Saturday, July 11, 2020

Frequently Asked Health Care Questions


Q.

How do I get in touch with the Trust Office?

A.

 You can email us, call us or stop by Monday through Friday 8:30am-5:00pm PT.
 www.UA598benefits.org 1.800.205.7002  5331 SW Macadam  Ave., Suite 220, Portland, OR 97239

Q.

When do I first become eligible for coverage?

A.

You become eligible for coverage on the first day of the second month following the month in which your credited hours of employment, with one or more contributing employers, total four hundred-twenty (420) hours or more, within a four (4) consecutive calendar month period or less.  These first four hundred-twenty (420) hours will not be credited to your Dollar Bank.  After you have worked these four hundred-twenty (420) hours, the additional hours you work will be credited to your Dollar Bank. For more information, please contact the Trust Office at 1.800.205.7002.

Q.

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

A.

You may obtain an enrollment form here or by contacting the Trust Office at 1.800.205.7002. Send the completed form to PMB#116, 5331 SW Macadam Ave, 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 if you are adding children.

Q.

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

A.

Please call the Trust Office at 1.800.205.7002.  Real-time Eligibility information will be accessible via this website soon.  Once available, members will receive instructions on how to create accounts to view their personal information.

Q.

How do I maintain my coverage?

A.

Coverage is maintained when enough contributions have been submitted to the Trust Office. Your employer will contribute based on your hours worked, and 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 1.800.205.7002.

Q.

I’m not working at the moment. How do I continue my health plan coverage?

A.

You can continue coverage through COBRA. Contact the Trust office at 1.800.205.7002 for more details.

Q.

What happens if I don’t enroll in the Retiree Plan at the time of retirement?

A.

If your spouse maintains coverage under an employer-sponsored health plan, then your spouse or you and your spouse may waive coverage under this Plan at the time of your retirement.  If coverage is waived, you may become covered under this Plan again if you notify the Trust Office within 31 days of the date coverage under your spouse’s health plan is terminated.  You may waive your coverage on a one time basis only at the time of your retirement.

Q.

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

A.

You can complete an Address Change Form and send the completed form to the Trust Office at PMB#116, 5331 SW Macadam Ave., Suite 258, Portland, OR 97239 or Fax to 503.228.0149.

Q.

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

A.

To enroll your new spouse, complete the Enrollment Form within 90 days of the marriage send the completed from the Trust Office at PMB#116, 5331 SW Macadam Ave., Portland, OR 97239 or fax to 503.228.0149. If you wish to update your pension beneficiaries, contact NW Plan Services. Please remember to include a copy of your marriage certificate.

Q.

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

A.

To enroll your newborn, complete the Enrollment Form within 90 days of your baby’s birth and send the completed form, along with a copy of the birth certificate, to the Trust Office at PMB #116, 5331 SW Macadam Ave, Suite 258, Portland, Oregon 97239 or Fax to 503.228.0149.

Q.

What do I do if I get divorced?

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 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.  If you wish to update your pension beneficiaries, please contact NW Plan Services.

Q.

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

A.

Call the Trust Office at 1.800.205.7002 to get a replacement medical ID card.

Q.

Where can I fill my prescription?

A.

Caremark provides a network of participating retail pharmacies and the mail order pharmacy program.  To view a complete list of participating pharmacies visit the Caremark website at www.caremark.com

Q.

How do I find a doctor?

A.

You can find a doctor by visiting http://www.aetna.com and clicking on “Find a Doctor.” Then go to the bottom right and select “Search our Public Directory” or by calling 1.800.205.7002

Q.

How do I find a dentist?

A.

The Plan does not contract with a network of dental providers; so eligible participants may seek services from the licensed dentist of their choice.

Q.

How do I find a vision provider?

A.

Contact VSP to find a vision provider or visit the VSP website at www.vsp.com.

Q.

How much is my Health Plan deductible?

A.

Please refer to the Summary Plan Description for your current year deductible and out of pocket.

Q.

My doctor won’t bill the insurance company. How do I get reimbursed?

A.

Please obtain an itemized receipt from the service provider along with a claim form, found here or calling our office Toll-Free 1-800-205-7002. Send the claim form and itemized receipt to the Trust Office at PMB#116, 5331 SW Macadam Ave, Suite 258, Portland, Oregon 97239.

Q.

Who is eligible for an HRA?

A.

In order to be eligible for contributions to go to your HRA you must have health and welfare eligibility. You will remain an HRA participant as long as there is money in your HRA account. An Employee must have health and welfare coverage provided by the Plan as a prerequisite to having the HRA Contribution transferred to the HRA account.

Q.

What is an HRA and how does it work?

A.

If the eligibility requirements are met the Trust will establish a HRA account. The HRA accounts will be used to receive your HRA contributions and to reimburse you for medical care expenses incurred by you or a dependent.

Q.

What expenses are eligible under the HRA?

A.

The funds in your HRA can be used to pay for (or receive reimbursement for) the following eligible expenses:

  • Plan premiums (example: self payment, COBRA payment, Early or Medicare retiree)
  • Deductible & Co-pay for Medical, Dental, Prescription and Vision benefits for yourself and your covered dependents
  • Medical care expenses you pay for after having exhausted visit or dollar limits. For example, chiropractic visits over the 12 visit limit