Present your pay-direct card to your dental office receptionist when you arrive for your appointment. When you are eligible, you will be notified by the Trust Fund Administrator, Compusys of Utah. Sault Marie and Toronto. Edit Information/Details. . Phone: 212 695-5206. Mercer Island, WA 98040. Please enable javascript to view this Very important changes to your emergency travel insurance. %PDF-1.6 % This number is pre-printed on the form. You must be a member in good standing of Local 721 on the date you retire; You must have been in good standing with Local 721 for at least 10 uninterrupted years immediately preceding your date of retirement;*, You were either working or were available for work under the jurisdiction of Local 721 or the Union, during the 12 months immediately preceding your date of retirement;**. Iron Workers Fund Office 15 and 424 Benefit Funds. professionals, any medical or dental facility, any insurance company or government body, and any other person or institutions to release relevant information to the Plan Administrator solely for the purpose of processing this claim. `EZ. ironworkers dental insurance - BigPapaSmokem; benefit calculation and disability eligibility - Ironworkers 798; Ironworkers Local Union No. Contact: Fully Effective Employees 161 Granite Avenue Administered by the Ontario Ironworkers/Rodmen Benefit Plan Administrators . Contact information can be found here. The Plan also provides insured benefits: life and accidental and dismemberment insurance. Member Paid Medical, Dental and RX Claims, may be submitted for direct reimbursement to: NW Ironworkers Health and Security Trust PO Box 34464 Seattle, WA 98124-1464. $65,304,291. VISIT US. You may receive a 34-day supply. NOTE: Dependents age 13 and older need to complete a Dependent PIN Request Form for online access. The Iron Workers tries to give you the good life. The Local 580 Insurance, Pension, Annuity, Vacation, Scholarship & Educational Funds have been organized under the Taft Hartley Act of 1947 and are managed by a Joint Board of Trustees consisting of both Union and Employer representatives who have an equal vote and who serve with unselfish dedication on behalf of the participants and their families. You must be prepared to prove that persons claimed as dependents are actually dependent upon you. www.fee-eap.com. Present your pay-direct card to your dental office receptionist when you arrive for your appointment. Example: If you begin working for a contributing employer in March and by the end of May, you have 175 hours reported from your employers. Youve worked 2400 hours in the 18-month work period immediately prior to the effective date. We, here at Local 580, have one of the finest Apprentice Programs as well as Journeyman upgrading programs in all of New York City.We are one of the oldest and proudest Labor Unions in New York with a history rich in tradition and experience. 501 W. 42nd St. 2nd Floor. The administration staff provides services for more than 5,000 active and retired plan members and their families. Part 3 also collects information about other Benefit or Insurance Plans that you may be eligible to co-ordinate a claim from. To book an appointment with a representative, please click here. Box 34203 There is no Deductible for orthodontic treatment. 17495 Hurley St, City of Industry, CA 91744, United States Local. Administered by Welfare & Pension Administration Service, Inc. 2023 Welfare & Pension Administration Service, Inc. Summary of Benefits and Coverage (SBC) and Glossary of Terms. ALL RIGHTS RESERVED. California Ironworkers Field Defined Contribution Pension Trust Fund; About; Forms; Plan Documents; Shop 509 . 29 Portland OR, and Union Local 86 Seattle WA. Retirees do not have Dental,other than one cleaning/exam per year, Weekly Accident and Sickness or Alternative Care coverage. Please refer to the SPD below or the copy supplied to you by the Fund Office for additional information on your Health & Welfare benefits. You should contact the Iron Workers Fund office at 617-265-3757 with questions on member eligibility, vision benefits, disability benefits and life insurance. Please contact us at [email protected] for assistance. THE IRONWORKERS LOCAL 764 BENEFIT TRUST FUND GROUP DENTAL CLAIM FORM . Organization. Any amounts for the Member that are not paid by the Members Plan can be submitted to the spouses plan for reimbursement. Counselors are available to address a wide range of personal issues including: Grief or loss, family conflict, marriage problems, divorce, parenting issues, difficulty at work, alcohol or drug abuse, financial or legal problems, eldercare or childcare issues, depression, trauma, stress, anxiety or other emotional issues. If you need to bring documentation or information to the office, there are drop boxes available at each of our office locations. If you werent able to use your pay-direct card and your dentist charged you for the full cost of the services provided, you can submit your claim for reimbursement using theDental Claimform. If you are an active employee, you are eligible to participate in the Medical, Dental, Vision, Prescription Drug, Alternative Care Benefit, Physical Exam, Home Health Care, Hearing, and Weekly Accident and Sickness benefits.To be considered an active employee you must work either a minimum of 600 hours per eligibility period, 1200 hours during the last two periods, or 2400 hours (beginning on the August 1,2008 eligibility period) over the last three periods. The Active Plan covers orthodontic treatment (including correction of malocclusion) up to a lifetime maximum per individual of $2,500. Street Address for Claims, Eligibility, and Pension. The Iron Workers District Council of New England Health and Welfare Fund provides benefits for you and your eligible dependents and it is a self-insured Fund. *If you do not meet Number 2 above (10 year union membership), you may be able to continue your benefits for up to 12 months by electing an Active member option. This web site provides details of Benefit Plans, but is not a legal document. This Plan describes benefits funded by the Trust: medical, prescription drug, dental, vision, hearing aid, and weekly disability benefits. Your coverage starts on the first day of the second month after you have a total of 100 bank hours in your hour-bank account (a total of 600 hours if you are a probationary member). We are excited to bring you many new features on this . If you become a member of a plan covered by a reciprocal agreement within 12 months of the last date contributions were made on your behalf directly to this Plan, you will continue to be a member of this Plan. Seattle, WA 98124-1203, WPAS, Inc. Information Needed to Complete the Form. Out of network providers: You will pay 40% of Reasonable and Customary charges after the yearly deductible has been met. All dental services performed on and after June 1, 2019, will be processed by Delta Dental of Ohio (Delta Dental). Your fully completed claim form and receipts can be emailed [email protected] faxed to (604) 299-8136 or mailed/dropped off to thePlan Administrator. You were covered for benefits as an Active member without interruption during the 12 months immediately preceding your date of retirement (this includes Active member pay-direct coverage under Option 1 and Option 2, but not Option 3); You must be receiving or be in the process of successfully applying for a monthly retirement benefit from the Ironworkers Local 721 (Rodmen) Pension Plan; You must, on an uninterrupted basis from your date of retirement, remain a member in good standing of Local 721 or the Union; You must make the required monthly contributions to the Administrators office on an uninterrupted basis. The contributions made on your behalf to the other plan will be transferred to this Plan. Delta Dental of Ohio will be the new dental network for the Plan going forward. In network providers: A $20 copayment per visit will apply, then the visit is paid at 100% of the PPO rate, no deductible applies. Your dentist must completePart 1 of the form. The Northwest Ironworkers Trust also provides health and annuity benefits to eligible members and dependents of Local Union No. The Health and Welfare Fund offers benefits and care from a network of doctors and hospitals through Cigna CareAllies and Tufts CareLink Health Plan. Powered by Union Labor Works. Welfare & Pension Administration Service, Inc. Premera Blue Cross (Washington and Alaska), Alcohol and Chemical Dependency Treatment Pre-Authorization, Pacific Northwest Ironworkers Federal Credit Union. Get your flu shot at an Albertsons, City Market, King Soopers or Safeway pharmacy, and the pharmacy will submit a claim for you. Dental examinations, scaling and cleaning of teeth or gums, up to twice in a calendar year; Dental X-rays, but not more than one, whether bitewing or full mouth, in a calendar year; Topical application of sodium fluoride or stannous fluoride, but only for Eligible Dependents under 15 years of age; and. IRONWORKERS LOCAL 433. ), Transparency in Coverage Machine Readable Files. Phone: (303) 623-5386 If you are a member of the Union or one of the Ontario Locals, you become a member of the Plan when you first work for an Employer who pays contributions to the Plan on your behalf. We are having trouble matching the information you entered during registration to our database. 1330 E. 1st Street Wichita, KS 67214 hToQ?v.cMW[d +m3QAfYCFI)iW!m[Dj(x;wOpsr $_41' A8T~ The Administrators' duties include the collection of employer contributions, the adjudication of extended health, vision, disability, dental, and travel medical assistance benefits, as well as life and accident insurance. Since you meet the requirement of working 100 hours for a contributing employer, you will become eligible for benefits under the Plan. This number is pre-printed on the form. Reimbursements are made according to a schedule. The SPD linked below describes benefits for Active Employees, Self-Pay Employees, and Retired Employees. In the event of any conflict between the contents of this web site and the actual Plans and contracts or regulations, the provisions outlined in those documents apply. Ironworkers work both indoors and outdoors, erecting and installing steel and iron parts in all kinds of large buildings, bridges and dams and are considered the most dangerous in the building trades, requiring great courage and skill. This is the Plan and Summary Plan Description for the Ironworkers Intermountain Health and Welfare Plan. Every union contract is different, from local to local and company to company, but if you join the union, you can typically expect: Want to fight back against the forces that have made middle class living harder and harder? The Plan provides coverage for a $30,000 Life Insurance policy and an additional $30,000 Accidental Death and Dismemberment Coverage policy. Continue. Submit all dental claims to: Iron Clad Insurance, 161 Granite Ave., Dorchester, MA 02124 Prescription Drugs/Mail Order Part 3 is for patient information whether that is yourself, your spouse, or one of your dependent children. Basic and Major Services combined have an annual maximum of $2,700. Completed forms should be forwarded to the Plan Administrator. View your Welfare, Pension, Annuity and Vacation fund information conveniently and securely, Access the Ironworkers DC of New England online remittance processing system, www.tuftshealthplan.com/carelink/ironworkers, Summary of Benefits & Coverage Active Plan, Summary of Benefits & Coverage Retiree Plan, Summary of Benefits & Coverage Cobra Plan, 2021 Womens Health & Cancer and Credibility Coverage Notice, Youve worked 600 hours in the six-month work period immediately prior to the effective date; or, Youve worked 1200 hours in the 12-month work period immediately prior to the effective date; or. 2d Enrolment Card and Beneficiary Designation, Long Term Disability Attending Physicians Statement, Pension Enrolment and Beneficiary Designation Form, Travel Medical Emergency Assistance Wallet Card/Statement of Benefits. Please see the General Information section for a description of Coordination of Benefits. Endodontic treatment, which includes root canal therapy; Anesthesia in connection with any Basic or Major Restorative Service; and. Use the Dental Claim form if youve paid your dentist the full cost of the services that are covered under the Plan and you wish to be reimbursed. If a Member or any eligible Dependents are entitled to receive similar benefits simultaneously under the Health & Welfare Plan or any other group insurance plan (including Provincial Plans), to prevent over payment, benefits payable under this Plan would be co-ordinated with the other Plan. IRONWORKERS LOCAL UNION NO. The spouses plan would be primarily responsible for the spouses claims and the claims of the children.