FREQUENTLY ASKED QUESTIONS

How do I order a new health & welfare ID Card?

Contact the Fund Office and ask to speak with an Accounts Receivable Specialist. They will verify eligibility and request a new health & welfare ID card. Your new ID card will arrive within 10-15 business days from the date you notify the Fund Office that you need a new card.

How do I locate a health & welfare network provider?

The Important Contact Information page under the Schedule of Benefits provides contact information for the various benefits provided by your Plan.

Non-Supplemental Plan A Schedule of Benefits
Non-Supplemental Plan B Schedule of Benefits
Supplemental Plan A Schedule of Benefits
Supplemental Plan B Schedule of Benefits

How do I view my Explanation of Benefits (EOB)?

If you need to obtain a copy of your EOB contact the Fund Office.

How do I file an out-of-network health claim?

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 and provide this invoice to the Fund Office.

How do I change my address?

In order to change your mailing address, you must 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.

How do I add a dependent to my health insurance?

To enroll your spouse for coverage under the Plan, submit a completed Dependent Enrollment Form along with the required documentation (see below) to the Fund Office. You have 30 days from the date of your marriage to notify the Fund Office. Once notification is received benefits will be paid retroactively to the date of your marriage. If you do not notify the Fund Office, in writing, within 30 days of your marriage, your spouse’s coverage will not begin until the first day of the month following the month in which you notify the Fund office.

To enroll your dependent child for coverage under the Plan, submit a completed Dependent Enrollment Form along with a copy of the birth certificate or adoption papers to the Fund Office. You must enroll your child for coverage before the Fund pays any benefits for that child.

With respect to an adoption, placement for adoption, or placement of a foster child, if you notify the Fund Office, in writing, within 30 days of your dependent becoming eligible, benefits will be paid retroactively to the date your dependent became eligible. If you do not notify the Fund Office, in writing, within 30 days, your dependents coverage will not begin until the first day of the month following the month in which you notify the Fund Office.

With respect to a newborn child, if you notify the Fund Office, in writing, within 60 days of the birth, benefits will be paid retroactively to the date of birth. If you do not notify the Fund Office in writing, within 60 days, your newborn child’s coverage will not begin until the first day of the month following the month in which you notify the Fund Office.

What type of documents are required for enrollment?

Required documents for enrollment includes (but may not be limited to) the following:

Government-issued identification
With respect to a spouse, a marriage certificate AND ONE of the following documents
1. a.) Page 1 and signature page of the employees most recent federal income tax return
2. b.) A document dated within the past six months such as a mortgage statement, loan papers, lease agreement, automobile registration, or credit card or account statement in the name of both the member and spouse.
With respect to a dependent child, a birth certificate, court order or certificate of adoption

Is same sex marriage recognized under the plan?

Same sex marriage is recognized only under the supplemental plans C or D. Contact the Fund Office for more information.

How do I file for disability benefits? – DOOR STAFF ONLY

Submit a completed Initial Report Form to the Fund Office.

How can I find more information about the health benefits offered through my health plan?

The Schedule of Benefits is the document that details the benefits of the health plan. The schedule of benefits document will provide information about the health plan such as the applicable co-pay amounts, deductible amounts, and out of pocket maximums.

Non-Supplemental Plan A Schedule of Benefits
Non-Supplemental Plan B Schedule of Benefits
Supplemental Plan A Schedule of Benefits
Supplemental Plan B Schedule of Benefits

When do I receive my medical card?

You will receive your medical card 10-15 business days from the end of the month, following receipt of the required contributions to be eligible for benefits.

How do I get the health & welfare Summary Plan Description Booklet (SPD)?

You can review the Summary Plan Description electronically or you can call the Fund Office to request a hardcopy of the SPD Booklet.

Non-Supplemental Plans A and B Summary Plan Description (SPD)
Supplemental Plans A and B Summary Plan Description (SPD)
Doorstaff Summary Plan Description (SPD)

If I get divorced, what happens with my former spouse’s coverage?

You or your spouse must notify the Plan and mail a fully executed copy of your divorce decree to the Fund Office. Once the Plan receives the divorce decree, your former spouse’s coverage will be terminated back to the date of your divorce.

When I retire, what are my options for continuing health coverage?

The plan does not offer a retiree health and welfare benefit.

Who do I contact with questions?

If you have any questions, contact the Fund Office at (630) 288-6868 or (866) 844-0488.

How do I access our service providers?

The Important Contact Information page under the Schedule of Benefits provides contact information for the various benefits provided by your Plan:

Non-Supplemental Plan A Schedule of Benefits
Non-Supplemental Plan B Schedule of Benefits
Supplemental Plan A Schedule of Benefits
Supplemental Plan B Schedule of Benefits

LIFE EVENTS

Birth or Adoption

To enroll your dependent child for coverage under the Plan, submit a completed Dependent Enrollment Form along with a copy of the birth certificate or adoption papers to the Fund Office. You must enroll your child for coverage before the Fund pays any benefits for that child.

With respect to an adoption, placement for adoption, or placement of a foster child, if you notify the Fund Office, in writing, within 30 days of your dependent becoming eligible, benefits will be paid retroactively to the date your dependent became eligible. If you do not notify the Fund Office, in writing, within 30 days, your dependents coverage will not begin until the first day of the month following the month in which you notify the Fund Office.

With respect to a newborn child, if you notify the Fund Office, in writing, within 60 days of the birth, benefits will be paid retroactively to the date of birth. If you do not notify the Fund Office in writing, within 60 days, your newborn child’s coverage will not begin until the first day of the month following the month in which you notify the Fund Office.

Marriage

When you marry, your spouse is eligible for healthcare coverage as of the date of your marriage. However, the Fund will not pay benefits on behalf of your spouse until you enroll your spouse for coverage. To enroll your spouse for coverage under the Plan, submit a completed Dependent Enrollment Form along with the required documentation (see below) to the Fund Office. You have 30 days from the date of your marriage to notify the Fund Office. Once notification is received, benefits will be paid retroactively to the date of your marriage. If you do not notify the Fund Office, in writing, within 30 days of your marriage, your spouse’s coverage will not begin until the first day of the month following the month in which you notify the Fund office.

Required documents for enrollment includes (but may not be limited to) the following:

Government-issued identification
With respect to a spouse, a marriage certificate AND ONE of the following documents
- Page 1 and signature page of the employees most recent federal income tax return
- A document dated within the past six months such as a mortgage statement, loan papers, lease agreement, automobile registration, or credit card or account statement in the name of both the member and spouse.
With respect to a dependent child, a birth certificate, court order or certificate of adoption

Disability

If you are unable to work as a result of a non-work related injury or illness and you are under the care of a physician, you may be entitled to the weekly disability income benefit. To apply, submit a completed Disability Claim Form to the Fund Office. Once approved for the weekly disability benefit, you will be responsible to complete the Weekly Disability Supplementary Form.

Moving

If you have recently moved, please complete a Change of Address Form.

Loss of Employment/Coverage

If coverage is lost due to lack of sufficient employer contributions and hours in your individual record system, then you will have the option to elect to continue coverage under COBRA for up to 18 months. Please contact the Fund Office with questions relating to your eligibility.

Divorce

If you and your spouse get a divorce or legal separation, your spouse will no longer be eligible for coverage. However, a spouse may elect to continue coverage under COBRA for up to 36 months upon divorce or legal separation. You or your spouse must notify the Fund Office, within 60 days of the divorce or separation date for your spouse to obtain COBRA continuation coverage. You must also submit a copy of the divorce decree to the Fund Office.

Retirement

If you meet certain criteria defined in the health & welfare Summary Plan Description you and your family may be eligible to participate for regular retiree plan or retiree Medicare supplement plan. Please contact the Fund Office for your retiree options for continuing health coverage.

Supplemental Plans A & B Summary Plan Description
Non-Supplemental Plans A & B Summary Plan Description
Doorstaff Summary Plan Description

Death

In the event of your death, your dependents may continue coverage for up to 36 months by electing COBRA continuation coverage or by electing the retiree plan or the Medicare supplemental plan for surviving spouses and dependents. Your survivors will need to make the required self-contributions for this coverage.

HEALTH & WELFARE

IMPORTANT RESOURCES

FORMS