Yes. The Local 705 I. B. T. Health & Welfare Plan is a self-insured plan that leases the Blue Cross Blue Shield PPO Network.
How do I find a medical service provider?
Does the Plan automatically cover my dependents? Do I pay separately for them?
Once you meet the eligibility requirements, the Health & Welfare Plan will cover your qualified dependents at no additional charge to you.
How do I add a new dependent to my coverage?
Contact the Fund Office at 312-738-2811 to add a dependent. You will be required to complete an Enrollment/Dependent card and provide the required documents.
If my spouse is employed and has insurance, who pays first?
In most situations, the person that holds the insurance is primary.
Who is primary for our children?
The Plan that covers the parent whose date of birth occurs earlier in the calendar year, excluding the year of birth, is primary.
If I’m divorced who covers the children?
The divorce decree would usually indicate that information.
Do I need to contact someone if I am hospitalized?
Yes. You or your physician must notify Utilization Management (UM) at 800-441-7705 whenever you or a dependent is hospitalized. In case of an emergency admission, UM must be notified by the next business day after the emergency.
You must also notify UM for outpatient tests, procedures and any durable medical equipment that is ordered by your doctor.
Does the Plan cover chiropractic services?
A chiropractic benefit is available for the Participant and Dependent Spouse only. The Plan allows up to $100.00 per visit for active or corrective therapy. Maintenance care is not covered.
Who do I contact if I need mental health or substance abuse care?
Contact ComPsych at 800-444-4281.
How do I file a claim for benefits?
Medical claims must be sent by the provider to Blue Cross Blue Shield. Dental and Vision claims may be sent directly to the Health & Welfare Fund Office.
How do I fill a prescription? Do I have to go to CVS?
You may fill a short-term prescription using your prescription drug card at most major chain pharmacies with the exception of Walgreens, Wal-Mart and Sam’s Club. Maintenance (long-term) medication must be filled at a CVS Pharmacy or through the CVS/Caremark Mail Order Service.
Do I have to use the mail order program for prescription refills?
No. Mail order is an option, not a requirement. The Fund allows you to receive refills of up to a 90 day supply at your local CVS Pharmacy.
How do I find a dentist in the PPO network?
You may go to any dentist. However, to receive discounted rates for your dental care, contact the Dental Network of America at 866-522-6758 or log onto www.dnoa.com to find a participating provider near you.
How often can I get my teeth cleaned?
The Plan allows for one routine oral exam and cleaning every 6 months. Please note that the time in-between your routine exam and cleaning must be at least exactly 6 months, otherwise the claim will not be payable under the Plan.
Is surgery to remove wisdom teeth covered under the dental plan?
Yes. Oral surgery is paid as General Dental Services subject to the dental deductible.
Are dentures covered?
Yes. Dentures are considered a Major Dental Service.
Where can I go for an eye exam and for glasses or contact lenses?
You may go to any vision service provider with the exception of Wal-Mart or Sam’s Club.
What does my vision benefit cover?
The Plan covers eligible expenses up to $300 per person each year for the participant and any dependent over the age of 18. For dependents 18 and under, the Plan covers one complete vision exam per calendar year, plus either glasses or an annual supply of contact lenses.
I had to pay for my vision exam, glasses, etc. How do I get reimbursed?
You must send your original, detailed, itemized bill and paid receipt to the Fund Office for reimbursement.
Do I have to pay up front for my vision care or can my doctor send a bill to the Health & Welfare Fund?
Many vision service providers require payment at the time services are rendered. However, if your vision provider is able to bill the Fund, the Fund will reimburse your provider directly.
When do I become eligible for health and welfare coverage under the Plan?
You become eligible for benefits on the first day of the month immediately following the receipt of one full month of employer contributions on your behalf.
When do my dependents become eligible for benefits?
Generally, your dependents (spouse and children) become eligible for coverage on the date you become eligible, or, if later, on the date you acquire a covered dependent (through marriage, birth, adoption, etc.).
When does my coverage end?
Once you are covered under the Plan, you and your eligible dependents will be eligible until the end of the month in which less than a full month of contributions are made on your behalf.
Until what age are my children eligible for coverage?
Your children are eligible for coverage until the age of 26.
What happens after my coverage ends?
When your coverage ends, you may be able to continue coverage by making self-payments or by electing COBRA Continuation Coverage.
What does it cost for COBRA Continuation Coverage?
Effective January 1, 2023, the Level I rate for COBRA Continuation Coverage is $1,704 per month for medical and prescription coverage and $1,845 per month for medical, prescription, dental and vision coverage. Effective January 1, 2023, the US Foods’ rate for COBRA Continuation Coverage is $1,816 per month for medical and prescription coverage and $1,957 per month for medical, prescription, dental and vision coverage.
Is retiree medical coverage available under the Plan?
Yes. Generally, you are eligible for retiree coverage under the Plan at any age (before you are eligible for Medicare) if when you retire from industry employment you:
- Have been in covered employment under the Local 705 IBT Health & Welfare Plan for the three-consecutive-month-period immediately before retiring; and
- Have at least:
- 20 years of benefit service and are receiving a pension from the Local 705 IBT Pension Plan; or
- 20 years of covered employment under the Health & Welfare Plan.
What is the cost for retiree medical coverage?
Effective July 1, 2013, the cost for retiree medical coverage is $386 per month for the participant and $193 per month for each additional dependent.
When does the retiree medical coverage terminate?
- Age 65.
- When you become eligible for Medicare for any reason, including disability (you must notify the Fund Office immediately upon becoming Medicare eligible or you will be liable to reimburse the Fund any medical and prescription monies paid out on your behalf).
- The last day of the month for which the Retired Employee makes the required Self-Payment.
- The date the Trustees discontinue this Plan of Benefits.
- The date of the Retired Employee’s death.
What is the minimum amount of service I need to work in covered employment to get any pension service credit?
You earn one year of future benefit service for each calendar year in which you complete at least 50 weeks of covered employment. You may earn a partial year of future benefit service if you complete at least 22 weeks and less than 50 weeks of covered employment in a plan year.
How many years do I need to be vested for a pension benefit?
As of January 1, 1997, you become vested once you complete five years of vesting service. You earn one year of vesting service after you complete at least 22 weeks in a plan year. If you are no longer a participant, you are subject to the vesting provisions in effect at the time you left covered employment.
How do I apply to commence payment of my pension benefits?
No more than six (6) months before your pension eligibility date, you should contact the Pension Fund office for an Application to Commence Payment of Pension Benefits.
What types of pensions are there?
There are six types of pensions. They are Service Pensions, Normal Pensions, Early Pensions, Deferred Vested Pensions, Disability Pensions and Reciprocal Pensions which are described in the Pension Plan’s Summary Plan Description.
What types of payment options are there?
Generally, if you are unmarried when you retire, you will receive a life only pension. A life only pension pays a monthly pension to you for your lifetime. When you die, your pension stops.
If you are married when you retire, your benefit will be paid in the 50% Joint and Survivor basis unless you elect one of the following payment options with your spouse’s consent:
- Life only pension (if you have less than 20 years of benefit service)
- 50% joint and survivor pension
- 50% joint and survivor pension with pop-up
- 75% joint and survivor pension with pop-up
- 100% joint and survivor pension with pop-up
- Life only with post-retirement death benefit (not available for deferred vested pensions or normal or early pensions if you have less than 20 years of benefit service)
These options are described in the Pension Plan’s Summary Plan Description.
What are the advantages of direct deposit of my pension benefit?
Electronic Funds Transfer (“EFT”) direct deposit of your monthly pension payments is a method of payment of your pension benefit. It deposits funds to your bank account via computer, eliminating postal service delays and the potential for lost checks. EFT is recognized as the most secure and convenient means of receiving recurring monthly benefit payments.
Am I able to work after I retire and do I have to notify the Pension Fund of my re-employment?
Yes, you are able to work after retirement as long as you are not engaged in Industry Related Employment. Under Pension Plan provisions, a participant must notify the Administrator if he or she returns to work for determination of whether a specific contemplated employment would be considered prohibited Industry Employment.
What is a break in service?
A Plan year in which you have less than 11 weeks of covered employment is considered a break year.
Can I lose any pension benefit service if I have a break in service?
If your break in service occurred prior to 1976, your prior vesting service and benefit service are canceled if you were not vested in the Plan before your break if you have two or more consecutive break years. If your break in service occurred after 1976, your prior vesting service and benefit service are canceled if you were not vested in the Plan before your break and your consecutive break years equal or exceed your prior years of vesting service. There are some exceptions which are explained in the Pension Plan’s Summary Plan Description.
What if I die before I retire and commence my pension benefit?
In the event of your death after you are vested for a pension benefit, your eligible spouse may be eligible to receive a monthly pension. Your spouse would receive the 50% joint and survivor form of payment that he/she would have received if this form was elected. See the Pension Plan’s Summary Plan Description for more details.
Do my survivors receive a death benefit when I die?
The Plan may provide a $1,000 death benefit that will be payable upon your death if you meet the eligibility requirements. These are explained in the Pension Plan’s Summary Plan Description.
How do I commence my pension benefit if I become disabled?
If you become totally and permanently disabled, you may qualify for a Disability Pension as long as you have at least 15 years of benefit service before your disability begins, your disability continues for at least 26 weeks after your covered employment ends and, you apply for a disability pension in writing within seven months of your disability. You must have become disabled while in covered employment and apply for Social Security Disability. See the Pension Plan’s Summary Plan Description for more information.
What happens if I get divorced and my ex-spouse is entitled to a portion of my pension?
If you divorce before or after retirement, your spouse may be entitled to receive a portion of your pension benefit in accordance with the terms of a Qualified Domestic Relations Order (“QDRO”). A QDRO may affect the amount of pension benefit you will receive or are receiving.
What is a Qualified Domestic Relations Order?
A Qualified Domestic Relations Order is a domestic relations order that creates or recognizes the existence of an alternate payee’s right to receive, or assigns to an alternate payee the right to receive, all or a portion of the benefits payable with respect to a participant under a pension plan, and that includes certain information and meets certain other requirements.
What is a Domestic Relations Order?
A domestic relations order is a judgment, decree, or order (including the approval of a property settlement) that is made pursuant to state domestic relations law (including community property law) and that relates to the provision of child support, alimony payments, or marital property rights for the benefit of a spouse, former spouse, child, or other dependent of a participant.
A state authority, generally a court, must actually issue a judgment, order, or decree or otherwise formally approve a property settlement agreement before it can be a domestic relations order under ERISA. The mere fact that a property settlement is agreed to and signed by the parties will not, in and of itself, cause the agreement to be a domestic relations order.
For information on QDRO preparation and for a model QDRO, contact the Fund Office.
If you have a question that is not listed here, please contact us using the form below, or call the Fund Office (312) 738-2811.