Thursday, September 28, 2023

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  • Your Benefits Resourse



    In accordance with IRS Regulations, this notice is intended to provide you with information related to obtaining a copy of your IRS Form 1095-B from the Northwestern Ohio Plumbers and Pipefitters Healthcare Plan (the "Plan"). Form 1095-B provides you with information about your healthcare coverage, including who was covered, and when the coverage was in effect.

    You may request a copy of your Form 1095-B from the Plan via email, phone, or written request.  The Plan will mail you the form within 30 days of receiving your request, or email the form if you clearly indicate that you would like to receive the 1095-B electronically and provide a valid email address to send to. Please include your name and address in your request. The contact information to submit a request for Form 1095-B or for any questions you may have is:


     Northwestern Ohio Plumbers and Pipefitters Healthcare Plan, 7570 Caple Boulevard, Suite B, Northwood, Ohio 43619


    Email Address: 



    COVID-19 Home Test Kit Coverage through the Welfare Plan

        Effective January 15, 2022 Active and Early Retirees ONLY


    In response to the Biden Administration directive requiring group health care plans to provide coverage for over the counter (OTC), in-home COVID-19 diagnostic tests, the Northwestern Ohio Plumbers & Pipefitters Welfare Plans have taken the following steps:

    Beginning January 15, 2022, participants can obtain their FDA approved OTC at home tests under the Optum Rx pharmacy benefit with ZERO out of pocket cost.  Currently, ONLY Rite Aid, Walmart and Sam’s Club pharmacies are equipped to handle these point of service claims.  Optum Rx is expecting to expand this preferred pharmacy network in the coming weeks, details will be provided as soon as they are made available. 

    As an alternative, you may purchase FDA approved OTC at Home COVID-19 tests at any pharmacy and request direct member reimbursement from Optum Rx.  Forms are available at and the Benefit Office.  Tests purchased at other pharmacies will be reimbursed up to $12 per test.  If you order your test kits on-line, shipping costs will not be reimbursed.

     To summarize:

    ·     Use your Optum Rx Card at any Rite Aid, Walmart or Sam’s Club pharmacy to purchase your OTC COVID-19 test kit with $0 member out of pocket.

    ·    Submit receipts for OTC COVID-19 test kits purchased at other pharmacies to Optum Rx for direct member reimbursement.

    ·    Regardless of the method, a limit of 8 tests per covered individual, per month will be allowed.  


    FREE COVID-19 Home Tests through the Government Effective January 19, 2022   

    Every home in the U.S. will have the ability to order four at home COVID-19 tests at, beginning January 19, 2022.  These tests are FREE with no shipping costs and no credit card number required. Tests are expected to ship within 12 days of being ordered 


     Participant Website Enhancement  


    The Participant Website has been enhanced to allow all participating members to register and create an account directly on the website!



    The Employee Assistance Program (EAP) is offering beneficial new resources in assistance to members coping with the COVID-19 Pandemic via the Corona Virus Microsite.

    1. “Stress Management” webinar – understanding different types of stress and their effects, plus practical tools and information regarding healthy habits and coping skills.

    2. “Caregiver Stress” webinar – discover steps every caregiver can take to preserve their health and wellbeing. 

    3.  “Challenging Negative Thoughts” webinar – learn the impact of negative thinking and ways to identify, challenge and change these thoughts


    4.  Understanding Self-Quarantine tip sheet


    5. Receiving Home Deliveries During COVID-19 tip sheet


    Additions to the Microsite will continue throughout the pandemic so you'll receive regular updates to keep you informed. Resources can be accessed by clicking the following link:      





    There was some additional legislation passed (the CARES Act) that changed the cost-sharing requirements for COVID-19 Testing. See below:

    Claims for COVID-19 testing both in and out of network are provided to participants at zero cost-sharing for claims on or after January 27, 2020 (previously this was only effective starting on April 2, 2020).

    The list of permissible COVID-19 testing that is to be provided without cost-sharing includes not only FDA-approved tests, but tests that are pending FDA approval, tests that have been approved for use by the state, and tests that the Department of Health and Human Services has deemed appropriate. For Medicare prescription drug claims only, all Part-D covered drugs are available for up to a 90-day supply.

    Effective April 2, 2020 any screening and/or testing for COVID-19 completed in-network and out of network will be paid at 100% with no pre-approval or other medical management techniques necessary. This includes but is not limited to, the visit, associated lab testing and radiology services in an in-network and out of network hospital, emergency or urgent care setting, or medical office.  If a member receives a COVID-19 screen and/or test, all medical services that lead to the medical provider to administer the COVID-19 screen and/or test, will be paid at 100% both in-network and out-of-network. An example of such medical services that may lead a medical provider to administer a COVID-19 screen and/or test, may be a flu test with a negative reading that then leads the medical provider to administer a COVID-19 screen and/or test due to the similarity of the symptoms between the flu and COVID-19. 



    FrontPath, in partnership with the Joint Replacement Surgeons (‘JIS’) and White Fence Ambulatory Surgery Center (‘White Fence’) in New Albany, Ohio, provides FrontPath Members exclusive pricing arrangements and preferential scheduling for their surgical services.


    In order to access this exclusive savings opportunity, FrontPath Members’ Plan Participants must contact FrontPath Health Coalition (before seeking care) directly at 419-891-5206, option 5 to allow the Preferred Scheduling process to start. The folks at FrontPath and JIS will take it from there.  Keep in mind, that without simply making this quick & easy call, the additional savings and preferential scheduling opportunities could be lost.




    SupportLinc -

    Username:  nwopp50

    Password:  linc123  

    Hot Line 1 888 881 5462 

     24 hours a day - 7 days a week 


    Your healthcare Plan has an Employee Assistance Program, otherwise known as a behavioral health program. This is administered by CuraLinc Healthcare. This valuable benefit offers confidential, professional assistance for problems of concern to you and your immediate family members.  Your benefits through the SupportLinc include (but are not limited to) the following: 


    Short Term Counseling

    Legal Services

    Financial Services

    Dependent Care Referral Services


    In addition to in-person and telephonic services, a wide array of resources are available to you on the SupportLinc website.  Through this site, you and your family will have access to thousands of articles, tip sheets and videos covering a wide array of behavioral health and work-life topics. The site also contains child and elder care search engines, reference libraries, legal and financial resources, self-improvement programs and educational training modules. All requests for information or assistance through the program are a part of your benefits package, and held in strict confidence.  



    Effective immediately you can submit your Benny Card substantiation documents and claims for your Supplemental Credit Reimbursement Account (SCRA) via e-mail to


  • How do I add a new child or spouse as a dependent?
    If you acquire a new dependent from marriage, birth, adoption or placement for adoption, the dependent may become enrolled in the Plan as an eligible dependent if the Benefit Office is notified in writing within 30 days from the date of the marriage, birth, adoption or placement for adoption.
    If you do not notify the Benefit Office in writing during the 30-day Special Enrollment Period, coverage for your dependent will begin when you notify the Benefit Office in writing that you have acquired a dependent from marriage, birth, adoption or placement for adoption.  However, the coverage under the Plan will only be effective from the date the Benefit Office receives your written notification, NOT from the date of marriage, birth, adoption, or placement for adoption.    
    When do I become eligible for health benefits?
    You will be initially eligible for benefits beginning the month following the work month in which you completed the 160th hour worked in Covered Employment during two consecutive months.  
    What is a Plan Year?
    A Plan Year is a consecutive 12-month period running from January 1st to December 31st. The Fund uses Plan Years to determine many matters relating to the Plan.  
    Your Benefits Resource
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    Health Care
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    Retiree Health
    To view Documents and Forms please click here.
     Machine Readable Files - In-Network and Out-of-Network

     Click here to access In Network and Out of Network Machine Readable Files.   To access the files, under NW Ohio Plumbers, copy the locations for each of the files into your browser. The allowed_amount_file is the out of network file.

    For In-Network and OON files, please click here

    These links lead to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. 

     And for more specific questions, please Contact Us.

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