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Legal Notices and Plan Documents
Please see below for notices related to your healthcare and benefits provided by IBEW 313.
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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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How can I save money on prescriptions with 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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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.
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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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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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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!
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How do I file an out-of-network vision claim?Please follow the instructions on this form.
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What services and screenings are covered as preventive care?Preventive screenings can help you take better control of your health. They are an important foundation of early detection and prevention of disease. Preventive care services are NOT subject to a copayment or deductible when using in-network providers and must be billed to insurance with proper preventive coding. Take a look at this flyer to learn about the services and screenings that are covered as preventive care. Please note: Coverage for these services is subject to certain conditions, age and time limits.
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Where can I find information for Retirees or Medicare?Click here.
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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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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 www.deltadental.com or call customer service at 1-800-932-0783.
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Why is the insurance sending me a statement that says, “this is not a bill”?After submitting a claim for medical treatment, you may receive an Explanation of Benefits (EOB) from your insurance company. The EOB is a form that insurance companies send to their members to explain what part of a claim was paid by insurance, what part was not paid, and why. It is important to understand what this statement means.
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Who do I talk to if I have a problem with a claim or questions about my benefits?You may contact our Lacher Benefits Advocate, Stephanie Cassel at 267-498-0600 or stephanie@lacherinsurance.com.
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Who do I contact at Virgin Pulse with questions?You may contact Customer Service at 888-671-9395 or support@virginpulse.com.
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What is the wellness program?The Virgin Pulse wellness program provided by IBEW 313 allows you to earn gifts for healthy activities.
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How do I use my PulseCash to purchase items in the Virgin Pulse store?Click here to learn more!
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How do I navigate the Virgin Pulse website?Watch a short video here to learn more!
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How do I sign up for the program?Signing up is easy! Just go to member.virginpulse.com. Enter "313" for the Sponsor name. There is NO COST to sign up!
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How do I download the app?For Apple, click here. For Android, click here.
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Insurance carrier contact informationMedical: Zenith: 302-761-1080 Welfare Eligibility: ext. 556513 Welfare Claims: ext. 556712 Pension Inquiries: ext. 556706
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Prescription medicine informationSav-Rx 866-233-4239 https://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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How do I use Telemedicine?Medical Care Teladoc gives you access to a national network of U.S. board-certified doctors by phone or video who are available anywhere, 24/7/365 to treat many of your medical issues. Click here to learn more. Mental Health Care In addition to medical issues, you can also use Teladoc for Dermatological and Mental Health issues. Learn more. Ready to sign up? Visit www.teladoc.com/aetna. You will need your Member ID, found on your medical ID card.
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FormsClick here
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Aetna member website user guideClick here to learn how to register, print an ID card, view your claims, and much more!
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Search for a Medical providerYour medical plan uses the Aetna Choice POS II network. Click here to find a provider.
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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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Search for a Vision providerVisit www.e-nva.com/nva/content/home/find-provider.xhtml.
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Vision insurance carrier contact informationNational Vision Administrators 1-800-672-7723 www.e-nva.com
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MedicalSummary Plan Document Summary of Material Modification Notices: Dependent Child Waiver + Pension Updates Termination Eligibility Updated Delta - Teladoc - Spousal coverage update - LabCorp - Speech Therapy Vasectomies - Prostate-Specific testing - dental upgrade Colorectal Cancer - Chiro Services - MRA - Blue Light Lens coverage - Death Benefit Increase - Pension updates Dental Benefit Maxiumus - Contact Lens Coverage COVID Vaccinations Allergy Testing - Behavioral Health + Dermoatology with Teladoc - MRA claim reimbursement timeframe updated - Divorce Pension Updates COVID Tests - Substance Abuse Coverage - exclusion for OON services Chiropractic- Pension Update Hearing Aid Benefit - CVS minute Clinics - Ambulance Services - MRA updates COVID updates - Teladoc - CVS minute clinic - Pension Updates HIPAA Privacy Notice Your Rights and Protections Against Surprise Medical Bills
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DentalDental highlights Member booklet Stay connected - Download the Delta Dental App
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VisionClick here for vision details.
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