Friday, July 11, 2025

Frequently Asked Health Care Questions


Q. After I choose a medical plan, am I able to change it in the future?
A. After electing a medical plan when you first become eligible for benefits, the next opportunity to change it will be 12 months after your election date. There is a 12-month open enrollment policy which enables you to make changes to your plan any time after the 12-month waiting period has been met.
Q. Who is considered an eligible dependent?
A.
  • Your Lawful Spouse
  • California Registered Domestic Partner
  • Children that depend chiefly on you for support. Children can include:
    • Your natural children
    • Your legally adopted children
    • Your step-children
    • Child for whom you have been appointed legal guardian by court
    (Children that are not eligible under their own health coverage are covered through age 25)
Q. How do I get reimbursed if I paid out of pocket for a prescription?
A. Please contact Sav-Rx at (800) 228-3108 or info@savrx.com for reimbursement instructions. For PacifiCare/United Health Care plans, please call (800) 624-8822. For Kaiser plans please call (800) 464-4000.
Q. What do I need to do when I become eligible for Medicare?
A. You must enroll in both Medicare Part A and Part B as soon as you are eligible for Medicare. If you are retired, you must also enroll into Secure Horizons or Kaiser Permanente Senior Advantage. If you live outside the area, you can enroll into United Health Care Senior Supplement Plan.
Q. I am eligible to take time off work under the Family Medical Leave Act (FMLA)?
A. You and your employer must qualify under the FMLA guidelines. You will need to contact your employer for this information. If you and your employer qualify, your employer is responsible for making contributions for your health care coverage while you are off work on FMLA.
Q. Will my family and I be covered if I’m called to active military duty?
A. If you are called to active duty, you can elect to do the following:
  • Use your reserve hour bank to continue coverage until it’s expired.
  • Waive all coverage for you & your dependents while on active duty.
  • Make monthly COBRA payments to continue your coverage.
Q. Are there any benefits available if I become disabled?
A. If you become disabled, you may receive coverage at no charge for up to six months. The actual number of months is equal to the period for which you were continuously covered as a result of hours worked immediately prior to the disability, up to 6 months. Please refer to the Summary Plan Description booklet for eligibility rules.
Q. What documents are required to add a new dependent to my plan?
A.
  • Spouse – copy of your marriage certificate
  • Domestic Partner – copy of court documents showing registration in California
  • Child – copy of your child’s original birth certificate
  • Child that does not reside in your home – copy of child’s birth certificate along with copy of Qualified Medical Child Support Order.
  • Step-child – copy of child’s original birth certificate along with proof that step-child resides with member on a full-time basis.
  • Adopted child - copy of legal decree of adoption or letter from adoption agency stating the date child was placed in member’s home for purpose of adoption.
  • Child for whom you have been appointed their legal guardian – copy of legal guardianship documents (if temporary guardianship, status updates will be required every 6 months).
Q. How do I add my new baby or spouse to my insurance plan?
A. You are required to enroll your new dependents within 30 days of birth, marriage, or other event which makes a dependent eligible.

You must also fill out an Enrollment Form. You can download one off of this website located under “Forms” and mail it into the Trust Fund Office with the required documentation.
Q. When can I choose what plan I would like to enroll in?
A. When you become eligible for benefits a New Member Packet will be sent to you with information regarding your benefits and the required forms to be filled out.
Q. What if I don’t work enough hours to gain eligibility for the month?
A. You can accumulate a Reserve Hour Bank up to a maximum of 360 hours to use to maintain your coverage if your work hours fall short or you become unemployed.
Q. How do I maintain my monthly health care coverage?
A. You must work at least 120 hours per month to maintain your benefits.
Q. When do I become eligible for benefits?
A. Coverage will begin the first day of the second month following the month that the member accumulates 360 work hours within six consecutive months.

Example of when coverage would begin:

If the 360 qualifying hours are completed in April, coverage would begin June 1st
Q. How do I obtain a replacement Vision Card?
A. Please contact Vision Service Plan (VSP) at: 1-800-877-7195
Q. How do I obtain a replacement prescription ID card?
A.
  • If you are enrolled in Blue Cross, please contact SAV-Rx at (800) 228-3108
  • If you are enrolled in Kaiser or PacifiCare, please contact Kaiser at 1-800-464-4000 or PacifiCare at 1-800-624-8822.
Q. How do I obtain a replacement Dental Card?
A. Please contact the Plan Office at: (888) 208-0250 or (925) 208-9995.
Q. How do I obtain a replacement Medical card?
A.
  • For Blue Cross plans, please call the Trust Fund Office at (925) 208-9995 or (888) 208-0250.
  • For PacifiCare/United Health Care plans, please call (800) 624-8822.
  • For Kaiser plans please call (800) 464-4000.
Q. What number do I call for claim status?
A. (888) 208-0250.
Q. Where do I submit a claim for reimbursement if I’ve already paid out of pocket?
A. BAC Local 3
PO Box 1138
San Ramon, CA 94583
Q. What if I do not see the status of the claim I am checking on?
A. One of the most common reasons for not being able to view a claim status is the provider has not submitted the claim. Or it may simply have to be resubmitted. You may call your provider of service and inform them that they may need to re-submit the particular claim.
Q. How do I view my claims?
A. After you log in, if you are enrolled in the PPO plan, you’ll see your claims information under the ‘Member Information’ menu item.
Q. I have a question about my co-payment, who do I call?
A. Please call the Trust Fund Office at (925) 208-9995 or (888) 208-0250. If you are enrolled in an HMO, call the customer service department number listed on your card.
Q. How do I get a copy of the Preferred Drug List?
A. Go to www.savrx.com to obtain a copy of the Preferred Drug List. If you are enrolled in an HMO, call the customer service department number listed on your card.
Q. How do I get a Mail Order Prescription?
A. Call Sav-Rx at (800) 228-3108. If you are enrolled in an HMO, call the customer service department number listed on your card.
Q. How do I find a local pharmacy?
A. Go to www.savrx.com to locate a participating pharmacy in your area. If you are enrolled in an HMO, call the customer service department number listed on your card.
Q. If I am retired, what are my Medical/Rx coverage options?
A. If you are Medicare eligible, you may enroll in Kaiser Permanente Seniority Plus, PacifiCare Secure Horizons, or PacifiCare Senior Supplement. If you are not Medicare Eligible, you may enroll in Kaiser Permanente Traditional Plan, PacifiCare Early Retiree HMO, or PacifiCare out of Area PPO Plan for Early Retirees. Please call the Trust Fund Office with any questions.
Q. How do I know the reason why a claim has not paid?
A. You are able to view the Explanation of Benefits (EOB) for each claim that has been received. On this EOB, under Reason Code, it will explain the cause of why an entire claim or line item was denied. If you need further explanation, you may call the Trust Fund Office.
Q. How long should I wait for claim status to show on the website?
A. Normally, you will see claim status in about 15-25 days upon receipt of the claim.
Q. When can I enroll a new dependent?
A. New dependents must be enrolled within 30 days of birth, marriage, or to the event which makes a dependent eligible. If not they must wait for open enrollment.
Q. When will I become eligible?
A. Initial eligibility begins when 360 hours are obtained in a period of no more than six consecutive months. Eligibility begins the first day of the second month following the month in which 360 hours is completed. 120 hours are required per month to maintain eligibility.
Q. Whom should I call if I have a question about my eligibility?
A. Call the Trust Fund Office at (925) 208-9995 or (888) 208-0250.
Q. How do I find a Blue Cross Provider?
A. Go to www.anthem.com and under the visitor tab, click “find a doctor” follow the prompts for the type of provider you are looking for.