Saturday, September 19, 2020

Frequently Asked Health Care Questions


Q.

Who is eligible to become a Participant in the Plan?

A.

Active Employees, Retirees, COBRA Participants, Eligible Dependents, Surviving Spouses

Q.

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

A.

Members are allowed to self-pay for the cost of the plan minus any contributions received

Q.

How do I maintain my monthly Health Care coverage?

A.

By the plan receiving monthly contributions from your employer for the cost of the plan selected

Q.

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

A.

You may mail a check or money order to: Ohio Bricklayers Health and Welfare Plan at PO Box 645652 Cincinnati, OH 45264-5652

Q.

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

A.

(248) 641-4921 or toll free (833) 289-4921

Q.

Who are my eligible dependents?

A.

Spouse, Domestic Partner, Natural child, Step-child, Adopted children

Q.

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

A.

Yes

Q.

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

A.

To add a new baby or spouse to your insurance plan, you must notify the Benefit Office within 30 days. You will not be permitted to add a new dependent to your insurance plan after 30 days and will be required to wait until next year’s open enrollment period. To add a spouse, the Benefit Office will need a copy of the state issued marriage certificate and for a new baby, a copy of the state issued birth certificate.

Q.

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

A.

The Benefit Office will need a copy of the full, court issued Divorce Decree

Q.

How do I obtain a replacement ID card for medical benefits?

A.

Call the Benefit Office at (248) 641-4921 or toll free at (833) 289-4921

Q.

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

A.

Precert is required for inpatient hospitalization and surgery Healthlink 877-284-0102

Q.

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

A.

Ohio Bricklayers Health and Welfare Plan 833-289-4921

Q.

Who are my Dental benefits through and how do I file a claim?

A.

Ohio Bricklayers Health and Welfare plan P.O. Box 1058 Troy MI 48099-1058

Q.

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

A.

Ohio Bricklayers Health and Welfare Plan P.O. Box 1058 Troy MI 48099-1058

Q.

Who are my Vision benefits through and how do I file a claim?

A.

Ohio Bricklayers Health and Welfare Plan P.O. Box 1058 Troy MI 48099-1058

Q.

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

A.

Ohio Bricklayers Health and Welfare Fund 833-289-4921

Q.

How can I find out the balance remaining in my Health Reimbursement Account?

A.

Contact the benefit office at  833-289-4921

Q.

How do I file a Health Reimbursement Claim?

A.

Reimbursement claims can be submitted via: Email: Flexclaims@benesys.com; Fax: 248-556-2597 or Direct Mail to: PO Box 99550 Troy, Mi 48099

Q.

How do I build my Health Reimbursement Account balance?

A.

After you have accumulated two months worth of the monthly rate for your health care coverage in your dollar bank. All additional funds will roll over into the Health Reimbursement Account.

Q.

How do I file a disability claim?

A.

Disability claims can be submitted via: Email: Stdisability@benesys.com; Fax: 248-556-2596 or Direct Mail to: PO Box 99550 Troy, MI 48099