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WHAT TO KNOW
24/7 Member
Assistance Program
Talk to a board-certified counselor privately and at no cost to you. Learn more.
Questions?
If you have any questions about your healthcare or benefits, contact our dedicated advocate team at Lacher!
ELIGIBILITY
If you meet the eligibility requirements of the Fund, you will be automatically enrolled in the NECA Local 313 IBEW Health & Welfare Plan. Your eligible dependents will be enrolled as soon as the required documentation is submitted.
If you do not enroll within 90 days of your initial eligibility period, you will not have an opportunity to do so until the next open enrollment period, unless you have a Qualifying Life Event.
Eligible dependents include: (1) Your legal spouse; and (2) Your children up to age 26. Only those dependents who meet the eligibility requirements can enroll for coverage.
ELIGIBILITY REQUIREMENTS
Initial Eligibility - You are eligible for coverage under the Plan on the first day of the Benefit Quarter after you’ve completed a total of 1,000 hours of work with one or more Contributing Employers during four consecutive Working Quarters.
RESERVE ACCOUNT
Hours you work in excess of 300 during a Working Quarter, up to 900, are credited to a Reserve Account in your name. This account helps you maintain eligibility. If you don't work 300 hours during a Working Quarter, hours that have been credited in your Reserve Account may be used to help you reach the 300-hour minimum, making you eligible for coverage during the next Benefit Quarter.
If your hours worked and Reserve Account don't total 300 hours, those hours will be used to reduce your cost to purchase continued coverage, or they will be cancelled.
Medical
MEDICAL
The medical plans are administered by Zenith American Solutions using the Aetna network (Choice POS II).
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Where can I find information for Retirees or Medicare?Click here.
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What events enable me to make benefit changes in the middle of the year?These events are called Qualified Life Events (QLE) and include things like a birth of child/adoption, marriage, loss of coverage elsewhere, and more. Click here to read about QLEs.
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How do I file an out-of-network vision claim?Please follow the instructions on this form.
-
What is GoodRx?Here's how you get started: Visit www.goodrx.com to search a prescription. Locate the pharmacy that is most convenient to you, offering the lowest price for your prescription. If a coupon is available, you can print it out and take it with you when you pick up your prescription to receive an immediate discount. NOTE: if you use a coupon, the total charge will not apply to your deductible. For even easier access, download the app!
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How do I get a new ID Card?Contact Zenith Welfare Eligibility at 302-761-1080 ext. 556513, or email LRutter@zenith-american.com, to request an ID card.
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Why did I get billed for my preventive care visit?While regular medical care focuses on treating illness, preventive care aims to keep you from getting sick in the first place by focusing on helping you maintain good health. When you visit your doctor for a preventive care service - like a physical exam or a health screening - you should not be billed. However, if you ask your doctor about a specific health concern while you are at your preventive care visit, it may be billed as an office visit, and not a preventive care visit. Here’s how to be sure your preventive care visit is free for you: Mention prevention upfront – When scheduling your appointment, confirm that you are scheduling a preventive care visit. Know what to discuss with your doctor during the visit – During your visit, keep the conversation focused on how you can maintain a healthy lifestyle. Ask your doctor - If you do ask questions about a specific health concern while at your visit, ask your doctor if that will be treated as an office visit or as a preventive visit. Let your doctor know you are expecting this visit to be of no charge to you. For more information about preventive care, contact your Lacher benefits advocate.
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Where can I read information about Medicare?Visit www.medicare.gov for information. Take this short survey to determine if you will automatically receive Medicare or if you will need to sign up. You can also click here to read a comprehensive overview of Medicare and its various parts.
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Do I need a referral to see a specialist?No. But keep in mind that the Plan offers in-network coverage only.
-
Where do I get an Explanation of Benefits (EOB)?For Medical: For copies of EOBs from Aetna for the Health and Welfare Fund, you can contact Zenith American Solutions at 1-302-761-1080. For Dental: Members can register online and print an EOB at Deltadentalins.com or call customer service at 1-800-932-0783.
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Where should I go for medical care?Take a look at this flyer to learn about your choices when it comes to where you should receive care. High level overview: Primary Care Physician - This is your home base. Your doctor knows your history and is a good place to start. Cost to you: $10 copay per visit. Emergency Room - Go to an ER when you have a life-threatening issue. Cost to you: $10 copay per visit if admitted. $100 copay if not admitted. Urgent Care - Consider an urgent care center for non-life threatening condition. You'll save time and money over the ER. Cost to you: $10 copay per visit. Telemedicine - Consider using Teladoc for non-life threatening conditions, and when you need 24/7 care. Cost to you: $0 Install the Teladoc App on your phone today!
-
Should I go to Quest or LabCorp?You may go to either Quest or LabCorp. Both options are available and are in-network.
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Full Vision plan detailsClick here for vision details
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Vision insurance carrier contact informationNational Vision Administrators 1-800-672-7723 www.e-nva.com
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Search for a Vision providerVisit www.e-nva.com/nva/content/home/find-provider.xhtml.
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Dental insurance carrier contact informationDelta Dental 1-800-932-0783 www.deltadental.com
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Search for a Dental providerClick here and select Delta Dental PPO. When you access dental care, you can simply let your provider know your social security number and your group number, which is 19941. Also, you may click here to download a guide.
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Full Dental plan detailsDental highlights Member booklet Stay connected - Download the Delta Dental App
-
Search for a Medical providerYour medical plan uses the Aetna Choice POS II network. Click here to find a provider.
-
Prescription medicine informationSav-Rx 866-233-4239 www.savrx.com Click here to learn about the enhanced patient portal. Medicare Eligible Prescription: UHC 866-691-9209 www.uhcretiree.com
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Insurance carrier contact informationMedical: Zenith: 302-761-1080 Welfare Eligibility: ext. 556513 Welfare Claims: ext. 556712 Pension Inquiries: ext. 556706
-
FormsSubmit Online Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form Print and Mail Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form
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Read your rights as a participantSummary Plan Document Summary of Material Modification Notice - COVID Amendment Summary of Material Modification Notice - Chiropractic and Physical Therapy Amendment Summary of Material Modification Notice - Teladoc Amendment HIPAA Privacy Notice Your Rights and Protections Against Surprise Medical Bills
DENTAL
This benefit is available if you want a little extra protection for those pearly whites. The Dental plan is administered by Delta Dental.
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Where can I find information for Retirees or Medicare?Click here.
-
What events enable me to make benefit changes in the middle of the year?These events are called Qualified Life Events (QLE) and include things like a birth of child/adoption, marriage, loss of coverage elsewhere, and more. Click here to read about QLEs.
-
How do I file an out-of-network vision claim?Please follow the instructions on this form.
-
What is GoodRx?Here's how you get started: Visit www.goodrx.com to search a prescription. Locate the pharmacy that is most convenient to you, offering the lowest price for your prescription. If a coupon is available, you can print it out and take it with you when you pick up your prescription to receive an immediate discount. NOTE: if you use a coupon, the total charge will not apply to your deductible. For even easier access, download the app!
-
How do I get a new ID Card?Contact Zenith Welfare Eligibility at 302-761-1080 ext. 556513, or email LRutter@zenith-american.com, to request an ID card.
-
Why did I get billed for my preventive care visit?While regular medical care focuses on treating illness, preventive care aims to keep you from getting sick in the first place by focusing on helping you maintain good health. When you visit your doctor for a preventive care service - like a physical exam or a health screening - you should not be billed. However, if you ask your doctor about a specific health concern while you are at your preventive care visit, it may be billed as an office visit, and not a preventive care visit. Here’s how to be sure your preventive care visit is free for you: Mention prevention upfront – When scheduling your appointment, confirm that you are scheduling a preventive care visit. Know what to discuss with your doctor during the visit – During your visit, keep the conversation focused on how you can maintain a healthy lifestyle. Ask your doctor - If you do ask questions about a specific health concern while at your visit, ask your doctor if that will be treated as an office visit or as a preventive visit. Let your doctor know you are expecting this visit to be of no charge to you. For more information about preventive care, contact your Lacher benefits advocate.
-
Where can I read information about Medicare?Visit www.medicare.gov for information. Take this short survey to determine if you will automatically receive Medicare or if you will need to sign up. You can also click here to read a comprehensive overview of Medicare and its various parts.
-
Do I need a referral to see a specialist?No. But keep in mind that the Plan offers in-network coverage only.
-
Where do I get an Explanation of Benefits (EOB)?For Medical: For copies of EOBs from Aetna for the Health and Welfare Fund, you can contact Zenith American Solutions at 1-302-761-1080. For Dental: Members can register online and print an EOB at Deltadentalins.com or call customer service at 1-800-932-0783.
-
Where should I go for medical care?Take a look at this flyer to learn about your choices when it comes to where you should receive care. High level overview: Primary Care Physician - This is your home base. Your doctor knows your history and is a good place to start. Cost to you: $10 copay per visit. Emergency Room - Go to an ER when you have a life-threatening issue. Cost to you: $10 copay per visit if admitted. $100 copay if not admitted. Urgent Care - Consider an urgent care center for non-life threatening condition. You'll save time and money over the ER. Cost to you: $10 copay per visit. Telemedicine - Consider using Teladoc for non-life threatening conditions, and when you need 24/7 care. Cost to you: $0 Install the Teladoc App on your phone today!
-
Should I go to Quest or LabCorp?You may go to either Quest or LabCorp. Both options are available and are in-network.
-
Full Vision plan detailsClick here for vision details
-
Vision insurance carrier contact informationNational Vision Administrators 1-800-672-7723 www.e-nva.com
-
Search for a Vision providerVisit www.e-nva.com/nva/content/home/find-provider.xhtml.
-
Dental insurance carrier contact informationDelta Dental 1-800-932-0783 www.deltadental.com
-
Search for a Dental providerClick here and select Delta Dental PPO. When you access dental care, you can simply let your provider know your social security number and your group number, which is 19941. Also, you may click here to download a guide.
-
Full Dental plan detailsDental highlights Member booklet Stay connected - Download the Delta Dental App
-
Search for a Medical providerYour medical plan uses the Aetna Choice POS II network. Click here to find a provider.
-
Prescription medicine informationSav-Rx 866-233-4239 www.savrx.com Click here to learn about the enhanced patient portal. Medicare Eligible Prescription: UHC 866-691-9209 www.uhcretiree.com
-
Insurance carrier contact informationMedical: Zenith: 302-761-1080 Welfare Eligibility: ext. 556513 Welfare Claims: ext. 556712 Pension Inquiries: ext. 556706
-
FormsSubmit Online Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form Print and Mail Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form
-
Read your rights as a participantSummary Plan Document Summary of Material Modification Notice - COVID Amendment Summary of Material Modification Notice - Chiropractic and Physical Therapy Amendment Summary of Material Modification Notice - Teladoc Amendment HIPAA Privacy Notice Your Rights and Protections Against Surprise Medical Bills
Dental
Vision
VISION
Do you or your family wear glasses or contacts? This benefit may be right for you.
The Vision plan is administered by National Vision Administrators (NVA).
-
Where can I find information for Retirees or Medicare?Click here.
-
What events enable me to make benefit changes in the middle of the year?These events are called Qualified Life Events (QLE) and include things like a birth of child/adoption, marriage, loss of coverage elsewhere, and more. Click here to read about QLEs.
-
How do I file an out-of-network vision claim?Please follow the instructions on this form.
-
What is GoodRx?Here's how you get started: Visit www.goodrx.com to search a prescription. Locate the pharmacy that is most convenient to you, offering the lowest price for your prescription. If a coupon is available, you can print it out and take it with you when you pick up your prescription to receive an immediate discount. NOTE: if you use a coupon, the total charge will not apply to your deductible. For even easier access, download the app!
-
How do I get a new ID Card?Contact Zenith Welfare Eligibility at 302-761-1080 ext. 556513, or email LRutter@zenith-american.com, to request an ID card.
-
Why did I get billed for my preventive care visit?While regular medical care focuses on treating illness, preventive care aims to keep you from getting sick in the first place by focusing on helping you maintain good health. When you visit your doctor for a preventive care service - like a physical exam or a health screening - you should not be billed. However, if you ask your doctor about a specific health concern while you are at your preventive care visit, it may be billed as an office visit, and not a preventive care visit. Here’s how to be sure your preventive care visit is free for you: Mention prevention upfront – When scheduling your appointment, confirm that you are scheduling a preventive care visit. Know what to discuss with your doctor during the visit – During your visit, keep the conversation focused on how you can maintain a healthy lifestyle. Ask your doctor - If you do ask questions about a specific health concern while at your visit, ask your doctor if that will be treated as an office visit or as a preventive visit. Let your doctor know you are expecting this visit to be of no charge to you. For more information about preventive care, contact your Lacher benefits advocate.
-
Where can I read information about Medicare?Visit www.medicare.gov for information. Take this short survey to determine if you will automatically receive Medicare or if you will need to sign up. You can also click here to read a comprehensive overview of Medicare and its various parts.
-
Do I need a referral to see a specialist?No. But keep in mind that the Plan offers in-network coverage only.
-
Where do I get an Explanation of Benefits (EOB)?For Medical: For copies of EOBs from Aetna for the Health and Welfare Fund, you can contact Zenith American Solutions at 1-302-761-1080. For Dental: Members can register online and print an EOB at Deltadentalins.com or call customer service at 1-800-932-0783.
-
Where should I go for medical care?Take a look at this flyer to learn about your choices when it comes to where you should receive care. High level overview: Primary Care Physician - This is your home base. Your doctor knows your history and is a good place to start. Cost to you: $10 copay per visit. Emergency Room - Go to an ER when you have a life-threatening issue. Cost to you: $10 copay per visit if admitted. $100 copay if not admitted. Urgent Care - Consider an urgent care center for non-life threatening condition. You'll save time and money over the ER. Cost to you: $10 copay per visit. Telemedicine - Consider using Teladoc for non-life threatening conditions, and when you need 24/7 care. Cost to you: $0 Install the Teladoc App on your phone today!
-
Should I go to Quest or LabCorp?You may go to either Quest or LabCorp. Both options are available and are in-network.
-
Full Vision plan detailsClick here for vision details
-
Vision insurance carrier contact informationNational Vision Administrators 1-800-672-7723 www.e-nva.com
-
Search for a Vision providerVisit www.e-nva.com/nva/content/home/find-provider.xhtml.
-
Dental insurance carrier contact informationDelta Dental 1-800-932-0783 www.deltadental.com
-
Search for a Dental providerClick here and select Delta Dental PPO. When you access dental care, you can simply let your provider know your social security number and your group number, which is 19941. Also, you may click here to download a guide.
-
Full Dental plan detailsDental highlights Member booklet Stay connected - Download the Delta Dental App
-
Search for a Medical providerYour medical plan uses the Aetna Choice POS II network. Click here to find a provider.
-
Prescription medicine informationSav-Rx 866-233-4239 www.savrx.com Click here to learn about the enhanced patient portal. Medicare Eligible Prescription: UHC 866-691-9209 www.uhcretiree.com
-
Insurance carrier contact informationMedical: Zenith: 302-761-1080 Welfare Eligibility: ext. 556513 Welfare Claims: ext. 556712 Pension Inquiries: ext. 556706
-
FormsSubmit Online Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form Print and Mail Beneficiary Form Disability Proof of Claim Form Member Information Update Form Medical Reimbursement Form
-
Read your rights as a participantSummary Plan Document Summary of Material Modification Notice - COVID Amendment Summary of Material Modification Notice - Chiropractic and Physical Therapy Amendment Summary of Material Modification Notice - Teladoc Amendment HIPAA Privacy Notice Your Rights and Protections Against Surprise Medical Bills
Wellness
WELLNESS PROGRAM
When you sign up for our wellness program through Virgin Pulse, you can earn PulseCash which you can use to get cool things like fitness trackers, workout gear, headphones, and more! Earn up to $100/quarter in PulseCash. Follow the steps below to learn more and sign up.
What is the wellness program?
The Virgin Pulse wellness program provided by IBEW 313 allows you to earn gifts for healthy activities. Learn more.
How do I sign up for the program?
Signing up is easy! Just go to join.virginpulse.com. Enter "313" for the Sponsor name. There is NO COST to sign up!
How much can I earn?
You can earn up to $100/quarter in PulseCash. Spend it on fun items like headphones, fitness trackers, and much more.
Where do I go with questions?
Once enrolled, you can chat or call a Virgin Pulse representative. Just log in at member.virginpulse.com.
MEMBER ASSISTANCE PROGRAM
Available 24/7
When life throws us curve balls, it can be good to talk with someone. With our Member Assistance Program, you and your eligible family members can connect directly, privately, and at no cost, with a board-certified counselor by phone or text to discuss issues like anxiety, depression, and more. Plus your Member Assistance Program offers so much more. Click the button below to learn more.
MAP
OTHER
OTHER BENEFITS
Telemedicine
TELADOC
With Teladoc, you have 24/7 access to board certified doctors by phone or secure video chat. Find out more.
FAQ
Advocate
We have great news for all employees who have chosen to enroll in our healthcare & benefits program. As our benefits consultants, Lacher can help you get the most from your healthcare and benefits program.
We have a dedicated team of Benefits Advocates from Lacher who are ready to help you with:
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Any claims that you believe haven’t been properly paid
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Questions regarding a bill sent by a doctor, dentist, lab or hospital
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Further clarification on any insurance matters
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Questions about your healthcare benefits
Contact your dedicated advocate team
Direct line: 215-660-0334
benefits@lacherinsurance.com
Fax: 215-723-8604
LACHER WILL HELP
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