Tuesday, February 3, 2026

Frequently Asked Health Care - U.S. Plan Questions


Q.

Who is eligible to become a Participant in the Plan?

A.

You are eligible to participate in the Plan if you work for an Employer that is required to make contributions to the Health and Welfare Plan for the work you perform. For most Participants, this means working in a position covered by a Collective Bargaining Agreement between the Employer and the Union.

Q.

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

A.

If you fail to have the required employer contributions to continue Health Care coverage, you may be eligible to continue with COBRA Continuation Coverage. Please contact the Trust Fund Office at (702) 415-2189 or Toll Free at (855) 550-1696.

Q.

How do I maintain my monthly Health Care coverage?

A.

You must have employer contributions of a specified amount set by the Plan each MONTH, or elect COBRA Continuation Coverage to continue Health Care Coverage.

Q.

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

A.

You may make a self-payment to remain eligible for Health Care coverage through the COBRA Continuation or Retiree programs. You may mail your check or money order to:

United Brotherhood of Carpenters and Joiners of America General Office and Staff Health & Welfare Plan
PO Box 94465
City: Chicago
State/Province: IL
ZIP/Postal Code: 60690

Q.

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

A.

Please contact the Trust Fund Office at (702) 415-2189 or Toll Free at (855) 550-1696.

Q.

Who are my eligible dependents?

A.

  • Your lawful spouse
  • Your natural children up to age 26
  • Your legally adopted children up to age 26
  • Your step-children up to age 26
Q.

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

A.

Yes. Due to the new Healthcare Reform Act, dependent children are now eligible to remain covered until the age of 26, regardless of student status.

Q.

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

A.

You must submit legal documentation to the Trust Fund Office, along with a completed Enrollment Form. You can download the Enrollment Form off of this website located under "Forms" and mail it to the Trust Fund Office.

Legal documentation required:

  • Spouse - Copy of your certified marriage certificate
  • Natural/Step-Child - Copy of your child's certified birth certificate
  • Adopted Child - Copy of court order of adoption
Q.

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

A.

Please call the Trust Fund Office and advise the Eligibility and Pension Departments that you are in the process of getting a divorce or have already gotten divorced. You will also need to submit a FULL copy of your Dissolution of Marriage Judgment, QDRO (Qualified Domestic Relations Order) and child custody order assigned by the court.

Q.

How do I obtain a replacement Medical and Prescription Card?

A.

Please email or call the United Brotherhood of Carpenters and Joiners of America Benefit Office at staff@ubcbenefits.org or (855) 550-1696 to request a replacement card. Please provide us with your current mailing address.

Q.

How do I inquire about my eligibility, health care benefits and claims?

A.

You can log-in to this website with your username and password. After log-in, you can access your eligibility, healthcare benefits, and status of claims. If you need further assistance, you can email or call the United Brotherhood of Carpenters and Joiners of America Benefit Office at staff@ubcbenefits.org or (855) 550-1696.

Q.

Who is the Prescription Drug Benefit Vendor? What is their contact information?

A.

Express Scripts (800) 718-5910.

Q.

How do I find a physician or find out if my doctor is a preferred provider?

A.

Call BCBSIL (800) 810-2583 or visit www.bcbsil.com for a list of preferred providers.

Q.

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

A.

Call BCBSIL (800) 810-2583 or visit www.bcbsil.com for a listing of preferred providers. Prior authorization through BCBSIL (800) 851-7498 is required for inpatient services only.

Q.

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

A.

For medical care call BCBSIL (800) 433-3232; or for inpatient mental health and substance abuse services call BCBSIL (800) 851-7498.

Q.

How do I obtain a copy of my Explanation of Benefits (EOB) for a claim?

A.

You can log-in to this website with your user name and password. After log-in, go to Member Benefits and then click on Healthcare Claims. You are able to view the Explanation of Benefits (EOB) for each claim that has been received. If you need further assistance, you can email or call the United Brotherhood of Carpenters and Joiners of America Benefit Office at staff@ubcbenefits.org or (855) 550-1696.

Q.

What if I do not see the status of a claim I am checking on?

A.

One of the most common reasons for not being able to view claim status is the provider has not submitted the claim. This may be due to a wrong address to where the provider is submitting the claim. Or it may simply have to be re-submitted. You may call your provider of service and inform them that they may need to re-submit a particular claim.

Q.

How do I know the reason why a claim has not paid?

A.

You are able to view the Explanation of Benefits (EOB) for each claim that has been received. On the EOB, under Reason Code, it will explain the cause of why an entire claim or a single line item was denied. If you need further assistance, you can email or call the United Brotherhood of Carpenters and Joiners of America Benefit Office at staff@ubcbenefits.org or (855) 550-1696.

Q.

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

A.

When Medicare is primary, your provider will need to submit to Medicare first. After Medicare’s payment or denial, they will need to submit the claim and Medicare’s EOB to: United Brotherhood of Carpenters and Joiners of America General Office and Staff Health and Welfare Plan, P.O. Box 1618, San Ramon, CA 94583. You can inform your provider that Medicare claims may be received electronically through a Medicare Crossover Clearinghouse as well, if they do not wish to submit a paper claim.