Frequently Asked Questions - Welfare Trust Fund

INFORMATIONAL

Who are the PPO Providers being used by the Fund and how can I contact them?

Blue Cross Blue Shield for medical at 1-800-810-2583 (http://www.bcbsil.com). You can also use the Health Cost Estimator Tool at S365 Health Care Cost Estimator Tool to search for in-network providers and estimated costs for services and procedures.
Guardian for dental at 1-888-600-9200 (http://www.guardianlife.com)
CVS/Caremark for prescriptions at 1-844-345-3233 (www.caremark.com)

Why do I need to complete a Beneficiary Data Card?

In the event of your death, the individual you last named on your data card will be the recipient of your death benefits (if eligible). It is important to complete a new data card as you have changes in your life such as marriage, divorce and dependents. If no beneficiary is named, benefits will be paid to the surviving spouse; if no surviving spouse, then to the decedent's estate.

Does my spouse have to take his/her own insurance if it is offered by his/her employer regardless of the cost?

Yes; if your spouse is offered comprehensive major medical coverage through his/her employer, then your spouse must take the medical coverage to be eligible for secondary coverage with NECA-IBEW Welfare Trust Fund. Your spouse is only required to take medical coverage for himself/herself; your spouse is not required to take coverage for any dependents.

If your spouse takes vision and/or dental coverage, these benefits will be coordinated with NECA-IBEW Welfare Trust Fund.

How can I check my eligibility or claim status?

1. Go to www.neca-ibew.org
2. Click on the Check Welfare Fund Eligibility button at the top of the page and select an option.

CHECK ELIGIBILITY ONLINE
1. You will go to the MemberXG website, where you can check your eligibility status, as well as other information such as contributions and claims.

GIVE US A CALL
1. Call 1-800-765-4239, or click the phone number on a mobile device to call directly.
2. Press 9 for eligibility status.
3. Press the number 2 if you are the participant.
4. Enter the participant ID number.
5. Enter the birth date of the participant or dependent.
6. The system will provide eligibility status information.

What is the medical deductible per year for an individual and for the family?

As of February 1, 2015, the individual medical deductible is $600 each calendar year, and the family medical deductible is $1800 each calendar year.

How do I know if my provider is a PPO with BlueCross/BlueShield?

Ask the provider if they are in the BlueCross BlueShield network.
Go to the BCBS of Illinois website and use their provider finder services: Find a Hospital or Healthcare Provider in Illinois
Use the Health Cost Estimator Tool at S365 Health Care Cost Estimator Tool to search for in-network providers and estimated costs for services and procedures.

Why do I have to fill out a Participant’s Data/Claim Statement, and how often do I have to fill it out?

To receive benefits from the NECA-IBEW Health and Welfare Trust Fund, you are required to fill out a Participant’s Data/Claim Statement (Data Card). This card is sent to you on a periodic basis. The Fund uses the information on the card to update any changes on you, your spouse and your dependents that might have taken place since you last completed a card. Be sure and notify the Fund Office if your spouse changes employers or has a change in status with his/her employer in regards to being offered medical insurance.

How do I add someone to my coverage?

The best thing to do is to call customer service and tell us who you want to add to your coverage. We will ask for such things as marriage certificates, birth certificates, divorce decrees, proof of spousal insurance and child affidavits, depending on your particular situation.
You can also check out the Life Events page on the website for more information.

What is the reason for a HIPAA Customer Service Consent form?

The HIPAA Customer Service Consent Form allows designated family members and/or designated representatives to talk with and receive information from the Fund Office about you and other family members regarding their personal health information.

Natural parents of dependents under age 18 will not be required to complete this form to access their under-age-18 dependent's health information.

If I lose eligibility, will I be notified once I become eligible again?

It is your responsibility to keep track of your eligibility. You can check your eligiblity on the NECA-IBEW website, or by calling the Fund Office.

1. Go to www.neca-ibew.org
2. Click on the Check Welfare Fund Eligibility button at the top of the page and select an option.

CHECK ELIGIBILITY ONLINE
1. You will go to the MemberXG website, where you can check your eligibility status, as well as other information such as contributions and claims.

Do I need to complete an accident form even though my claim wasn’t due to an accident?

Yes, an Incident Questionaire is required if requested by the Fund Office. As your claim is being processed, a service, procedure, or diagnosis may indicate that the claim may be for an injury that may be the responsibility of a third party (such as a vehicular accident or a work injury). Due to the nature of how claims are processed, you may receive more than one Incident Questionaire; if you have already completed the form for the same injury, you do not need to complete another form.

Does my spouse have to meet two deductibles?

Your spouse would have to meet the deductible required by her primary coverage.

When your spouse's claims are processed as secondary coverage at the Fund Office, the Fund Office will apply the full Allowed Amount to the deductible; not the amount that the Fund may pay. This will allow your spouse to meet their secondary coverage Fund Office deductible more quickly and perhaps about the same time that they meet their primary coverage deductible.

DENTAL

Is there a deductible for dental and vision benefits?

No deductible has to be met prior to receiving Vision and Dental benefits. Please refer to the Schedules of Benefits for applicable benefit maximums.

What if my dentist isn’t a Guardian provider?

The Fund Office does not require that you visit an in-network Guardian dental provider. However, your benefit dollars can be maximized if you choose an in-network dental provider as in-network discounts may be applied to your claim.

Do we have a dental card?

You are not required to present a dental card to receive dental benefits. You can use your BlueCross BlueShield card to provide your Identification Number to your dental provider. The dental provider can use this Identification Number to check your eligibility/benefits as well as on the claim form that they will submit to the Fund Office.

VISION

How often can I get glasses or contacts?

For ages 19 and over, there is no limit on the quantity of glasses or contacts per calendar year; but a declining benefit balance does apply. For an in-network EyeMed provider, this declining balance amount is $500.

For ages under 19, there is no declining benefit balance. However, there are quantity limits on lenses and frames. One set of lenses and one set of frames are allowed per calendar year. Lenses can be one set of lenses for glasses, OR a one-year supply of contacts.

PRESCRIPTION

Is there a deductible on our prescription drug plan?

Yes, a $60 deductible (for the "Base Plan") has to be met each calendar year. Inquiries about RX deductibles should be referred to MedImpact at 1-888-807-5745. The information below pertains to Active (non-retired) participants and retirees, and their spouses, under the age of 65 who are not Medicare-eligible. For retirees and their spouses and dependents who are Medicare-eligible, please contact VibrantRX at 1-844-826-3451.

What are my options to fill my maintenance drug prescriptions?

The plan allows one (1) fill and two (2) refills at the retail pharmacy, however, you can now get a 90-day supply of your maintenance drug(s) at any CVS pharmacy nationwide. Through the "Maintenance Choice" program, Base Plan co-pays for a 90-day supply through the mail or at a CVS retail pharmacy are $25 for generic and $35 for brand. If a generic is available and you choose the brand, then you will pay the brand co-pay. For information regarding Alternative Plan co-pays, please refer to the 2020 Summary Plan Description and Plan Document under Documents & Forms or contact MedImpact at 1-888-807-5745.

How do I order new prescription cards?

Contact MedImpact directly; there is no need to call the Fund office.

Call 1-888-807-5745 and use the automated system to order new cards.
Register on the MedImpact portal at www.MedImpact.com

COBRA

How much is the COBRA monthly premium?

Rates-Effective 01/01/23:

$1099.00 Base Plan

$777.00 Alternate Plan

$518.00 Single Alternate Plan

Rates-Effective 12/01/23:

$445.00 Alternate Plan

$294.00 Single Alternate Plan

Rates-Effective 01/01/24:

$1169.00 Base Plan

If I elect COBRA, can I drop the dental and vision benefits and pay the ALT plan?

No; if you have Base Plan coverage, you must continue under the COBRA Base Plan when electing COBRA coverage.

If you have Alternate Plan coverage, you must continue under the COBRA Alternate Plan when electing COBRA coverage.

Do you take COBRA payments over the phone?

Yes, the Fund Office can take ACH (bank account) payments over the phone.

You can also elect to use the self-service eCheck Payment button on the home page of the Fund Website at www.neca-ibew.org.

At this time, only ACH transfers can be accepted, not debit/credit card payments.

How long can I stay on COBRA?

COBRA coverage can continue up to 36 months. However, in certain circumstances your COBRA continuation coverage could be terminated prior to 36 months, such as once you become entitled to Medicare.

DISABILITY

When I am receiving weekly income benefits due to disability, do I have to complete the weekly letter each week?

Yes. Disability Benefits will not be paid unless you complete the weekly letter and return it to the Fund Office. This letter is used to determine if you are still disabled and to show when you have recovered.

How often do I need to have a physician’s statement completed by my doctor?

A physician's statement must be completed by your doctor every six to eight weeks, unless your physician states on the form that you are “permanently and totally disabled”.

Do I have to pay taxes on the weekly income benefits?

Yes, as Weekly Income Benefits are considered income. Tax statements will be mailed out at the beginning of each year showing the total amount of benefits you received the previous year.

RETIREMENT

I will be retiring soon, what do I need to do?

The Retiree Plan is NOT automatic, so you will need to submit an application to our office.

YOU SHOULD VERIFY YOUR WORK HISTORY PRIOR TO SUBMITTING THE RETIREE APPLICATION, TO VERIFY THAT YOU QUALIFY UNDER THE 45 OF 60 RULE. ONCE A RETIREE APPLICATION HAS BEEN RECEIVED, IT CANNOT BE WITHDRAWN.

There are several other requirements that have to be met to qualify for the Retiree Plan; please contact the Fund Office for a complete listing. You can also visit the Life Events page on the Fund website for more information.

Do I have to be a certain age to retire?

If you are disabled with a Social Security Award, there is no minimum age requirement.

If you are NOT disabled, you must be at least 55 years of age AND have an award of retirement from the Social Security Administration, National Electrical Benefit Fund (NEBF), or any other pension fund in which Union Trustees are selected by one or more Local Unions affiliated with the IBEW.

How long do I have to submit my retiree application?

The application must be submitted to the Fund Office within 90 days of your retirement, but not more than 90 days prior to your retirement date.

However, the application MUST be received in the Fund Office:

Within 90 days of the last day worked,
90 days from the run out of bank hours, or
90 days from the date you receive your first proof of award.

If you are applying due to disability, we recommend that you complete an application for the Retiree Plan at the same time you complete an application for Social Security Disability.

There are several other requirements that have to be met to qualify for the Retiree Plan. Please contact the Fund Office for a complete listing, or visit the Life Events page of the Fund website for more information.

Is there a medical deductible for the retiree plan?

There is no medical deductible for retirees and their spouses who are age 65 or over. However, for retirees and their spouses under the age of 65, the individual and family deductibles per the respective plan (Base or Alt), do apply.

If I am on the retiree plan and return to work, what will happen?

It is very important that you notify the Fund Office when you return to work and when you cease working. Please keep in mind that when you return to work you will need to continue your retiree payments until you have worked 420 hours within a 6 month period and when you work less than the required 140 per month after you have regained initial eligibility.

If I return to work, will I have dental and vision coverage?

If you were previously on the Base plan, you will have dental and vision coverage ONLY the months that you are eligible due to hours worked. The Alternate Plan does not provide dental and vision coverage.

When I become eligible for Medicare, do I have to purchase Medicare Part B?

Yes, it is required that you enroll in both Medicare Part A and Medicare Part B.

When I become eligible for Medicare, will I still have prescription coverage?

Yes, your prescription coverage through the Fund will continue with the SilverScript Prescription Drug Plan (PDP). You will be notified by the Fund when it is time to enroll in SilverScript (Approximately 2-3 months prior to turning 65). The SilverScript coverage will remain in effect unless you elect a different Medicare Part D Plan outside of the Fund's SilverScript Plan.

When I am eligible for Medicare, do I have to take the Humana Medicare Advantage plan coverage if I wish to continue my participation in the Retiree Plan?

Yes, if you are Medicare eligible AND age 65 or older.
No, if you are Medicare eligible AND less than age 65.

If I am on the Retiree Plan, how does it work when I am Medicare eligible and over age 65 but my spouse is not Medicare eligible?

Your benefits will be paid according to the Schedules of Benefits for “Retired Employees Over Age 65 and Eligible for Medicare"
If your spouse is under age 65 and not Medicare eligible, your spouse's benefits will be paid according to the Schedules of Benefits for “Retired Employees Under Age 65” until your spouse becomes Medicare eligible.

Can I use my HRA to pay for my retiree premiums?

Yes, you can use your HRA account to pay for your retiree premiums in three different ways:

Complete a Direct Transfer form, and the Fund Office will automatically deduct your retiree premium from your HRA account every month (as long as funds are available in your account).
If your retiree premium is deducted from your checking account, you can complete a Request Automatic HRA Reimbursement of Retiree Premium form, and the Fund Office HRA Department will coordinate with the Retiree Department to send you your HRA reimbursement automatically after your payment is received.
If your retiree premium is deducted from your checking account, you can complete aN HRA Account Claim for Reimbursement form, and the Fund Office HRA Department process your request and reimburse your retiree premium from your HRA account.

What happens to my spouse if I pass away after I retire?

There is a Surviving Spouse option available under the Retiree Plan of Benefits.

HEALTH REIMBURSEMENT ACCOUNT (HRA)

How do I order new Benny Cards?

HRA Participant Portal: Login to your account, go to the Profile tab, and then click the Banking/Cards option.
You have two options:
Report Lost/Stolen - you will get 2 Benny Cards with a new number
Order Replacement - you will get 2 Benny Cards with the same number as your current Benny Card

Please note:

Your address will be displayed for verification. If your address has changed, please call the Fund Office before you order your new cards.
There is a $10 fee for new Benny Cards which is deducted from your HRA account (Note: this fee will not be waived if you neglect to verify your address before ordering new cards).
Mobile App: go to Me, Manage Debit Cards, then Report Lost/Stolen.

Please note: You can only report Lost/Stolen on the mobile app (which will send you 2 cards with a new number). For replacement cards with the same number, visit the HRA Participant Portal or call the Fund Office.

Why is my Benny Card suspended?

Your Benny Card is suspended when the card is used for an ineligible expense. This can occur in two ways:

You used the Benny Card to pay for an ineligible HRA expense. Please review the HRA Eligible Expenses list. The ineligible amount must be repaid to your HRA account; you can mail a check in the exact amount of the repayment due (shown on the Suspension Notice that you received) to the Fund Office, or you can use the eCheck Payment option on the website.
You used the Benny Card and we did not receive documentation to validate the transaction. The quickest way to get your card unsuspended is to upload the documentation on the consumer portal or mobile app.

Note: not all Benny Card transactions require documentation to be submitted. For more info, see How To Use Your Benny Card.

Frequently Asked Questions - Pension Trust Fund

What is normal retirement age?

The normal retirement age is 65 years old.

May I retire before age 65?

Yes, you may retire anytime on or between the ages of 55 thru 59 years old at an actuarially reduced pension, provided you are vested. If you retire on or between ages 60 thru 65 there is no reduction in your benefit. There are some individuals who may not be able to take early retirement until age 57. These same individuals will not receive a non-reduced benefit until age 62.

Who should I contact for information about my pension benefits?

You should contact the Fund Office for questions regarding your pension benefits.

How do I apply for pension benefits?

For your convenience, an interactive Pension Benefit Application form can be completed online. This form can be printed and returned to NECA-IBEW by mail or dropped off in person. Please do not email the Benefit Application as it contains private information and email may not be HIPAA-compliant. You may also contact the Fund Office to request a Pension Benefit Application to be mailed to you.

Should I apply for benefits even if I don’t think I am entitled?

Yes, there are some instances in which you would qualify for a benefit even though you are not vested.

Why do I need to complete a Beneficiary Data Card?

May I name someone other than my spouse as my beneficiary?

You may name someone other than your spouse as your beneficiary for your pension benefits; however, your spouse must consent in writing to this.

How long does it take for my benefits to begin once I retire?

Sometimes there is a delay in paying your benefits until your final hours are received in the Fund Office. For example: Hours worked in May are not received in the Fund Office until mid-June.

How many hours must I work to get a year of credited service toward my vesting?

After June 1, 1976, or the Participation date if later, you must work at least 870 hours in a plan year (June 1st thru May 31st) to get a year of credited service.

If I am called for military service, do I retain my pension rights?

Yes. Your rights are protected by Uniformed Services Employment and Reemployment Rights Act (USERRA). You are obligated by law to notify the Fund Office of entering the military and upon returning from duty. You are also required to seek employment upon returning from duty.

If I have a Deferred Vested Benefit under the Plan, do I need to do anything to receive these benefits?

Yes:

Always keep the Fund Office informed of your current address
When you retire, you must submit an application for the pension benefit

If I take another job after I retire, will I lose my pension?

If you return to work in the electrical industry, in the same trade or craft and in the same geographical area of the Pension Fund, you shall forfeit one (1) monthly pension payment for each calendar month during which you are employed forty (40) or more hours. You need to notify the Fund Office upon returning to work and upon terminating your employment. The amount of your monthly benefit may be increased if you meet certain conditions.

Do I need to notify the Fund Office if my spouse passes away?

Yes, you should notify the Fund Office immediately if your spouse passes away. If you were receiving a reduced monthly benefit in the form of a Joint & Survivor Option your benefit will revert to the amount you would have received under the Single Life Option.

What is the difference in the Joint & Survivor options and the 5 or 10 year certain options?

All options are a lifetime benefit for the participant. The Joint & Survivor options give you a reduced lifetime benefit which will continue for your spouse in the event of your death.
The 5-Year Certain (Early Retirement or Normal Retirement options) gives you a lifetime benefit, but if your death occurs after you have received at least 60 monthly payments (5 full years) no benefits will be payable to your beneficiary.
The 10-Year Certain (Early Retirement or Normal Retirement options) gives you a lifetime benefit, but if your death occurs after you have received at least 120 monthly payments (10 full years) no benefits will be payable to your beneficiary.

FAQs