Your Health Care Benefits
The Board of Trustees is pleased to welcome you to the new website for the Plumbers
and Pipefitters Union Local 525 Health and Welfare Trust Fund. Within this website,
you will now have access 24 hours a day, 7 days a week to commonly requested forms,
useful links, and frequently asked questions regarding your benefits provided by
the Plan. As always, please feel free to contact the Trust Fund Office at (702)
(844) 763-3228 if you have any additional questions or concerns.
There are basically two types of Medical Plans available to the Plumbers and Pipefitters
Local 525 Health & Welfare Trust Fund participants, PPO or EPO. The options
are described briefly below. Detailed information regarding each plan can be obtained
on this website or by calling the Trust Fund office at (702) 415-2199
or (844) 763-3228.
Your medical benefit network is provided by Anthem Blue Cross Blue Shield. To get the most out of your
benefits, it is best to use a provider that participates in the Anthem network. If you are covered under the EPO Plan, you MUST use an Anthem provider or services will NOT be covered. To locate a participating provider, please log into www.Anthem.com or call the Trust Fund office for assistance. Remember: for the best benefits, when accessing
care you should always use an Anthem provider. For primary care services, EPO Participants MUST use the Collective Union Health clinics or services may not be covered.
PPO Medical Plan – To obtain the highest level
of benefits (In-Network), with the lowest out of pocket expenses, participants of
the PPO Plan should select Anthem contracted providers. The PPO Plan also provides benefits for
Non-Contracted provider services; however, they are paid at a lower percentage, leaving the
patient with higher out of pocket costs.
EPO Medical Plan for Non-Residential Employees (for the first one year of eligibility,
only the Residential EPO plan is available to Residential employees. After that, Employees, except Residential Employees,
may change to the PPO or EPO Non-Residential Plan if they have been covered under the current plan for at least 12 months.
If you are covered under
the EPO Plan, you and your dependents 3 years old and up must use the Collective Union Health clinic as your primary care provider. A referral is not needed for specialist care. You must use an Anthem provider or services will not be covered. For a list of providers, visit www.Anthem.com.
EPO Medical Plan Residential Employees – If you are covered under the EPO Plan, you and your dependents 3 years old and up must use the Collective Union Health clinic as your primary care provider. A referral is not needed for specialist care. You must use an Anthem provider or services will not be covered. For a list of providers, visit www.Anthem.com.
Retiree Benefits (available to retired employees receiving a pension benefit
from the Plumbers & Pipefitters Local 525 Pension Trust) –
Medicare Eligible – Medical and Prescription benefits for an eligible retired
Employee, who is not eligible for
Medicare, will be the same as benefits for Employees under the PPO or EPO Plan.
Medicare Eligible – When you
become eligible for Medicare, you have a choice of two medical plans, the PPO Medicare
or EPO Medicare Plan, which pays secondary to Medicare.
Your dental benefit network is provided by Cigna. Using a participating
provider that is contracted with Cigna will ensure that
you get the most out of your dental benefits provided by the Plan. To locate a participating
provider, please contact Cigna at (800) 877-7195 or
click on the Cigna link on the right side of the page to connect to
Your vision benefit network is Vision Service Plan (VSP). Using a provider that
participates with VSP will ensure that you get the most out of your vision benefits
provided by the Plan. To locate a participating provider or for questions regarding
your vision benefits and claims, please contact VSP at (800) 877-7195
or click on the VSP link on the right side of the page to connect to their website.
Life Insurance / Disability
As a member, you are offered basic life/accidental death and dismemberment (AD&D)
insurance and disability coverage. The information pertaining to these benefits
can be found on this website under the Health Care / Documents tab.
Indemnity Medical Prescription Benefits
Your Prescription Benefit Manager is Navitus. Using a participating pharmacy will
ensure that you get the most out of the pharmacy benefits provided by the Plan.
To locate a participating pharmacy, please contact Navitus at (855) 673-6504
or click on the Navitus link on the right side of the page.