Friday, February 6, 2026

Frequently Asked Health Care Questions


Q. Who is eligible to become a Participant in the Plan?
A.

You are eligible to participate in the Plan if you work for an Employer that is required to make contributions to the Health and Welfare Plan for the work you perform and you accumulate 500 hours of covered work within a consecutive 12 month period.  For most Participants, this means working in a position covered by a Collective Bargaining Agreement between the Employer and the Union.

Initial eligibility is reached one you have worked your 500  hours and the Employer has reported those hours to Health and Welfare (H&W).  Once those hours are reported you would become eligible the 1st of the following month.  For example: you work your 500th hour on June 7th, hours are reported to H&W in July and your insurance coverage would begin August 1st.   
Q. What if I don’t work enough hours to gain eligibility for the month?
A. If you fail to have the required employer contributions to continue Health Care coverage, you may be eligible to make payment as a self-pay Employee directly to the Plan, or you may be eligible to continue with COBRA Continuation Coverage.  Please contact the Health & Welfare Fund office Toll Free at (844)568-6335 or (515) 207-3875, extension 5600 or 5601 .
Q. How do I maintain my monthly Health Care coverage after initial eligibility?
A. You must work at least 300 hours per contribution quarter or 1200 hours over the corresponding 12 month period, make payment as a self-pay Employee, or elect COBRA Continuation Coverage to continue Health Care coverage.
Q. How do I make a payment towards the continuation of my Health Care coverage?
A.

If you are in good-standing with Local 234, you will be allowed to make a self-payment to remain eligible for Health Coverage through the Retiree, Active, or COBRA Continuation programs.    A statement would be mailed the last day of the month to the most recent address on file with H&W.  It is your responsibility to update H&W with any address corrections.  If you fail to receipt your statement because of an incorrect address, your benefits will be cancelled due to non-payment.                    

Make Check Payable & Remit to:
                                                                      
Local 234 Health and Welfare Fund
4880 Hubbell Avenue, Suite 1
Des Moines, IA 50317                    

Q. Whom should I call if I have questions about my Health Care eligibility?
A. Please contact the Health & Welfare Fund office Toll Free at (844)568-6335 extension 5600 or 5601 or (515) 207-3875.
Q. Who are my eligible dependents?
A.
  • Your lawful spouse
  • Your natural children up to age 26
  • Your legally adopted children up to age 26
  • Your step-children up to age 26
Q. Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?
A. Yes. Due to the new Health Care Reform Act, dependent children are now eligible to remain on the coverage until the month they turn age 26, regardless of student status.                       
Q. How do I add my new baby or spouse to my insurance plan?
A. You must submit legal documentation to the Health & Welfare Fund office, along with a completed Vital Information Form. You can download the Vital Information Form from this website located under "Forms" and mail or fax it to the Health and Welfare office.

Forms Required Are:                  
  • Spouse - Photocopy of your state issued marriage certificate
  • Child - Photocopy of your child's state issued birth certificate.
  • Step-Child - Photocopy of step-child's state issued birth certificate along with a copy of a Divorce Decree or Custody Agreement.  If one is not available, contact the Health and Welfare office.                                 
  • Domestic Partner - Completed and notarized Common Law Affidavit Form
Q. Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A. Please call the Health and Welfare Fund office and advise the Eligibility Department that you are getting a divorce or have already gotten a divorce.  You will also need to submit a FULL copy of your final Dissolution of Marriage document to this office to remove your spouse from coverage.  This document is also required if there are dependent children involved to determine who is to maintain health coverage for the dependents.  If you fail to notify the H&W Office, you remain responsible for medical bills that are not paid by an ex-spouse AND it continues to cost your union for any medical claims.                     
Q. How do I obtain a replacement Medical and Prescription Card?
A.

Active members and pre-Medicare retirees,   contact Wellmark at (800) 524-9242; or www.wellmark.com

Medicare retirees,    contact Humana at (800) 733-9064; or www.humana.com
Q. Who is the Prescription Drug Benefit Manager?
A.

Active members and pre-Medicare retirees - Wellmark of Iowa

Medicare retirees - Humana
Q. How can I contact the Prescription Drug Benefit Manager?
A.

Active members and pre-Medicare Retirees Call (800) 524-9242 or visit www.wellmark.com

Medicare Retirees,   call (800) 733-9064 or visit www.humana.com
Q. If a service I need requires Prior Authorization, who do I (or my provider) contact?
A.

Active members and pre-Medicare retirees,    contact Wellmark at (800) 558-4409; or www.wellmark.com
Q. If I need to utilize Mental Health or Substance Abuse benefits, who do I contact?
A.

Active members and pre-Medicare retirees,   contact Wellmark at (800) 524-9242; or www.wellmark.com

Medicare Retirees,   contact Humana at (800) 733-9064; or www.humana.com
Q. How do I find a dentist or find out if my dentist participates with Wellmark Blue Dental?
A.

Refer to the online Blue Dental Provider Directory at www.wellmark.com or call the customer service number on your ID card.
Q. If I have a Medicare card and Humana insurance coverage, who does my provider submit the claim to?
A.

Providers should submit all claims directly to Humana.