Thursday, July 7, 2022

Frequently Asked Health Care Questions


Q.

Who is eligible to become a Participant in the Plan?

A.

Member, Spouse, Dependents

Q.

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

A.

You will lose eligibility for that month and have to meet initial eligibility requirements again.  

Q.

How do I maintain my monthly Health Care coverage?

A.

Part Time Single Coverage: At least 48 hours (4 Saturday month) or 60 hours (5 Saturday month) in two consecutive calendar months member eligible 1st day of month following.

Full Time Family Coverage: At least 48hrs per month (for 4 Saturday months but must work 60 hours if its a 5 Saturday month) AND at least 112hrs per month (140hrs if it is a 5 saturday month) in two of the three preceeding calendar months effective 1st day of month following.

Flat Rate: must work minimum number of covered hours within period of time required by CBA for rather full time or part time Employee. Effective first of month following.

D5 Tier A Hourly Owner - 160hrs per month required for eligibility

Q.

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

A.

Self payments for coverage are not accepted.  Cobra payments can be sent to Benesys PO Box 1613 Troy, MI 48099

Q.

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

A.

Benesys 800-621-5133

Q.

Who are my eligible dependents?

A.

Spouse, Domestic Partner, Children(Natural, Step, and Adopted)

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.

Call Benesys 800-621-5133 You will have to provide a birth certificate/Marriage License to enrollmentdocs@benesys.com

Q.

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

A.

Call Benesys 800-621-5133 You will have to provide a divorce decree to enrollmentdocs@benesys.com

Q.

How do I obtain a replacement Medical and Prescription Card?

A.

Prescription card call WellDyneRX 888-479-2000 Call BCBS of Illinois

Q.

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

A.

Call BCBS of Illinois

Q.

Who is the Prescription Drug Benefit Manager???

A.

Your prescription carrier us Welldyne RX

Q.

How can I contact the Prescription Drug Benefit Manager??

A.

You can contact WelldyneRX at (888) 479-2000

Q.

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

A.

Your provider would contact Active Health Management at (855) 210-8738.

Q.

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

A.

There are no stimulations for your mental health or substance abuse benefits.

Q.

How do I find a dentist or find out if my dentist participates with Careington Dental?

A.

You can find a participating dentist www.dnoa.com or, by calling the Dental Network of America Provider Finder phone number (866) 522-6758. 

Q.

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

A.

Vision benefits are self-funded through the UFCW. You may contact member service at (800) 621-5133 for benefit information.