Home Welfare Pension Annuity Benefit
   Operating Engineers Local 66 Welfare Fund  

MEDICAL CLAIMS.

IDENTIFICATION CARD - The Preferred Provider Organization (PPO) network that the Welfare Fund uses to cover your medical needs has the same basic benefits for both Plan One and Plan Two. A primary difference between the plans is the amount of out-of-pocket expenses you will incur as you use the benefits. Plan One has a lower co-insurance requirement than Plan Two.  In addition Plan Two has higher copayments and also does not include prescription drug benefits.  

Once eligible for benefits, Highmark Blue Cross/Blue Shield will issue an identification card to the participant and their dependents. The Blue Cross and Blue Shield symbols on your Blue Cross Blue Shield PPO Identification (ID) card are recognized throughout the country and around the world. Carry your ID card with you at all times, destroy any previously issued cards, and show this card to the hospital, doctor, pharmacy, or other health care professional whenever you need medical care. When an eligible participant or eligible dependent receives health care services:

  • Show the Blue Cross and Blue Shield identification card to the hospital or professional providers.
  • Pay the co-payment amount as shown on your card.

Filing Claims - Plan ONE and TWO, are Preferred Provider Plans or PPO's while the MEDICARE SUPPLEMENTAL PLAN is considered Traditional Coverage. If you receive services from a network provider, you will not have to file a claim. If you receive services from an out-of-network provider, you may be required to file the claim yourself.

PLAN ONE Member Reimbursement Benefit (MRB) Claims should be mailed to the Welfare Fund at PO Box 38682, Pittsburgh PA. 15238.

PLAN TWO Member Reimbursement Benefit (MRB) Claims should be mailed to the Welfare Fund at PO Box 38682, Pittsburgh PA. 15238

MEDICARE SUPPLEMENTAL Major Medical claims are to be submitted to Highmark Blue Cross Blue Shield. Call the Welfare Fund office at (412)968-9750 to obtain a claim form. Consult the Summary Plan Description book in the section titled MEDICARE SUPPLEMENTAL PLAN to obtain further information.

 



Eligibility.

Termination.

COBRA Continuation Coverage.

Medical Claims.

Vision.

Prescription Drugs.

Disability Benefits.
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