IMPORTANT REMINDERS



INTRODUCING A NEW RADIOLOGY NETWORK – Local 399’s H&W Fund has contracted with a diagnostic imaging network called DBM (Diagnostic Benefit Management) effective January 1, 2010.  Their toll-free number is (800) 331-5720.

Providers in this network meet high credentialing standards for quality.  The imaging providers are mainly free-standing facilities rather than hospital outpatient departments.  There are over 150 DBM network facilities in the area and almost 4,000 network facilities nationwide.

The advantage to you is that the cost of the imaging test will be lower overall resulting in less out of pocket for you.  The contracted amounts charged for tests done through this network are less than a hospital, and there is no additional charge for interpreting the test from a radiologist.  Tests performed in these DBM facilities result in one global fee depending upon the exact test.  Benefits will be paid to DBM at the in-network benefit level of 90%, subject to deductible.

DBM does the scheduling in a facility convenient for you, helps you with questions, gets pre-authorization when applicable, notifies your physician when you are scheduled and provides the physician with the results.  Call DBM's toll-free number (800) 331-5720 to start the process.

These imaging tests, numbering about 2,000 per year, currently represent almost 10% of H&W Plan costs.  We anticipate this network to be a positive change to decrease costs and increase service to the plan participants.


IMPORTANT NEWS:  Plan Improvements Effective January 1, 2010

MEDICAL – Your lifetime plan maximum for medical claims has been increased from $1 million to $1.5 million.

PRESCRIPTION DRUGS – Your calendar year maximum for prescription drugs will be increased from $15,000 to $20,000.

DENTAL – Your benefit for removal of fully impacted teeth will no longer be applied to the dental calendar year maximum.  The claims will continue to be administered by Delta Dental and subject to all other plan provisions.  

 


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 COLLEGE STUDENT IN THE FAMILY?

 

If your son or daughter is between 19 and 23 and is a full-time student in an accredited educational institution - remember to send the Fund Office proof of their Spring, 2010 full-time enrollment in the first month of the semester.  Don't wait until your child needs a prescription or medical care to find out their coverage was suspended.  You may be able to use a national website to obtain ths document by going to:  www.studentclearinghouse.org.

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 New Wife?  New Baby?

Enroll a new spouse or new baby in the H&W Plan within 30 days. Download a Dependent Change Form from the Forms Resource page and mail or fax it to the Fund Office.  Mail or bring in your original marriage or birth certificate when received to complete the process.  Upon request, we will make a copy of your certificate and return the original document to you.

                                    
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Vision Plan

 

When making an appointment for new glasses, remember the H&W Fund contracts with VSP providers to provide you with the maximum vision benefits.  You are in the VSP system with your alternate ID number, NOT your Social Security Number.  You can find your alternate ID number on your BlueCross or Caremark ID card.

If you choose not to have your services with a VSP provider, you can still file an out-of-network paper claim form with your itemized bill to VSP for reimbursement of up to $150 out-of-network benefit.  Again, this claim form should show your alternate H&W number, NOT your Social Security Number.


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DIAGNOSTIC BENEFIT
MANAGEMENT (DBM)

Effective January 1, 2010



Click Here to View DBM Flyer

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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