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HEALTH & WELFARE FUND
The SPD summarizes the key provisions of the Plan and includes important information about your benefits from the Plan.
The SMMs include additional information and changes to the Plan that are not included in the most recent Summary Plan Description.
This provides a quick reference to covered expenses, deductibles and out-of-pocket costs. Please reference the Summary Plan Description for the full explanation.
This provides a quick reference to covered expenses, deductibles and out-of-pocket costs. Please reference the Summary Plan Description for the full explanation.
This provides a quick reference to covered expenses, deductibles and out-of-pocket costs. Please reference the Summary Plan Description for the full explanation.
This provides a quick reference to covered expenses, deductibles and out-of-pocket costs. Please reference the Summary Plan Description for the full explanation.
The Summary Annual Report provides insurance information regarding the Plan and informs you of your rights to additional information.
Important Information About Your Prescription Drug Coverage and Medicare Prescription Drug Coverage
This notice provides information about Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP).
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
*To request any form marked with an asterisk please contact the Fund Office at (847) 827-1029 or access the form through the secure Member Portal.
Complete a Change of Address Form. You may print and complete the form, or you may contact the Fund Office and a form will be mailed to you. You may also complete the form online through the MemberXG portal. Information on how to access the portal can be found here.
Complete a Change of Name Form. You may print and complete the form, or you may contact the Fund Office and a form will be mailed to you.
The Plan requires a Statement of Merged Earnings from the Social Security Administration and a completed affidavit that must be completed in person at the Fund Office. Please contact the Fund Office with questions about what documentation is acceptable.
Contact the Fund Office and ask to speak with Accounts Receivable. They will verify eligibility and request a new health ID card. Your new ID card will arrive within 7-10 business days from the date you notify the Fund Office that you need a new card.
Please visit the Service Providers information below.
If you did not receive an EOB in the mail or need to request a new one, please contact the Fund Office.
If you receive services from a non-participating provider, you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider then complete an Initial Report of Claim Form. Forward the bill and completed form to the Fund Office. Some providers will still file the claim on your behalf.
Complete a Beneficiary Designation Form and mail to the Fund Office. You may also complete the form online through the MemberXG portal. Information on how to access the portal can be found here.
To enroll your spouse for coverage under the Plan, submit a completed Family Update Form along with a certified copy of the marriage certificate to the Fund Office.
To enroll your dependent child for coverage under the Plan, submit a completed Family Update Form along with a certified copy of the birth certificate or adoption papers and verification of their Social Security Number to the Fund Office.
Additional documentation may be requested following receipt of the initial request.
Submit a completed Disability Claim Form to the Fund Office.
The Summary Plan Description is the document that details the benefits of the health plan. The SPD will provide information about the health plan such as covered medical expenses, prescription drug benefits, as well as vision and dental benefits if applicable under your plan classification. An annual Summary of Benefits and Coverage (SBC) is also available that outlines specific coverage amounts by Plan.
You can review the Summary Plan Description electronically or you can call the Fund Office to request a hard copy of the SPD Booklet.
You or your spouse must notify the Plan and submit a fully executed certified copy of your divorce decree to the Fund Office. Once the Plan receives the divorce decree, your former spouse’s coverage will be terminated on the last day of the month in which you and your spouse divorced.
Eligible retirees and their spouse, under age 65 may be eligible for Pre-Medicare Retiree Plan II or Plan III based on how many hours you worked before retiring. Contact the Fund Office for more information. Eligible retirees and their spouse, that are 65 and over, may be eligible for the MAPD plan. The Fund has contracted with RetireeFirst to assist all members enroll in this coverage plan. You must have signed up for Medicare Parts A and B to enroll. The Fund is reimbursing eligible members and their spouse for 50% of their Medicare Part B premium. To enroll or if you have questions about the MAPD Program, please contact RetireeFirst at 630-214-9636 or toll free at 855-430-7104. Click here for the most recent announcement letter and FAQ. If you choose to Opt Out of the MAPD Plan, you will not have medical and prescription drug coverage through the Fund and you will not be able to enroll at a later date. You also will not be eligible for any reimbursement of your Medicare premiums.
You can visit the Greenlight website to use the cost estimate tool.
Visit the BCBSIL website to read more about Machine Readable Files.
Your provider can fax or mail dental claims to our office. Full contact information can be found on our Contact Us page.
If you have any questions about your eligibility, benefits or claims, contact the Fund Office at (847) 827-1029.