Optum Rx

Should you have any questions or need to order additional ID cards, you can contact OptumRx member services by calling (855) 295-9140.

Local 132 Trust Fund

You can contact IUOE Local Union 132 Trust Office by calling (800) 642-3525.

Anthem

You can contact Anthem BlueCross BlueShield member services by calling (800) 810-2583.

Message from the Trustees

NEW Anthem BC/BS ID Cards

On March 15, 2022, we mailed all eligible participants a new Anthem Blue Cross Blue Shield card.  There have been no changes to your benefits, however your Member ID number has changed.  You will need to present this ID card to your providers effective April 1, 2022.  There have been NO CHANGES to your Benefits.

Start using this card on and after April 1, 2022 and destroy your old cards.  If you need additional cards, please reach out to the Fund Office at (304) 525-0482 or 1-800-642-3525.

  1. When is this card effective?
    Your cards are effective Friday, April 1, 2022.  You should destroy your old cards and provide your new cards to your provider at your next visit.
  2. Were there any changes made to my benefits?
    No.  There were no changes made to your benefits.
  3. How do I know that my current provider participates in the Anthem PPO network or how can I locate a provider in the network?
    This process has not changed.  However, you can easily find a participating provider online at www.anthem.com or call 1-800-676-BLUE (2583).  The Anthem web site address and the phone number are located on the back of your new ID card.  You can also call your provider directly and ask if they participate in the Anthem PPO network.

 

Over-the-Counter In-Home COVID-19 Test Kits

Beginning January 15, 2022, the Health & Welfare Fund will cover the costs of at-home, over-the-counter (OTC) COVID-19 tests.  The tests must be FDA-approved or FDA-authorized OTC COVID tests.  The Plan will cover the full cost of the tests purchased during the public health emergency.  There is no cost-sharing to the participant or any type of pre-authorization, and a prescription or doctor’s order is not required.

Each individual eligible under the Plan is entitled to receive up to 8 tests per 30-day period or per calendar month.  For example, a family with two parents and two children could receive 32 tests per month, free of charge.  Also, there is guidance which clarifies that if there are multiple tests in a box, each test in the box counts toward the 8 per month maximum.  The tests must be purchased for the primary purpose of your individual diagnosis or treatment of COVID.  The Plan does not provide coverage of OTC COVID-19 tests that are for employment reasons. We have prepared the appropriate Claim Form for your convenience.

Get informed on COVID-19 vaccines

Recently, the United States Food and Drug Administration (FDA) issued emergency use authorization (EQU) for coronavirus vaccines from Pfizer/BioNTech and Moderna.  The Centers for Disease Control and Prevention (CDC) advisory committee also officially recommend the vaccines. OptumRx has prepared the included notice to assist with any questions you may have.

Remember, the Fund is committed to ensuring your benefits continue to support you and your loved ones during the coronavirus (COVID-19) health emergency.  A Summary of Material Modification (SMM) is attached detailing updated benefits for COVID-19 testing as well as important information below for your reference.  We encourage you to follow all local, state and national COVD-19 regulations, and the advice and practice tips offered by medical professionals.

 

Important Reminders about Your Benefits

Dental/Vision Care Benefit

The Board of Trustees are pleased to announce that due to the continued improvement in the financial standing of the Health & Welfare Fund, they have made the following benefit improvements at their most recent meeting.

Effective January 1, 2021, the maximum benefit which will be paid on behalf of a covered individual for expenses incurred in a calendar year has been increased from $750 to $1,500, reimbursed at 100%.

In regards to the pediatric dental/vision care benefit, if an eligible minor child(ren), age 19 or less, incurs expenses for dental or vision care services which are not covered under the Major Medical benefit, such expenses will be reimbursed at 100% of the first $1,500, then 50% thereafter.

Medical Benefits

The Plan covers preventive care at 100%, up to $1,000, when you go to an in-network or out-of-network provider. If you have been in close contact with someone with COVID-19 or you are a resident in a community where there is ongoing spread of COVID-19 and develop symptoms of COVID-19, call your doctor. Your provider will decide whether you need to be tested and, as the tests become more readily available, it is covered 100%. Keep in mind, there is no treatment for COVID-19 and people who are mildly ill may be able to isolate and care for themselves at home.

You can also use the Fund’s telehealth service – LiveHealth Online – for a consultation without leaving your home.  Sign up at www.livehealthonline.com and, if using a smartphone, download the app.  You will need the Subscriber ID number (including the three letter prefix that is printed on your Anthem ID card.

Prescription Drug Benefits

If possible, utilize OptumRx’s mail order pharmacy to save yourself a trip to the pharmacy.  You can do this by logging on to www.optumrx.com to register or call 1-855-295-9140.

Medical Treatment

Taking an active role in your own medical treatment may be one of the most important decisions of your life. It is essential for patients and doctors to be partners in health care and a good partnership with your doctor begins with open communication.

The American Society of Internal Medicine estimates that 70% of a correct diagnosis depends on what the patient tells their doctor. Simply making a list of questions before an office visit will improve communication by helping you to organize your thoughts and your doctor to clearly understand your concerns.

When you need to seek medical attention, be sure to check with Anthem Blue Cross Blue Shield, your primary Preferred Provider Organization (PPO), to see if they do participate.  Remember, Blue Cross Blue Shield providers have agreed to accept the allowable charges permitted for services.  This means they will not bill you the difference (any amount over the allowable charge).  Also, your Fund pays a higher percentage to PPO providers, which means, you will pay a lower copay, which saves you money.

Anthem Blue Cross Blue Shield

LiveHealth Online

Anthem’s LiveHealth Online can provide a video visit in minutes with a board-certified doctor 24/7 on your smartphone, tablet or computer with a webcam.  No appointment is needed.  Just go to livehealthonline.com or download the free app to register and get started.

The service is not intended to replace your usual health care providers.  Rather, this service has been added as a convenient supplemental product.

This is available to all eligible active participants at no cost to you.  Please note, when using this service, you will be required to enter your credit card information, as LiveHealth Online normally collects a member payment for an online doctor visit.  Remember, they will not charge your credit card.

If you have questions about how to use LiveHealth Online, you can call toll free at 1-888-LiveHealth (548-3432).