Author Archives: htmt_g890musq

After serving for more than forty years on the Maine Municipal Employees Health Trust Board of Trustees, Richard Metivier, formerly the Finance Director for the City of Lewiston, has retired from the Trust Board, effective December 31, 2023.

Dick was a dedicated member of the Trust Board since its inception, and served as its Chairman from 1993 to 1998. After Dick graduated from Husson College with a B.S. in Business Administration, his first job was for the City of Lewiston as Assistant to the Controller.  This allowed him to work in his hometown, and to gain a highly respected  level of expertise in municipal government and finance.  He has been truly committed to representing the interests of MMEHT members and retirees, and to ensuring they have access to the best possible coverage, and to controlling costs and limiting premium growth. Dick will continue as a nominee of the Maine Municipal Association on the MainePERS board, representing the Participating Local Districts.  The MMEHT Board of Trustees and the MMA staff thank Dick Metivier for his four decades of devoted service to the Health Trust and wish him all the best.

The Board of Trustees would also like to thank Martin Puckett and Belle Ryder for their dedicated service to the Trust.  Martin, the former City Manager of Presque Isle, was a member of the Board of Trustees from 2011 to 2023, and was the Board’s most recent Chair.  Belle served on the Board from 2021 to 2023, representing the Town of Orono.  Both Martin and Belle have recently taken new positions outside of municipal government, and we wish them well.

The Trust’s Selection Committee has appointed three new Trustees to replace these departing Trustees on the Board.  The Board of Trustees is pleased to welcome Stephen Fields, Jessica Maloy and Heather Hunter to the MMEHT Board.

Stephen Fields, Town Manager of Corinth, was selected to fill the remainder of the vacant term through December 31, 2023, and then to a three year term commencing January 1, 2024 and ending December 31, 2026.  Stephen has more than ten years’ experience in municipal government in leadership and human resource management roles, representing larger Maine cities and now a very small town. He also served many years in operations management in the Maine Air National Guard.

Jessica Maloy, Finance Director of the Town of Freeport, was appointed as Trustee to fill the remainder of the term ending December 31, 2025.  Jessica has a strong municipal financial background, as she has served 13 years as the Finance Director for two different towns.  She is also the current Chair of the Maine Municipal Tax Collectors Treasurers Association.

Heather Hunter, City Administrator, City of Lewiston, will serve effective January 1, 2024 through December 31, 2026.  Heather has worked for the City of Lewiston for past 34 years, the bulk of which was in the finance department, where she dealt with employee and plan and benefit administration, enrollment, and rate cost-sharing considerations, and also sat on the City’s Wellness Committee.

The Health Trust expresses its deepest concerns for all affected by the tragic event that occurred in the City of Lewiston. We want to remind our employers and their employees that the Health Trust, in conjunction with Anthem, provides an Employee Assistance Program (EAP) to all employers that participate in the Health Trust health plan.  For many employees, talking with a professional resource can be the key to recovering from a traumatic event.

The Anthem EAP covers all employees, even those who are not enrolled in the health plan.  It also covers the household members of all employees.  Unfortunately, retirees are not eligible to use this service.

To access EAP resources, call 1-800-647-9151 or go to www.anthemeap.com and choose Login in the Members box and enter “MMEHT”.

The Health Trust also offers Critical Incident Response (CIR) services to employers who offer the health plan.   This program provides trained professionals to help your employees through times of crisis when they are exposed to events such as this.

For more resources and flyers about the EAP or CIR programs please visit the Health Trust website:

https://www.mmeht.org/other-benefits/employee-assistance-program/

https://www.mmeht.org/wp-content/uploads/employer-resources/CIR-Handout-4-2023.pdf

The Health Trust’s Open Enrollment period will begin on November 15, 2023, and end on December 15, 2023, for a coverage effective date of January 1, 2024. Enrollment/Change Forms must be received by the Health Trust by December 15.  If no changes are being made to coverage, no forms are required.

Information regarding premiums for 2024 will be mailed to employer group representatives and participants by mid-November.

New ID cards will be distributed only to members who make coverage changes.

If you have any questions, please contact the Health Trust Billing and Enrollment Department at 1-800-452-8786, ext. 2585 or via email at htbilling@memun.org.  Thank you.

Employers: please post this notice about Open Enrollment for your employees.  Thank you.

2024 Open Enrollment Flyer

Are you interested in serving as a Trustee for the Maine Municipal Employees Health Trust? If so, the Health Trust’s Selection Committee would like to hear from you. There is an anticipated vacancy on the Health Trust Board, for a term that begins January 1, 2024.  Interviews will be held for the vacancy in early fall.

An eleven-member Board governs the Health Trust, and oversees its health, dental, short and long-term disability, vision and life insurance plans. The Board typically meets five times a year for half day meetings, with a two-day strategic planning meeting in the summer. Trustees are also expected to serve on one of the Trust’s standing committees that require additional meetings throughout the year.

Covenant Health, which operates St. Joseph’s hospital in Bangor and St. Mary’s hospital in Lewiston, has been negotiating a new contract with Anthem.  Covenant stated in early May that unless an agreement can be reached, they will remove their physicians, providers, and other facilities in Maine from the Anthem provider network, effective July 5, 2023.

While negotiations are ongoing, no agreement has been reached at this time.  We are hopeful that an agreement will be reached soon, but we are ready to assist members when and if these providers and facilities leave the Anthem network. 

The Health Trust is concerned about the potential lack of access to these established providers and hospitals, and we understand that members may be anxious about disruption with their current providers.  However, we also recognize that there is a balance to be maintained in order to control the costs of healthcare.  Covenant has asked for very large increases in the amounts they are paid for services provided, and these costs are shared by all Health Trust members.

Anthem has created a website to share updated information about this matter at https://www.anthem.com/covenantmaine/.

In early May, Anthem sent out letters to all members who utilized a Covenant Health provider within the past 12 months.  Members on a Health Trust POS plan who currently see a Covenant Health primary care physician (PCP) will also be receiving letters shortly assigning them to another, non-Covenant provider and subsequently a new ID card listing the new PCP.   If you receive a letter and would like to change your PCP to another in-network provider, please contact Member Services for assistance with this process. Please note that members on a Health Trust PPO plan are not required to have a PCP under their plan and therefore will not receive a letter assigning them to another non-Covenant PCP. However, if you continue to see a Covenant Health PCP after July 5, 2023, your benefits will be paid at the out-of-network level.

Under the Continuity of Care provisions, you may also be able to continue treatment with your current doctor(s) for a limited time past July 4th, if you are receiving certain types of care.

Under federal law, this includes care if you are:

• In treatment for a serious and complex condition. This can be a sudden (acute) illness that requires specialized treatment in order to avoid death or permanent harm. It can also be an ongoing (chronic) illness that is life threatening or potentially disabling and requires specialized care over a long period of time.
• In a hospital or other inpatient facility.
• Scheduled for nonelective surgery by your current doctor, including your post-operative care for the surgery.
• Pregnant.
• Terminally ill.

Continuity of Care Application Form

Please contact MMEHT Member Services so that we can assist you with the Continuity of Care process, or with finding a new in-network provider if you so choose.  Member Service Representatives are available Monday through Friday from 8:00 a.m. – 4:30 p.m. at 1-800-852-8300.

Covenant Health, which operates St. Joseph’s hospital in Bangor and St. Mary’s hospital in Lewiston, has been negotiating a new contact with Anthem.  Covenant has recently stated that unless an agreement can be reached, they will remove their physicians, providers, and other facilities in Maine from the Anthem provider network, effective July 5, 2023.

The Health Trust is concerned about the potential lack of access to these established providers and hospitals, and we understand that members may be anxious about disruption with their current providers.  However, we also recognize that there is a balance to be maintained in order to control the costs of healthcare.  Covenant has asked for very large increases in the amounts they are paid for services provided.

The Maine Municipal Employees Health Trust was founded in 1983 with the goal of containing healthcare costs while maintaining quality benefit programs and providing superior services. For forty years it has been our pleasure to serve municipal and quasi-municipal employees, retirees and their dependents.

As required by the Affordable Care Act, the Health Trust will be sending out Forms 1095-B to all employees (including non-Medicare retirees and COBRA participants) who were covered under a Health Trust health plan during calendar year 2022. The 1095-B forms provide information on each individual (employee and dependents) who had health coverage through the Trust in 2022, including which months they were covered. Forms were mailed in mid-February, prior to the March 2, 2023 deadline.

The 1095-B forms provide information that may assist you in preparing your taxes, however they do not need to be filed with the tax returns. The IRS has stated that taxpayers need not wait for these forms, and should file their returns as they normally would. Copies of all of the forms will be filed with the IRS by the Health Trust, through its eligibility vendor.

If you have any questions about your Form 1095-B, please contact the Billing & Enrollment staff at 1-800-452-8786, or htbilling@memun.com.

We are pleased to offer the Lark Diabetes Prevention Program as of January 1, 2023. This smartphone-based program is recognized by the Centers for Disease Control (CDC) and is based on their well-known Prevent T2 curriculum.

Lark is a personalized digital health coaching that provides education, resources, and support to members at risk for diabetes, accessed through the Anthem Sydney Health app. Eligible members receive a free wireless smart scale upon enrollment.

You can engage in the program at your own pace. It provides digital weight loss support, nutrition therapy with customized feedback through daily check-ins, and customized guidance on sleep and physical activity.

Lark Diabetes Prevention Program Flier

In June Anthem, Inc., the parent company of Anthem Blue Cross Blue Shield Maine, changed their name to
Elevance Health and created Carelon, a new healthcare services brand. Anthem Maine will continue to use
their current name.

Effective January 1, 2023, Anthem Maine’s pharmacy benefit manager IngenioRx will join the Carelon
company and change its name to CarelonRx. As a result of this change, IngenioRx Home Delivery Pharmacy
will become CarelonRx Mail and IngenioRx Specialty Pharmacy will become CarelonRx Specialty
Pharmacy. This name change will have no impact on members’ benefits, coverage or how they fill their
prescriptions. Members using the home delivery and specialty pharmacies have been receiving updates on
this change for the past few months, and after January 1 will receive an insert in their first prescription filled
by either of these pharmacies noting the details of the new branding.