Saturday, July 11, 2020

Frequently Asked Health Care Questions


Q.

How do I get in touch with the Trust Office?

A.

You can call us Monday through Friday 8:00am-6:00pm MT at (208) 288-1610 or Toll Free (800) 808-1687.

Q.

When do I first become eligible for coverage?

A.

To first become eligible, you must work at least 300 covered hours within no more than five (5) consecutive months. After a one-month lag 140 hours are deducted from your hour bank.

Q.

How do I maintain my coverage?

A.

140 covered hours are required in each month to continue coverage. Amounts over that will remain in your hour bank up to 560 hours. If you do not have enough hours, you have the option to continue coverage by making timely payments to the Trust Office. If you have questions about maintaining your coverage or how to make a payment, please call us at (208) 288-1610 or Toll Free (800) 808-1687.

Q.

Where can I obtain and submit a health plan enrollment form?

A.

You may obtain an enrollment form on the Health Care Documents page of this website or by contacting the Trust Office at (208) 288-1610 or Toll Free (800) 808-1687. Send the completed form to PMB #116, 5331 SW Macadam Avenue, Suite 258, Portland, OR 97239. Please be sure to include a copy of your marriage certificate if you are adding a spouse and birth certificates for adding children.

Q.

How do I know if I am eligible for health coverage this month?

A.

You can call the Trust Office at 208.288.1610 or Toll Free (800) 808-1687, Monday through Friday 7:00 am – 6:00 pm Mountain Time.

Q.

I am moving. How should I provide my new address?

A.

You can complete a change of address by completing a H&W Plan Change Form found on the Health Care Documents page of this website and send the completed form to the Trust Office at PMB #116, 5331 SW Macadam Avenue, Suite 258, Portland, OR 97239 or Fax to (208) 288-1670.

Q.

We just had a baby. How do I enroll my newborn in the health plan?

A.

To enroll your newborn, complete the H&W Plan Enrollment Form found on the Health Care Documents page of this website within 60 days of your baby’s birth and send the completed form to the Trust Office at PMB #116, 5331 SW Macadam Avenue, Suite 258, Portland, OR 97239 or fax to (208) 288-1670. You may have an additional 30 days to submit the legal documentation (birth certificate).

Q.

I am getting married. How do I add my new spouse to my health coverage?

A.

To enroll your new spouse, complete the H&W Plan Enrollment Form found on the Health Care Documents page of this website within 60 days of your date of marriage and send the completed form to the Trust Office at PMB #116, 5331 SW Macadam Avenue, Suite 258, Portland, OR 97239 or fax to (208) 288-1670. You may have an additional 30 days to submit the legal documentation (marriage certificate).

Q.

What do I do if I get a divorce?

A.

You must notify the Trust Office immediately in the event of your divorce. Any benefit payments made by the Plan on behalf of an ineligible Dependent will be your responsibility. Failure to notify the Trust Office of a divorce will be considered an omission that constitutes fraud and an intentional misrepresentation of a material fact that is prohibited by the terms of the Plan. If you do not notify the Trust office of your divorce, the Plan may recover any payments made for claims incurred by your former spouse after your divorce.

Q.

I lost my ID card. Where can I get a replacement?

A.

Call Blue Cross of Idaho at (208) 331-7347 or Toll Free (800) 627-1188 for your Medical, Dental, Vision ID Card or go to their website at www.bcidaho.com to order a replacement card. Call OptumRx at (800) 797-9791 to order a replacement card for prescriptions.

Q.

How much is my Health Plan deductible?

A.

Please refer to the Summary Plan Description found on the Health Care Documents page of this website for your current deductible and out of pocket maximum.

Q.

How do I find a doctor?

A.

You can find an in-network doctor on the Blue Cross of Idaho website www.bcidaho.com or by calling BlueCard Network Access at (800) 810-2583 for network providers outside of Idaho.

Q.

Do I have to use an in-network doctor?

A.

If you use an out of network provider, your claims will be paid at a different percentage rate (See page 20-21 of the Summary Plan Description) for Medical Benefit Highlights.

Q.

Where can I fill my prescription?

A.

OptumRx provides a network of participating retail pharmacies and the mail order pharmacy program. To view a complete list of participating pharmacies, visit the OptumRx website at www.optumrx.com or by calling the OptumRx Help Desk (800) 797-9791.

Q.

How do I find a dentist?

A.

You can find an in-network dentist on the Blue Cross of Idaho website www.bcidaho.com or by calling BlueCard Network Access at (800) 810-2583 for network providers outside of Idaho.

Q.

How do I find a vision provider?

A.

You can find an in-network vision doctor on the Blue Cross of Idaho website www.bcidaho.com. or by calling BlueCard Network Access at (800) 810-2583 for network providers outside of Idaho. The website will link you to VSP for the in-network vision providers.

Q.

I have been covered on the Plan for a while: will my dependents automatically remain covered as long as I am?

A.

The Trust office will mail an Annual Enrollment Form to you in October. You must complete, sign and return the annual form to the Administrative Office no later than November 30th each year in order for your dependents to be covered in the next calendar year.

Q.

My spouse is becoming eligible for her employer’s insurance plan next month, should she enroll on that coverage or can she just stay on my coverage?

A.

If your spouse works at least 20 hours per week or 80 hours per month and has group health coverage available through an employer but does not elect that coverage, your Spouse will not be considered an Eligible dependent on the IPTT Plan. This applies whether or not your Spouse must pay for the other coverage. You are required to notify the trust of any changes in your dependent’s eligibility for or enrollment in another plan by completing the appropriate enrollment form. For reporting health coverage availability or enrollment, please complete the Health & Welfare Plan Change Form located on the Heath Care Documents page of this website. For more information please refer to page 8 of the Summary Plan Description.