Anthem Blue Cross Blue Shield

We are pleased to announce that your Health and Welfare Fund has developed a relationship with Anthem Blue Cross Blue Shield.  The implementation is effective April 1, 2009 and applies to all Active and Non-Medicare retired participants and dependents enrolled in the Plan.  As a result, the Fund will no longer have a contract with 4MOST for provider network discounts.

The following questions and answers were developed to make you aware of the effect of this relationship:

Why is the plan associating with Anthem Blue Cross Blue Shield?
Anthem offers the plan and its member's access to the BlueCard program.  This program electronically links all Blue Cross Blue Shield Plans and their providers - creating one large, national network.  The network includes more than 80 percent of the hospitals and 90 percent of the physicians in the United States.  And, the Fund and its members have access to them all.  This broader network provides better healthcare discounts that help keep your expenses down - lowers the amount you are responsible for related to coinsurance - and it helps the Fund control its overall claims cost.

When is the implementation effective?
The implementation is effective on April 1, 2009.  This means, if you receive medical care or treatment on or after April 1, 2009 you MUST use your new ID card with the Blue Cross/Blue Shield logo.

Were there any changes made to my benefits?
No.  There were no changes made to your benefits.  The plan of benefits under which you are covered will be exactly the same and will still be administered by the Fund Office.  (Anthem BCBS will not be paying your claims.)

When should I use my new ID card?
Use your new ID card for any medical services you receive on April 1, 2009 and after.  Make sure your provider makes a copy of your new ID card for their file.  Your Blue Cross Blue Shield member ID card is nationally recognized.  (Don't forget to destroy your old medical benefits ID card, as it will no longer be valid.  You do not need to destroy your Caremark Prescription Drug Card, although the new ID card also includes information about that program.)

When will I get my new ID card?
Two copies of your new ID card will be mailed to you near the end of the month.  The new cards will not be valid until April 1st.  DO NOT USE THE NEW CARD BEFORE April 1st.  (If you need additional cards, such as for a student away at college, please contact the Fund Office.)

Why did my ID card number change?
Your new ID card contains a unique member ID number and does not use your Social Security Number.  The change to a unique member ID number helps protect you against possible identity theft.

What up-front expenses will I be required to pay?
You are not required to pay for any services up front when using a participating provider.  Please notify the Fund Office should a participating provider request an up-front payment, such as we will work with Anthem to ensure the appropriate provider education is completed.

Can the participating providers bill me for the difference between what the Blue Plan reimburses and what the provider charges for covered services?
No.  The participating PPO providers cannot bill you for the difference between what the Plan reimburses and what the provider charges for covered health services.  You are only responsible for the plan copayments, deductible and coinsurance, just as you are today.

How do I file my claims?
Your Blue Cross Blue Shield provider will file your claims for you with the local Blue Cross Blue Shield Plan.  Also, many healthcare providers will file your claims with the local Blue Cross Blue Shield Plan, even if they are not participating in the network.

How do I file a claim if I elect to use a non-participating Blue Cross Blue Shield provider?
You are encouraged to use a participating provider so that you aren't required to pay for medical services up-front and so that you can take advantage of the Blue Cross Blue Shield negotiated provider discounts.  Claims should be sent to local Blue Cross Blue Shield Plan regardless of the provider's participation status.  If a non-participating provider won't file the claim for you, you are responsible for filing the claim.  Assistance with filing the claim will be provided by the Fund Office.

Will the plan notify me about how my claim was paid?
Yes, the Plan will provide you with an Explanation of Benefits (EOB), like we always have.

Whom do I contact if I have questions regarding my eligibility or benefits?
You will contact the Fund Office, just as you have in the past.  The customer service phone number is listed on the ID card.

Whom does my provider contact if they have questions regarding my eligibility or benefits?
Your provider can get eligibility and benefit information by dialing 1-800-676-BLUE (2583).