ABOUT YOUR FUND
Edited by Frank J. Runey
Secretary Treasurer
Trustee - UFCW
National Health & Welfare Fund
Your Healthcare benefits are managed by the UFCW National Fund. The provider network is Horizon
Blue Cross Blue Shield of New Jersey. Through this network you can access any participating Blue Cross Blue Shield provider in theUnited States. As a member of the UFCW Health and Welfare Fund you have tremendous benefits at a tremendous price. You can help
maintain these benefits by using your benefits wisely.
For example:
- Please don’t use the Emergency Room of the hospital for regular
Doctor’s visits.
- Analyze your bills and call the FUND if you find something that doesn’t seem correct.
- If you receive a
bill from a provider that hasn’t been paid, call the FUND, sometimes they haven’t received the bill because the doctor’s office sent
it to the wrong address.
- Make sure you carry your I.D. card when you have a health-related appointment and make
sure the billing clerk understands where to send the bill. This will avoid claims being filled incorrectly with another UFCW Fund
or third party administrator.
- If you experience a “Change in Status” it’s vitally important that you notify both your Human Resource
manager and the Fund office.
- If you have a “Qualifying Event” you have to notify your HR manager and the Fund within 30
days. Please don’t wait for the 30th day! Qualifying Events are:
o You get married;
o You have a child either through birth or adoption;
o A death occurs in your family;
o You get a divorce or legally separated;
o A change in address;
o Your dependent child or children attain age 19 or get married or;
o Your dependents obtain
coverage through employment.
- If you or your dependent have bills relating to an accident, tell us about it as soon as you know that you will incur bills as a result.
The more information you supply, the less your claims will be delayed.
- Fill out our annual Coordination of Benefits form completely.
If someone works but does not have insurance, you must still give us the name and address of the company so that the Fund can verify
the information. If the form is not complete, the claim can’t be paid.
- Read your Explanation of Benefits (EOB). If there
is something in there that isn’t accurate please contact a claim representative at the Fund office - 1-888-773-8329.
- Whenever
you contact the Fund office, find out who you are talking to, document their name and the time and date of your call. That way
in the event of a problem you will have the necessary information that will rectify the problem much quicker.
- Become familiar
with the Summary Plan Description (SPD).
- Generic drugs not only cost you less but they cost considerably less for the UFCW National
Health & Welfare Fund. That saves us all in the long run. By controlling costs we can maintain a high level of benefits.
- If
you are on Maintenance Prescription, try and purchase a 90 day supply at an Osco (Shaw’s pharmacy) because it will save you money.
- Be
diligent and follow your doctor’s instructions and maintain a healthy lifestyle.
Please understand that the fund is asking these
questions to protect all of you against sharp rises in premiums which could be the result of people receiving the benefits of insurance
to which they are not entitled. It is not our intention to make life difficult for you but to insure that your co-pay does not go
through the roof.
The problems related with the ever increasing costs of health care seem to be everywhere – newspapers, radio,
television, and in the political arena. Unfortunately, if our elected officials don’t take some bold action, the problems plaguing
health care will only get worse not better.
We have been insuring union members for over 46 years and our premiums are
still the best in sight. We aim to keep them that way and we can only do so with your cooperation.
Doing the things within our
control will go a long way in keeping the costs lower for the Fund and more importantly save you money in the long run. You
have the commitment from the leadership of this union that we will continue to work hard in all areas to help bring the costs and
accessibility of healthcare within reason. That result will benefit everyone in the future.
If you have any questions please
contact Frank Runey at 1-800-535-2752.
Proudly serving workers in Massachusetts,
Rhode Island and Maine since 1947
Russell F. Regan, President
Frank J. Runey, Secretary-Treasurer
