Friday, July 11, 2025

Frequently Asked Health Care Questions


Q.

Who is eligible to become a Participant in the Plan?

A.

Active Members, Non-Medicare Retirees and Dependents.

You must earn 360 Hours of Work to satisfy the Plan's initial eligibility requirements. Your coverage will begin the second month after you satisfy the Plan's initial eligibility requirements.

Q.

What if I don’t work enough hours to gain eligibility for the month?

A.

You will be eligible to pay to continue your health coverage under COBRA.

You must have 120 Hours of Work credited to your hour bank within 3 months of the month in which it dropped below 120, to regain coverage. If you don't, you must reestablish initial eligibility, by again working 360 hours.

Q.

How do I maintain my monthly Health Care coverage?

A.

You must have at least 120 Hours of Work in your hour bank. If your Employer timely makes contributions on your behalf, you will be credited with your Hours of Work in the month you work the Hours to provide coverage two months later.

Q.

How do I make a payment towards the continuation of my Health Care coverage?

A.

You will have 45 days from the date you elect COBRA to make your initial Self-Payment. The payment amount is established by the Board of Trustees, and is adjusted from time-to-time. This initial Self-Payment must include the COBRA payments due from the date you lost coverage through the end of the last full month before you pay. (This could mean payment for more than one month of coverage is due at one time.) Before the end of the grace period, which is the 30th of the month in which you pay, you must submit payment for that month. Subsequent payments are due on the first day of the coverage month. All payments must be made by check timely sent to the COBRA Administrator.

Q.

Whom should I call if I have questions about my Health Care eligibility?

A.

Please contact the Trust Office, Eligibility Department (888) 867-9510

Q.

Who are my eligible dependents?

A.

a. The Participant’s lawful spouse.

B. The Participant’s children, as follows:

-biological or adopted (and placed for adoption) children and stepchildren, age 25 and younger;

-grandchildren for whom the Participant has, by reason of a State Court order, full financial responsibility and permanent legal custody, age 25 and younger; and

-biological or adopted (and placed for adoption) children, stepchildren, or grandchildren as described in (ii) above, age 26 or older, who are incapable of self-sustaining employment by reason of mental retardation or a physical handicap provided the Participant continues the child’s coverage under the Plan

Q.

Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?

A.

If you enroll them within 30 days of your initial eligibility and if you provide a marriage certificate (spouse) and birth certificates (children).

Children include your biological children, adopted children, stepchildren and some grandchildren over whom you have permanent legal custody, age 25 and younger.

Q.

How do I add my new baby or spouse to my insurance plan?

A.

Contact the Trust Office, Eligibility Department (888)867-9510

You have 30 days to enroll your Dependents after you are first eligible for coverage. 

Enroll them during Open the Annual Enrollment.

Enroll them Mid-Year within 60 days of a qualifying event: Marriage, or of Other Coverage, or Birth/Adoption

To enroll your Dependent you must properly complete the Plan's Enrollment Form, and the Administrative Office must receive your completed Form within the time limits described above.

Q.

Whom should I contact if I'm getting a divorce and what documents do I need to submit?

A.

Please contact the Trust Office, Eligibility Department (888) 867-9510

Q.

How do I obtain a replacement Medical and Prescription Card?

A.

Please contact the Trust Office, Eligibility Department (888) 867-9510

Q.

How do I inquire about the status of my medical claim?

A.

Please contact the Trust Office, Member Services Department (888) 867-9510

Q.

Who is the Prescription Drug Benefit Manager?

A.

Sav-RX

Q.

How can I contact the Prescription Drug Benefit Manager?

A.

Please call (888) 662-4766.

Q.

If a service I need requires Prior Authorization, who do I (or my provider) contact?

A.

Please contact Cigna at (800) 768-4695.

Q.

If I need to utilize Mental Health or Substance Abuse benefits, who do I contact?

A.

Contact Cigna at (800) 768-4695 for pre-cert for inpatient, rehabilitation, residential treatment, licensed substance abuse treatment center, intensive outpatient substance abuse or mental health services

Q.

How do I find a dentist?

A.

Contact Cigna at Cigna Dental (800) 768-4695 or visit their website at www.cignasharedadministration.com

Q.

If I have Medicare, who does my provider submit the claim to?

A.

BeneSys

PO Box 240127

Apple Valley, MN 55124

Q.

Who are my Vision benefits through and how can I contact them?

A.

Contact BeneSys at (801) 904-4897 or at Toll Free (888) 867-9510. Please also see the Health Care page of this site.

Q.

Eligibility: How do I become eligible for Disability Benefits. 

A.

New employees are eligible to participate in the Plan two months after they earn 360 Hours of Work within 4 consecutive months. Hours of Work in excess of 360 are credited to the Active Employee's hour bank following initial eligibility.

Q.

Does the fund offer any extensions? 

A.

No, the fund does not offer any extensions.

Q.

How much does the Disability Benefit Pay per week? 

A.

The disability benefit pays $350.00 per week.

Q.

How long can I collect a Disability Benefit? 

A.

Disability benefits can be collected for 21 weeks.

Q.

How is the Health Reimbursement Account money deposited into my account? 

A.

You are eligible for reimbursement from your HRA once you have received contributions in the amount of $120.00.

Q.

Is there a minimum reimbursement amount?

A.

No, there is no minimum.

Q.

Can I use the PCA reimbursement account for Self payments? What about COBRA? 

A.

Yes, both are acceptable.

Q.

Is the a filing limit? 

A.

Claims must be filed within 90 days from the Date of Service.

Q.

Can I lose my balance? 

A.

Your HRA balance will be eliminated if you are not available for  Covered Employment or, if you are a Retiree, under age 65, and you have lost eligibility for Retiree Coverage because you work for an employer that does not have a Written Agreement with the Plan. if your HRA is terminated it is also not available for your Dependents' medical care expenses and can never be reinstated.