аЯрЁБс>ўџ 9;ўџџџ8џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС5@ №ПМbjbjЯ2Я2 (&­X­XМџџџџџџˆ2222222F****>F_і^^^^^^^^орррррр$URЇ‚2) ^^) ) 22^^ƒƒƒ) О2^2^оƒ) оƒ(ƒЋ&22r^R аС|Ю?ŒШ*ч .>о/0_F,)X)rFF2222)2rl^€оƒ№ мЬ ]^^^FFф*mFF*March 22, 2008 Board of Trustees 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 as soon as possible. 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 of insurance coverage for the year 2008. Charles J. Cotnoir Member - Teamsters Local 59, since (? May 1999?) 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. MY HEALTH SITUATION: After looking at all the options, - Surgically removing the prostate (probable results of Impotence and Incontinence), Radiation Seeding (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 for Prostate Cancer. I have been accepted at Loma Linda Medical Center for Proton Beam Treatment. MY INSURANCE SITUATION: I have three health insurance plans and am a VA disabled veteran. I have Tricare for life (military health insurance), Medicare, and Network Blue from NNEBT. Tricare and Medicare are secondary payors. 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 cover the cost of the Proton Beam Therapy. Over the last three months, 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 alternatives that we have discussed and tried are: Have Blue Cross send a Denial of Coverage because it is Out of Network. Blue Cross did send this to Loma Linda but they also included a section which stated that coverage is available in Massachusetts. Loma Linda’s legal department rejected this because after payment submittal and subsequent denial by Blue Cross and subsequent submittal 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. Use the normal billing procedure and have the procedure done at Loma Linda and submit the bill to Blue Cross for denial of payment and then send the bill to Medicare and Tricare for Life. Loma Linda is unwilling to risk the chance of a protracted billing fight 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 a small 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 to be too large Quit my job and cancel my insurance that way. I gave serious considereation to that option because of the life-threatening risk that I’m under, but 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.  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