Tuesday, June 18, 2024

Frequently Asked Health Care Questions


Q.

Who is eligible to become a Participant in the Plan?

A.

You, your legal spouse, children, step-children and adopted children

Q.

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

A.

If you do not maintain eligibility you will receive a cobra or self-pay notice advising of your continuation options.

Q.

How do I maintain my monthly Health Care coverage?

A.

Once you have earned initial eligibility, you will continue to earn three-month periods of eligibility called eligibility quarters. You will stay eligible as long as you work at least 400 hours per work quarter and the fund receives employer contributions for those hours. If you drop below hours in a work quarter, you can still be eligible if at least 800 hours of employer contributions have been made for you in the last two consecutive work quarters.

Q.

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

A.

Payment can be made to the fund office by check, money order or credit card.

Q.

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

A.

Contact the fund office at 410-872-9544.

Q.

Who are my eligible dependents?

A.

Your legal spouse, children, step-children and adopted children.

Q.

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

A.

Yes they will be covered.

Q.

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

A.

Provide the fund office with a copy of the birth certificate and social security card to add a newborn  on the plan permanently. The proof of birth will cover the child initially for 90 days. Provide the fund office with a copy of your marriage certificate to add a spouse to the account.

Q.

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

A.

Contact the fund office at 410-872-9544 to advise of your status change. You will need to provide a copy of your divorce decree.

Q.

How do I obtain a replacement Medical and Prescription Card?

A.

Contact the fund office at 410-872-9544

Q.

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

A.

Contact the claims department at 410-872-9544

Q.

Who is the Prescription Drug Benefit Manager?

A.

Prescription drug benefits are provided through CVS/Caremark.

Q.

How can I contact the Prescription Drug Benefit Manager?

A.

Contact CVS/Caremark at 1-866-282-8503.

Q.

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

A.

Contact American Health Holdings 800-641-5566.

Q.

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

A.

Contact the Fund Office at 410-872-9544.

Q.

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

A.Contact LaborFirst at 410-774-0560 or Toll-Free 855-347-0933.
Q.

Who are my Vision and Dental benefits through and how can I contact them?

A.

Vision and dental benefits are provided directly through the fund. Contact the fund office at 410-872-9544 for information on benefit levels and how to file a claim.