Railroad Retirement annuities of between $23 and $43 a month, which are payable to employees who retire directly from the rail industry with 25 or more years of service.

2. Are the benefits awarded to recent retirees generally greater than the benefits payable to those who retired years ago?

Yes, because recent awards are based on higher average earnings. Age annuities awarded to career railroad employees retiring in fiscal year 2018 averaged about $4,175 a month, while monthly benefits awarded to workers retiring at full retirement age under Social Security averaged nearly $1,915. If spouse benefits are added, the combined benefits for the employee and spouse would total $5,815 under Railroad Retirement coverage, compared to $2,875 under Social Security. Adding a supplemental annuity to the railroad family’s benefit increases average total benefits for current career rail retirees to about $5,850 a month.

3. How much are the disability benefits currently awarded?

Disabled railroad workers retiring directly from the railroad industry in fiscal year 2018 were awarded $3,050 a month on average, while awards for disabled workers under Social Security averaged $1,340.

While both the Railroad Retirement and Social Security Acts provide benefits to workers who are totally disabled for any regular work, the Railroad Retirement Act also provides disability benefits specifically for employees who are disabled for work in their regular railroad occupation. Employees may be eligible for such an occupational disability annuity at age 60 with 10 years of service, or at any age with 20 years of service.

4. Can railroaders receive benefits at earlier ages than workers under Social Security?

Railroad employees with 30 or more years of creditable service are eligible for regular annuities based on age and service the first full month they are age 60, and rail employees with less than 30 years of creditable service are eligible for regular annuities based on age and service the first full month they are age 62.

No early retirement reduction applies if a rail employee retires at age 60 or older with 30 years of service and his or her retirement is after 2001, or if the employee retired before 2002 at age 62 or older with 30 years of service.

Early retirement reductions are otherwise applied to annuities awarded before full retirement age, the age at which an employee can receive full benefits with no reduction for early retirement. This ranges from age 65 for those born before 1938 to age 67 for those born in 1960 or later, the same as under Social Security.

Under Social Security, a worker cannot begin receiving retirement benefits based on age until age 62, regardless of how long he or she worked, and Social Security retirement benefits are reduced for retirement prior to full retirement age regardless of years of coverage.

5. Can the spouse of a railroader receive a benefit at an earlier age than the spouse of a worker under Social Security?

If a retired railroad employee with 30 or more years of service is age 60, the employee’s spouse is also eligible for an annuity the first full month the spouse is age 60.

Certain early retirement reductions are applied if the employee first became eligible for a 60/30 annuity July 1, 1984, or later, and retired at ages 60 or 61 before 2002. If the employee was awarded a disability annuity, has attained age 60 and has 30 years of service, the spouse can receive an unreduced annuity the first full month she or he is age 60, regardless of whether the employee annuity began before or after 2002, as long as the spouse’s annuity beginning date is after 2001.

To qualify for a spouse’s benefit under Social Security, an applicant must be at least age 62, or any age if caring for a child who is entitled to receive benefits based on the applicant’s spouse’s record.

6. Does Social Security offer any benefits that are not available under Railroad Retirement?

Social Security does pay certain types of benefits that are not available under Railroad Retirement. For example, Social Security provides children’s benefits when an employee is disabled, retired or deceased. Under current law, the Railroad Retirement Act only provides children’s benefits if the employee is deceased.

However, the Railroad Retirement Act includes a special minimum guaranty provision which ensures that railroad families will not receive less in monthly benefits than they would have if railroad earnings were covered by Social Security rather than Railroad Retirement laws. This guaranty is intended to cover situations in which one or more members of a family would otherwise be eligible for a type of Social Security benefit that is not provided under the Railroad Retirement Act. Therefore, if a retired rail employee has children who would otherwise be eligible for a benefit under Social Security, the employee’s annuity can be increased to reflect what Social Security would pay the family.

7. How much are monthly benefits for survivors under Railroad Retirement and Social Security?

Survivor benefits are generally higher if payable by the RRB rather than Social Security. At the end of fiscal year 2018, the average annuity being paid to all aged and disabled widow(er)s was $1,705 a month, compared to $1,305 under Social Security.

Benefits awarded by the RRB in fiscal year 2018 to aged and disabled widow(er)s of railroaders averaged nearly $2,185 a month, compared to approximately $1,265 under Social Security.

The annuities being paid at the end of fiscal year 2018 to widowed mothers/fathers averaged $1,900 a month and children’s annuities averaged $1,110, compared to $985 and $860 a month for widowed mothers/fathers and children, respectively, under Social Security.

Those awarded in fiscal year 2018 averaged $2,200 a month for widowed mothers/fathers and $1,350 a month for children under Railroad Retirement, compared to $960 and $855 for widowed mothers/fathers and children, respectively, under Social Security.

8. How do Railroad Retirement and Social Security lump-sum death benefit provisions differ?

Both the Railroad Retirement and Social Security systems provide a lump-sum death benefit. The Railroad Retirement lump-sum benefit is generally payable only if survivor annuities are not immediately due upon an employee’s death. The Social Security lump-sum benefit may be payable regardless of whether monthly benefits are also due. Both Railroad Retirement and Social Security provide a lump-sum benefit of $255. However, if a railroad employee completed 10 years of creditable railroad service before 1975, the average Railroad Retirement lump-sum benefit payable is $1,020. Also, if an employee had less than 10 years of service, but had at least 5 years of such service after 1995, he or she would have to have had an insured status under Social Security law (counting both Railroad Retirement and Social Security credits) in order for the $255 lump-sum benefit to be payable.

The Social Security lump sum is generally only payable to the widow(er) living with the employee at the time of death. Under Railroad Retirement, if the employee had 10 years of service before 1975, and was not survived by a living-with widow(er), the lump sum may be paid to the funeral home or the payer of the funeral expenses.

9. How do Railroad Retirement and Social Security payroll taxes compare?

Railroad Retirement payroll taxes, like Railroad Retirement benefits, are calculated on a two-tier basis. Rail employees and employers pay Tier I taxes at the same rate as Social Security taxes, 7.65 percent, consisting of 6.20 percent for retirement on earnings up to $132,900 in 2019, and 1.45 percent for Medicare hospital insurance on all earnings. An additional 0.9 percent in Medicare taxes (2.35 percent in total) will be withheld from employees on earnings above $200,000.

In addition, rail employees and employers both pay Tier II taxes which are used to finance Railroad Retirement benefit payments over and above Social Security levels.

In 2019, the Tier II tax rate on earnings up to $98,700 is 4.9 percent for employees and 13.1 percent for employers.

10. How much are regular Railroad Retirement taxes for an employee earning $132,900 in 2019 compared to Social Security taxes?

The maximum amount of regular Railroad Retirement taxes that an employee earning $132,900 can pay in 2019 is $15,003.15, compared to $10,166.85 under Social Security. For railroad employers, the maximum annual regular retirement taxes on an employee earning $132,900 are $23,096.55, compared to $10,166.85 under Social Security. Employees earning over $132,900, and their employers, will pay more in retirement taxes than the above amounts because the Medicare hospital insurance tax is applied to all earnings.