About Us

A Note from the Executive Director

I would like to take this opportunity to introduce you to our website. As you navigate, you will find information related to the success of our organization, its function, people involved in the everyday operation as well as updates regarding your benefits and wellness initiatives. It is our hope that you find this site helpful.

We are pleased to have you as a member of our organization and hope that your experience with us assists you in managing your insurance premiums. It is our goal that Labor-Management Healthcare Coalition members learn healthy lifestyle habits through our wellness program, resulting in their overall improved well-being.

If you are a Governmental or public entity, meet the criteria outlined in our eligibility section, and would like to learn more about our organization, please contact this office by phone. We will be glad to provide the information necessary to be considered for membership by the Labor-Management Healthcare Fund Board of Trustees.

Kindest regards,
Victoria E. Martino

About the Fund

The LMHC contracts with the Labor-Management Healthcare Fund (LMHF) to administer the healthcare plans. The LMHF Board of Trustees assumes fiduciary responsibility for the Fund. The Trustees preside over the Fund operations and staff.

The LMHF staff strives to ensure member satisfaction through providing education of plan designs, assisting in enrollment, and working with healthcare providers on behalf of our members, thereby contributing to the success of the program. We are able to assist you through any unresolved issues regarding your member ID cards, enrollment status, unpaid claims, etc. and answer any questions you have regarding your benefits.

The Fund office provides the following services:

Education - surrounding the plan components, design and history

Enrollment Services - including employee communication, telephone and online enrollment services

Customer Service - specific to plan understanding, enrollment, and initial implementation phase

Wellness Initiatives - provide ongoing wellness activities, seminars, and communication materials to educate and inform membership

Communication - provide members with information relative to their plan, any upcoming changes (as determined by the LMHC with the exception of formulary changes and/or any NYS mandated changes), and other health related items

Market Liaison - work closely with Univera Healthcare and Pharmacy Benefit Dimensions to monitor plan performance and issue resolution

Utilization Review

Eligibility Requirements:

To be considered for membership, you must meet the following criteria:

Governmental, public entity and quasi-governmental agencies including but not limited to cities, towns, villages, school districts and governments in and around Western New York.

The group is required to employ individuals in a unit of personnel represented in collective bargaining by an employee organization that has been lawfully recognized or designated as the Unit’s Collective Bargaining Representative.

The LMHC, in conjunction with its chosen health insurance carrier, BCBSWNY, will determine eligibility based on their underwriting criteria, including but not limited to a review of census, demographics, family status, historical loss experience (if available), and related information of active, COBRA and retirees.

Entities will determine individual eligibility for group health insurance based upon either a Collective Bargaining Agreement between management and labor or the entities’ eligibility criteria. Entities have the right to determine their own waiting period before they are eligible to participate in the group health plan.
Based upon the size of the employer group, underwriting guidelines will determine the minimum participation requirements for enrollment.
Requirement to participate in the Plan is to be a sole offering.
Current retirees and active employees are required to participate to be eligible for the Plan.