HEALTH COVERAGE TAX DOCUMENTS
OF RIGHT TO REQUEST TAX NOTIFICATION FORM 1095-B
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:
Ohio Plumbers and Pipefitters Healthcare Plan, 7570 Caple Boulevard,
Suite B, Northwood, Ohio 43619
Email Address: firstname.lastname@example.org
Home Test Kit Coverage through the Welfare Plan
Effective January 15, 2022 Active and Early
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 www.optumrx.com 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.
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.
receipts for OTC COVID-19 test kits purchased at other pharmacies to Optum Rx
for direct member reimbursement.
of the method, a limit of 8 tests per covered individual, per month will be
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 www.COVIDtests.gov, 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
Participant Website has been enhanced to allow all participating members
to register and create an account directly on the website!
CORONA VIRUS MICROSITE
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.
– understanding different types of stress and their effects, plus practical
tools and information regarding healthy habits and coping skills.
Stress” webinar – discover steps every
caregiver can take to preserve their health and wellbeing.
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:
COVID-19 TESTING AND SCREENING
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
YOU KNOW YOUR PLAN HAS EXCLUSIVE PRICING FOR JOINT REPLACEMENT?
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.
FOR EVERY DAY ISSUES IN YOUR WORKLIFE OR HOME?
SupportLinc - www.supportlinc.com
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
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.
ADDRESS FOR BENNY CARD AND SCRA CLAIMS
Effective immediately you can submit
your Benny Card substantiation documents and claims for your Supplemental
Credit Reimbursement Account (SCRA) via e-mail to email@example.com.