Wednesday, September 18, 2019

Frequently Asked Alaska Seafood Processors Questions

 
Q.

Is there a Preferred Provider Organization for my Plan?

A.

If you are on the Alaska Seafood processors plan, you have the freedom of choice for Dental and Vision providers.  It is up to your provider whether they will bill your insurance or will require payment at the time of services and then you must submit your receipt and claim for reimbursement.

Q.

When will I become eligible for coverage?

A.

You must meet the eligibility requirements outlined in your collective bargaining agreement and have made the required employee deductions from your gross pay before your employer will make a payment for your health coverage.  If those requirements are met and your employer contributes for your health coverage, your effective date will be October 1.

Q.

How long will my coverage last if I get laid off?

A.

Coverage is granted in either a 6-month or a 12-month block based on hours worked in the previous year. Your coverage is not affected if you no longer work for your employer.

Q.

Have my Dental or Vision bills been paid?

A.

You can view your eligibility status, claims information, Explanation of Benefits (EOBs), and benefit plan contributions on-line in the 'Member Benefits' section of this site. You will be able to view your information almost as soon as your claim is processed. Of course, for the protection of your privacy, all your personal information is stored behind commercial-strength firewall's and is encrypted while being transmitted over the Internet. 

Q.

How do I file a claim?

A.

When you receive Dental or Vision care, your provider's office usually takes care of filing your claim.  However, to ensure your claim is sent to the proper address you must show the receptionist or billing department your ID card.   It is important that you ask that they update their computer records with the claim address information shown on the card.

If your provider requires payment at the time of service and you need to file a claim, you may print a claim form (found on our website), attach your proof of payment, and send it to:

     Alaska Seafood Processors' Plan-IBU 
     PO Box 1618
     San Ramon, CA 94583

Q.
How do I get a replacement ID card?
A.

Please contact the Benefit Office for a replacement ID card.

Q.

What happens if my claim is denied or not paid as I believe it should be ?

A.

If you submit a claim and the Benefit office doesn't pay it, you will be sent a written notice, also called an Explanation of Benefits or EOB. If you want to have the denial reviewed, simply write the Trustees of the IBU Health Trust to request a review. In your request, you should state the reason you want the review and provide any additional information you think would be helpful to your case. Make sure you include your name, social security number, and which claim it is you want reviewed. This request must be made within 60 days after you received the written notice that your claim was denied.

Q.

What should I do in the case of a life changing event?

A.

If a covered member passes away, please contact the Benefit Office to determine if there are any life insurance benefits, please be sure your beneficiary information is up to date!  A beneficiary form may be found on this website.