National IAM Benefit Trust Fund Medical and Rx Plans
The National IAM Benefit Trust Fund offers five medical plans, which are administered by CareFirst Administrators. Covered employees and their dependents may participate in a Benefit Trust Fund medical plan if it is negotiated into the Collective Bargaining Agreement. All five plans generally pay benefits for the same eligible medical expenses. The primary differences between the plans are the annual deductible amounts, coinsurance (the percentage paid for covered services after the annual deductible is met), and the annual out-of-pocket maximum.
The National IAM Benefit Trust Fund is utilizing Quantum Health as a dedicated, third-party that helps those insured through the Benefit Trust Fund navigate insurance complexities. You may visit Quantum Health's website here, or find out more through your personal Care Coordinator by calling 1-866-871-0839.
Cost Sharing
Health plans exist so participants do not have to pay the full cost of medical services. To do this, participants share the cost of services with their employers or the insurance companies.
Please contact the Fund Office by clicking here if you have questions about how any of the above cost sharing features work on Benefit Trust Fund medical plans.
Transparency in Coverage Rule
In 2020, the Departments of Health and Human Services, Labor, and the Treasury finalized the Transparency in Coverage Rule. Under this Rule, the National IAM Benefit Trust Fund is required to provide machine-readable files ("MRFs") on its website. MRFs make data and other information available in a digital file format that can be imported into or read by a computer system for further processing. MRFs are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.
Please visit https://individual.carefirst.com/individuals-families/mandates-policies/machine-readable-file.page to access the MRFs for:
- In-Network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers.
- Out of Network: Allowed amount paid to, and billed charges from, out-of-network providers for all covered services within a 90-day period.