аЯрЁБс>ўџ 57ўџџџ4џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅСM №П bjbjт=т= "*€W€WџџџџџџlЈЈЈЈЈЈЈМДДДД РМИірррррррр7999999$Ў ЮŽ]Јррррр]фЈЈррrфффрњЈрЈр7фр7фŒ фpыЈЈ7рд Рэ`в˜ŽШМјДкR7ˆ0И ,\,И\7фММЈЈЈЈйBoard of Trustees March 22, 2008 Northern New England Benefit Trust Dear Board Members, In the interest of my health, I petition the Board of Trustees of NNEBT to grant me dissolution of my insurance contract for the year of 2008 and to terminate my insurance benefit, if possible, immediately. I further ask that a letter of (?Termination of Insurance Benefit?) be issued and that the premium paid in April 2008 for the coverage period of July, August, and September be (?discounted?) I am willing to pay NNEBT a reasonable penalty for this privilege. I understand that if this request is granted, I forfeit and waive any future insurance claims to NNEBT after the cancellation date of insurance coverage for the year 2008. Charles J. Cotnoir Member - Teamsters Local 59 as of August 2000 Jo Ann Murphy, Notary Board of Trustees Northern New England Benefit Trust Gentlemen, Thank you for allowing me to present my case to you. My name is Chuck Cotnoir and I have Prostate Cancer. I am trying to get it cured before it spreads into the rest of my body. MY HEALTH SITUATION: After looking at all the options, - Surgically removing the prostate, lymph nodes, and ???? (with the probable side effects of Impotence and Incontinence), Radiation Seeding of the prostate (eventually the prostate turns to mush), and Proton Beam Therapy, (no side effects), I chose Proton Beam Therapy, a highly focused beam of radiation that accurately targets just the cancer cells. I want to go to Loma Linda University Medical Center in Loma Linda, California to have this procedure done. Loma Linda University is the originator of this procedure and is the world’s leading facility for these procedures, having treated over 12,000 patients. Even more favorable for me, is that 60% of their Proton Beam treatments are specifically for curing Prostate Cancer. The Loma Linda doctors medically accepted me for Proton Beam Therapy treatment in November 2007. I applied to Loma Linda in August 2007. The cancer was discovered in March 2007. MY INSURANCE SITUATION: I have three health insurance plans and am a VA disabled veteran. I have Tricare for Life (military health insurance for retirees), Medicare (Secondary Payors), and the NNEBT’s plan (primary payor). MY DELEMMA: My NNEBT Health plan does not cover out of network claims (Loma Linda in California). According to the Loma Linda insurance department, my Medicare and Tricare for Life health plans will completely cover the cost of the Proton Beam Therapy, provided that they are the primary payor. However, my primary insurance is the NNEBT’s plan. Over the last four months, since December 2007, Brenda Albin and Caroline Levigne have been patiently helping me explore the various options that are available to me under NNEBT’s plan and, at the same time, trying to help me find a way to go to Loma Linda. They are to be commended for their fine work. The situation comes down to this. According to Loma Linda’s insurance department, I can get the treatment at Loma Linda, but only if I can use my Medicare and Tricare for Life health plans. In order for this to happen, NNEBT’s insurance plan has to be cancelled and a letter of Termination of Coverage has to be issued by NNEBT and submitted to Loma Linda. Some of the solutions that Brenda, Caroline, and I have discussed and tried are: After determining that NNEBT’s plan would not cover the cost of the procedure, Loma Linda’s insurance department asked me, in late November 2008, to request Blue Cross to send a Denial of Coverage letter because Loma Linda’s treatment is out of the Blue Cross network. I did this with the significantly delayed help of my primary care physician and in concert with NNEBT’s helpful advice. Blue Cross did send this to Loma Linda (Jan 2008) but they also included a section, which stated that the procedure is available within the network in Massachusetts. Loma Linda’s legal department rejected this letter because the letter states that coverage is available within the Blue Cross network. Loma Linda’s position is that after they submit the bill to Blue Cross for payment, and are denied payment by Blue Cross (because the procedure was done out of the network) and then submit the bill to Medicare - Loma Linda’s experience has been that Medicare would refuse to pay because the original denial letter from Blue Cross stated that the procedure was available under the primary insurer’s health plan (in Massachusetts but not at Loma Linda). Use the normal billing procedure. Have the procedure done at Loma Linda and submit the bill to Blue Cross with the resulting denial of payment and then resubmit the bill to Medicare and Tricare for Life. Loma Linda is unwilling to risk the chance of a protracted billing fight with Medicare for the $125,000 estimated cost and, quite frankly, so am I. I might get caught holding the bag. Use the NNEBT’s plan and have the procedure done in Massachusetts. Although the procedure is available at Mass General, their procedure is geared more to cancer of the brain, head, and neck. The total number of patients treated is only a small fraction of what Loma Linda does and of those, only an even smaller fraction of those are for cancer of the prostate. I decided that my chances of a successful outcome are far better at Loma Linda. Use a procedure other than Proton Beam. I considered both Surgery and Radiation Seeding and decided that the risk of Impotence and Incontinence were just too great, when balanced with the no risk outcomes for proton beam therapy. Discussed why I signed the contract initially on Dec 31, 2007. Prior to signing, I questioned Blue Cross regarding the case and was assured that they would deny coverage, as Loma Linda had asked. I did not realize that further complications would surface. I also talked to several insurance professionals and they counseled me to never give up health insurance coverage. Notwithstanding these facts, I went back to my employer on Jan 7, 2008 to try to withdraw from the insurance and was told that it was impossible to withdraw. Over the last 3 months, I have spoken about withdrawing from the insurance with numerous persons at the Steamship Authority, Teamsters Local 59, NNEBT, Blue Cross, and the Mass Department of Insurance Consumer Affairs and received much the same response. It wasn’t until Mar 21, 2008 that the option of writing to the Board of Trustees was made available to me. Quit my job and cancel my insurance that way. I gave very serious consideration to the “quit my job”, “lose my seniority” option because of the life-threatening risk that I’m under, but even that option is not available to me as I am currently awaiting surgery for a work-related injury and am currently under Workman’s Compensation rules. So, I thank you for your consideration and I hope that you will be able to reach a conclusion that will allow me to get my cancer removed. Your action of canceling my insurance coverage immediately, which is preferable, or to at least (?disregard?) the April premium for July, August, and September would be greatly appreciated. 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