Find Answers to Frequently Asked Questions about Health
- What is my deductible period?
- July 1st through June 30th.
- What is my coinsurance period?
- July 1st through June 30th.
- What is COBRA?
COBRA (the Consolidated Omnibus Budget Reconciliation Act) is a federal law that requires group health plans to provide temporary continuation of group health coverage that otherwise might be terminated. For example:
- You lose or quit your job
- You divorce the employee
- The employee dies
- You are no longer covered as a dependent due to your age
- I am a new employee and just got a COBRA letter. What to do next?
- Initial COBRA notices are mailed to all new participants who recently gained Health coverage under the Trust. This notice explains your COBRA rights.
- Why am I still receiving COBRA?
- If you do not have enough contributions built up in your dollar bank for at least one additional month of coverage. The cobra election form gives you the option to self-pay for coverage in the months that you do not have coverage based on active employment. If you are currently working full time, you will probably have enough hours reported to continue your coverage without a break.
- What expenses do not apply to my coinsurance limit?
- Balance-billed charges, health care this plan doesn’t cover, vision services, alternative provider benefits, non-PPO coinsurance, expenses in excess of usual, customary and reasonable (UCR), benefits for foot orthotics, non PPO hospital copay and penalty and expenses in excess of Plan limits.
- What services must be pre-authorized?
- All in-patient hospital admissions (emergency admissions must be pre-authorized by the next business day following admission). Certain outpatient procedures also require pre-authorization. A complete list of those services can be found in the benefit booklet or by calling First Choice Health at the number below in the next Q&A.
- Who do I contact for pre-authorization?
- First Choice Health at 800-986-9156.
- Who is our preferred provider organization (PPO)?
- Premera Blue Cross (WA and AK), Blue Card-Blue Cross in all other States. (Does not apply to Medicare Retirees or Medicare eligible dependents.)
- Where can I find a preferred provider?
- Visit www.premera.com, login as a visitor and select the Heritage and Heritage Plus 1 option for WA & AK providers. Select Blue Card PPO option for all other states or call 800-810-2583.
- Where can I find my identification number?
- Your identification number is listed on your ID card. Your identification number begins with the letters EGN.
- I am a health provider, where do I submit claims?
Submit claims for any service by Premera contracted providers, or any provider in WA or AK:
Premera Blue Cross
P.O. Box 91059
Seattle, WA 98111-5159
Submit claims for services outside of WA or AK to the local Blue Cross Plan.
Submit member paid claims, dental and time loss claims:
IUOE Locals 302 & 612
P.O. Box 34684
Seattle, WA 98124-1684
- What do I do if I worked on the pipeline, but you have not received any of my health or pension contributions?
- The contributions are sent to the IUOE Pipeline Health & Welfare Fund and the Central Pension Fund.
- The member must contact the appropriate Fund office.
- The member is required to complete a transfer form, provided by that Fund. Only one form is required for the Health Fund. However, every time the member changes jobs they will be required to send a new form to the Central Pension Fund.
- IUOE Pipeline Health & Welfare, (888) 255-3863
- Central Pension Fund, (202) 362-1000
- What do I do if I worked in another local's jurisdiction, but NOT under a Keyman agreement?
- The member must contact the local that they are working in.
- The member is required to complete a reciprocity transfer form, provided by that local.
- The Administration Office will only accept health contributions from other locals signatory to the International Reciprocity agreement.
- What do I need to do to get coverage?
- You need to work the required number of hours and have contributions remitted by your employer(s) to meet the dollar bank eligibility requirements or your employer must remit the appropriate flat rate contribution if the CBA requires a flat rate rather than hourly payment.
- What do I need to do to get my dependents covered?
- Your dependents will be covered when you are. You must complete and submit an enrollment form listing your eligible dependents. You are required to provide documentation verifying your dependents’ eligibility and relationship to you, the subscriber. Acceptable forms of documentation include: marriage certificate, birth certificate, adoption decrees, legal guardianship orders, Qualified Medical Child Support Orders and/or parenting plans (if applicable).
- How do I add a spouse or child to my insurance coverage?
- Complete a new enrollment form to add new dependents. You are required to provide documentation verifying your dependents’ eligibility and relationship to you, the subscriber. Acceptable forms of documentation include: marriage certificate, birth certificate, adoption decrees, legal guardianship orders, Qualified Medical Child Support Orders and/or parenting plans (if applicable).
- How do I update my addresses or my dependents address?
- You may fill out a new enrollment form or submit the request in writing to the administration office to update addresses.
- Should my dependents have their own card with their name on it?
- No, dependents are on the data base but cards are not issued in their name, only the member's.
- How do I update my beneficiary for my Life insurance and Pension?
- You must fill out a new enrollment form to update beneficiary information.
- How do I update my hoist and shovel beneficiary?
- You must fill out a new hoist and shovel beneficiary form to update your beneficiary. You can contact the administration office for a form or download one from the website.
- How do I order a plan booklet (H&W and/or Pension)?
- You can either call or email the administration office for a booklet or they are available on the Trust website.