Tuesday, October 15, 2019

Your Health Care Benefits


Your Health Care Benefits

The Board of Trustees is pleased to welcome you to the new website for the IBEW Electrical Workers Local 357 Health and Welfare Trust Fund. Within this website, you will now have access 24 hours a day, 7 days a week to commonly requested forms, useful links, and frequently asked questions regarding your benefits provided by the Plan. As always, please feel free to contact the Trust Fund Office at (702) 415-2188 if you have any additional questions or concerns.

Medical Benefits

There are five Medical Plans available to the Electrical Workers Local 357 Health & Welfare Trust Fund members. The options are described briefly below. Detailed information regarding each plan can be obtained on this website or by calling the Trust Fund Office at (702) 415-2188.

Your medical benefit network is provided by MultiPlan. The MultiPlan network products available to Participants under this Plan are Beech Street and PHCS. When accessing services in Nevada, providers contracted with Beech Street are considered PPO providers. When accessing services anywhere else, providers contracted with PHCS are considered PPO providers. If a provider is not contracted under the applicable network, your claims will be processed as Out of Network, and benefits will be reduced. The network information is on the front of your medical ID card. To locate a participating (PPO) provider, please call (888) 636-7427 or click on the MultiPlan/Beech Street/PHCS link on the right side of this page to connect to their website.

Preferred Plan (must live in the Preferred Plan Service Area; non-adult children are covered, but are not subject to the rules of the Preferred Plan) – The Preferred Plan offers a unique combination of health care and customer service along with the lowest out-of-pocket expenses. Participants of the Preferred Plan are required to select a Primary Care Provider (PCP) from a dedicated network of physicians and must adhere to certain rules and guidelines. This plan was designed to provide you and your covered adult dependents with quality health care that is convenient and cost effective. It is unique from tradition PPO plans, in that it provides you with personalized VIP access to a specific group of Primary Care Providers. For a list of Preferred Plan PCPs, contact the Benefit Office.

PPO Plan (the participant must live outside of the Local 357 jurisdiction or in the Preferred Plan Service Area but does not wish to enroll in the Preferred Plan) – The PPO Plan contains lesser benefits (higher out-of-pocket costs) than the Preferred Plan, but does not require the participant to select a Primary Care Physician or follow the rules and guidelines set forth by the Preferred Plan. If you do not select a Plan upon eligibility, you will automatically be enrolled in the PPO Plan. Non-adult children of parents covered under the Preferred Plan will be enrolled in the PPO Plan.

Union Family Health Center Plan (mandatory for newly eligible Active Employees residing in Clark County or portions of Nye County, specifically Pahrump, who have not had coverage under the Electrical Workers Health & Welfare Fund for a period of five or more years are required to enroll in the Union Family Health Center Plan for the first two years of coverage and also available for participants who reside within the Preferred Plan service area) – The Union Family Health Center Plan requires that you obtain all primary care services from the Union Family Health Center, and requires referral for specialist care.  Eligible Dependents under the age of three years old are not required to obtain primary care services from the Health Center, nor are referrals required for specialist care.  The Plan contains the same calendar year deductible as the Preferred Plan, and has the following additional features:

  • No out-of-pocket cost sharing for primary care physician services
  • No out-of-pocket cost sharing for diagnostic and lab services at the Health Center
  • No out-of-pocket cost sharing for limited generic prescription drugs

Flex Plan - The Flex Plan is offered to employees working under contracts where the Flex Plan has been negotiated. This plan is similar to the PPO Plan, with a slightly different benefit structure.

Medicare Retiree Plan (available to retired employees receiving a pension benefit from the IBEW Local 357 Pension Trust) – The Medicare Retiree Plan offers PPO benefits, secondary to Medicare, designed to provide coverage for most of the out-of-pocket expenses after Medicare. In some cases, the benefit may not cover 100% of the balance due after Medicare.

Dental Benefits

Your dental benefit network is provided by Diversified Dental. Using a participating provider that is contracted with the Diversified Dental network will ensure that you get the most out of your dental benefits provided by the Plan. To locate a participating provider, please contact Diversified Dental at (866) 270-8326 or click on the Diversified Dental link on the right side of the page to connect to their website.

Vision Benefits

Your vision benefit network is Vision Service Plan (VSP). Using a provider that participates with VSP will ensure that you get the most out of your vision benefits provided by the Plan. To locate a participating provider or for questions regarding your vision benefits and claims, please contact VSP at (800) 877-7195 or click on the VSP link on the right side of the page to connect to their website.

Life Insurance / Disability

As a member, you are offered basic life/accidental death and dismemberment (AD&D) insurance and disability coverage. The information pertaining to these benefits can be found on this website under the Healthcare Documents section.

Prescription Benefits

Your Prescription Benefit Manager is Veridicus (VRx). Using a pharmacy that participates with VRx will ensure that you get the most out of the pharmacy benefits provided by the Plan. To locate a participating pharmacy, please contact VRx at (855) 586-2571 or click on the VRx link on the right side of the page.