Pacific Maritime Association

2020 | THE YEAR IN REVIEW contributory for the participants and is completely funded by employer contributions. Refer to pg. 41 for more information. Healthcare Benefits The healthcare plan – the ILWU-PMA Welfare Plan – is among the most generous in America, with no employee premiums and low out-of-pocket costs for out-of-network services. In the 2020 fiscal year the healthcare cost per ILWU registrant was $51,550. Tackling Healthcare Fraud, Waste, and Abuse Since 2013 the employers have continued intensified focus on addressing fraud, waste, and abuse of the healthcare plan. The third-party claims administrators have also continued their rigorous review of medical bills and identification of fraud and abuse. Through strong management and a clear strategy for mitigating fraud and abuse, the plan costs have stabilized despite a projected trend that showed welfare costs increasing to over $1.5 billion in the 2020 fiscal year. Since 2014, due to suspected fraud and/or abuse, the number of providers that have been excluded from billing the plan has continued to increase. In calendar year 2020, 40 providers were excluded, compared to 27 during calendar year 2019. Only 7 providers were excluded before 2014. A total of 153 providers have been excluded from billing the plan and medical care costs are more than 50 percent below what they would have been had they grown at the rate of healthcare inflation. Employers are committed to continuing to provide comprehensive healthcare benefits and ensuring that providers are accurately billing the plan for only covered services that have been provided in accordance with Plan terms. Going forward, we will continue to exclude providers, press investigations, and where appropriate, initiate litigation and recover losses. Other Healthcare Benefits In addition to health coverage, the ILWU-PMA Welfare Plan also provides the following benefits: • Dental benefit (100% for children and 80% for adults), including dental implants; • Vision benefit ($300 frame allowance every 24 months); • Alcoholism/Drug Recovery Program (paid at 100% for the first episode of substance use disorder treatment); • Subsequent Artificial Limbs and Eyes Benefit covering lost or damaged prostheses; • Life and AD&D insurance; • Hearing Aids; • Blood Sugar Monitors; and • Social Security Supplementation Benefit for Pensioners. 5 0 10 15 20 30 40 25 Before 2014 2014 2015 2016 2017 2018 2019 2020 8 9 14 40 as of the printing of the annual report 17 27 27 11 Excluded Providers - Before 2014-2020 Number of Excluded Providers Plan Year $1,600 $1,400 $1,200 $1,000 $800 $600 $400 $200 $0 04/05 08/09 06/07 12/13 10/11 14/15 16/17 18/19 19/20 Indemnity Plan Indemnity Projected Trend Total Welfare Projected Trend HMO Plans All Other ILWU-PMA Actual vs. Projected Total Welfare Costs (Millions) 19 19 PACIFIC MARITIME ASSOCIATION

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