Plan Benefit Overview

As a Washington Metropolitan Area Transit Authority (“WMATA,” “Authority” or “METRO”) Employee under the ATU Local 689 collective bargaining agreement, you and your family members are eligible for comprehensive health care coverage through the Transit Employees’ Health & Welfare Plan. Coverage includes medical, vision and dental care, plus income protection if you are injured or ill and cannot work.

The information on this site is just a summary of your benefits. Full descriptions are contained in the Summary Plan Description (SPD) and other benefit materials you receive from the Plan and from our insurance partners.

 

Find Ways to Use Your Plan Effectively

All of us have encountered difficulties in navigating the medical care system. The following six videos and supporting materials have been produced to help members of the Transit Employees’ Health & Welfare Plan use the medical system as effectively as possible. We know that when you use the Plan more effectively, you and the Plan will save money.

More importantly, you will have better/faster medical recoveries. The focus in the following videos is on wise and effective use of medical care (and cost savings is just a side benefit). But in reality, if medical cost increases are kept as low as possible, then the Plan will be more affordable for everyone, and the chances of the Plan remaining as generous as it is now will be improved. Enjoy the videos, share them with family members, and tell your co-workers about them. And we appreciate any feedback you would like to offer.

Click on the images below to view the videos and earn 70 points on Go365 for viewing each video. You must have a Go365 account to earn the points. Opt-in here!

Video #1

Plan Introduction

  • How does your plan compare to others?
  • Understand terms, so you don't get trapped.
  • Don't get tripped up by "exclusions."

Screen Shot 2018 05 02 At 111606 AM

 

 

Video #2 

How You Can Reduce Your Costs

  • What are ways my out-of-pocket costs can be reduced?
  • If I get better quality care and use primary care more, will this save money?
  • Will “Coordinated Care” help me recover faster and better?
  • If everyone works together, can costs be reduced for everyone?

 Screen Shot 2018 05 02 At 123029 PM

 

Video #3

Some Important Cautions and Medical Care-Use Tips

  • How could “Observation Status” in the hospital cost me lots more later?
  • Should a scary diagnosis be handled differently?
  • Are there dangers in self-referred clinical trials?

Screen Shot 2018 05 02 At 124235 PM 

 

Video # 4

The Most Information-Packed Video

  • How can my use of doctors, hospitals, labs and Rx be more effective?
  • When is “Informed Consent” not informed consent?
  • What is the critical ingredient in understanding your doctor correctly?
  • Why take a pre hospital-admission shower?
  • Why are written hospital discharge instructions so important?

Screen Shot 2018 05 02 At 125309 PM 

 

Video # 5

Be Prepared in Advance

  • Why advance preparation for your doctor’s appointment will ensure your best outcome
  •  Learn how support groups are good for your health and recovery
  • Why careful selection of doctors/hospitals on the basis of quality of care is important
  • Is the cost of medical care a good measure of quality of care?

Screen Shot 2018 05 02 At 125514 PM

 

Video # 6

Who Should be in Charge in My Sunset Days/Weeks

  • How can I be sure my preferences for my last days/weeks are respected in case I can’t express these wishes near the end of my life?
  • What are voluntary Advance Care Directives and POLST forms, and what role can they play in my end days?
  • Could/Should I consider palliative care and/or hospice care?
  • How can “Caregiver Burnout” be reduced?
  • Helpful advice to caregivers

 Screen Shot 2018 05 02 At 10038 PM 

Downloads Icon

Related Documents and Links

FAQs Icon

FAQs

I am on Workers’ Compensation. Who pays for my health insurance?

If you are on Workers’ Compensation, you must make monthly premium payments, at the rate paid by active employees, to stay covered under the Plan. Payments are not deducted from your Workers’ Compensation check, so it is your responsibility to send timely payments directly to the Plan.

View All FAQs