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Online Forms 2011 Enrollment Form   Address Change   Dependent Change and Beneficiary Change   Disability Income   Request ID Card   Coordination of Benefits Information   Student Status Update   Supplemental Life Insurance   Published Documents 2011 Plan Improvements Letter   Summary Plan Description 1-1-2010   Notice of Privacy Practices (HIPAA)   Women's Cancer Right Act Document   Links www.bcbsil.com   www.caremark.com   www.vsp.com   www.deltadentalil.com   www.eliteadmin.com   www.groupba.us   www.iuoe.org   www.cpfioue.org   Member Information Contact Us     KEEP YOUR INFORMATION CURRENT ON LOCAL 399'S FILES!  Do we have your Correct Beneficiary in our Files? The H&W Plan has a $10,000 death benefit. Active members of Local 399 have a $1,000 death benefit. If you want to be certain we have a correct and current beneficiary on our files, please call the Fund Office and inquire. If there is a change, we will have you complete a beneficiary change form and change  both the H&W and union beneficiary designation accordingly.    Have you enrolled your 18+ year old dependent child? If you did not acknowledge the mailing sent by H&W in May or ongoing reminders on this website, and neglected to enroll or continue to cover a child who is over the age of 18, call the Fund Office immediately. Full-time student status is no longer a requirement to carry your child over the age of 19 on the H&W Plan. The only requirement to keep your age 19-26 year old on the Plan is your signed affidavit form stating that this child does not have eligibility for their own employer based coverage. Local 399 H&W does not have an annual open enrollment period; if you miss this one-time opportunity, there is no other option for you to provide your adult dependent children with the H&W Plan coverage.   Click here to view/download Young Adult Eligibility Certification Form   Have you moved, changed phone numbers or home email address?  Dont overlook notifying the union and H&W of a change of address or phone number when you make these changes. An expired post office forwarding order can mean you do not receive H&W Plan information, Local 399 Newsletters, Explanation of Benefit statements and other mailings. Keep us informed!   ______________________________________________________________________   IMPORTANT NOTICE ABOUT SIGNIFICANT PLAN IMPROVEMENTS    Click here to download a copy of the Plan Improvements letter   _______________________________________________________________________ DBM Dia-Tri Radiology Network We continue to encourage you to use the radiology network endorsed by the Plan.   If you are having a diagnostic imaging test, such as a CT scan, or an MRI, please call DBM at 800 331 5720 and let them schedule your test at one of their contracted facilities near your home or work.   There are  excellent savings to both the Fund and you if you use this network for elective scans or MRIs.   If you are in an emergency situation, you will be directed by the physician or the hospital to a facility immediately.   But if you are handed a script for a test, and asked to schedule that test, you can call DBM DiaTri and they will take it from there.  Their network will consist of free-standing facilities that are not hospital based and as a result will have a lower billed charge.                                              Health & Welfare DIAGNOSTIC BENEFIT MANAGEMENT (DBM) Effective January 1, 2010 Click Here to View DBM Flyer __________________________________________________ Contact Numbers: H&W Fund Office Phone:  (312) 372-9870  Option 3 H&W Dedicated Fax Number:  (312) 842-0291 Click here for a H&W staff contact list For questions or issues on Medical Coverage, please call Elite Administration at (312) 243-1265 For questions or issues on Dental Coverage, please call Delta Dental at (800) 323-1743 For questions on Prescriptions, please call Caremark at (888) 727-0504 For questions or issues on Vision Coverage, please call VSP at (800) 877-7195 For scheduling an elective MRI or CT Scan please call DBM at (800) 331-5720 If you are a member needing assistance, please phone or e-mail the Health & Welfare Fund Office Staff.  BENEFIT SUMMARIES
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