BLUE CROSS/BLUE SHIELD PPO NETWORK – You must present your eligibility card when services are provided. Contact the BLUE CROSS/BLUE SHIELD PPO NETWORK to easily identify physicians, hospitals and other health care services available to you at a discount through the network. Allowable services under the PPO network are paid at 90%. Call 1-800-810-BLUE (2583) or check the website at www.bcbsil.com.
CVS/CAREMARK – Prescription Drug Services – You must present your Prescription Drug Card when purchasing prescriptions. If you do not have a Prescription Drug Card contact the Fund Office 1-847-742-0900 or toll free at 1-866-828-0900. Most pharmacy chains and independent pharmacies participate in the CAREMARK retail network program. For additional pharmacies in your area, you can use the Caremark Pharmacy Locator on their website at www.caremark.com or call Customer Service at 1-800-824-6349.
DENTAL NETWORK OF AMERICA PPO NETWORK – Effective November 1, 2010. To find a participating dentist and maximize your savings, visit the DNoA Preferred Network website at www.dnoa.com, enter your zip code and select “Labor” or call 1-866-LABOR-L-U (1-866-522-6758) between 8:00 a.m. and 6:00 p.m. CDT. If your dentist is not in the PPO network, you can nominate him/her for inclusion in the DNoA Preferred Network by contacting DNoA Preferred Network at www.dnoa.com for a recruitment package that will be sent directly to your dentist.
ERS – Employee Resource Systems, Inc. – The Employee/Member Assistance Program is a FREE and confidential program that provides supportive resources to members and their family to make their lives easier. These services include individual, relationship, and family counseling; dug and alcohol assessment and treatment referrals; and WorkLife services that includes access to free, 30-minute legal or financial consultations. Assistance is available 24/7 at 1-800-292-2780 or you can visit their website at www.ers-eap.com. The WorkLife portal containing thousands of tools, articles, and videos to make your life easier can be accessed by clicking on the portal link in the upper right hand corner of the ERS webpage. New users should following the prompts and use the code “laborers” to create a new account.
EyeMed Vision Care – Contact EyeMed Vision at 1-866-723-0514 to find out more about your vision benefits and to locate a participating provider near you. Call center hours of operation are Monday through Saturday, 7:30 a.m. to 11:00 p.m. and Sunday, 11:00 a.m. to 8:00 p.m. Or visit their website at www.eyemed.com.
Guidelines for Using Your Benefits
- Call the Fund Office for eligibility and benefit information at 1-847-742-0900.
- Requests for pre-determination of benefits must be submitted via fax to the Fund Office at 1-847-742-4430.
- File all medical claims with the local BCBS.
- Send all dental claims to P.O. Box 21553, Eagan, MN 55121.
- Send Medicare, vision, coordination of benefit claims, and any other claims to Fox Valley Laborers Health and Welfare Fund, 2371 Bowes Road, Suite 500, Elgin, IL 60123-5523.
- For coordination of benefits on all claims with other insurance, including Medicare, provide an explanation of benefits paid statement when submitting claims for secondary payment.
- Pre-notification of all inpatient hospital services, including behavioral health/chemical dependency is required by calling Hines & Associates, Inc. at
- Case Management is available through Hines & Associates, Inc. to plan and coordinate care throughout an extended period of serious illness or chronic illness. Contact Hines & Associates, Inc. at 1-800-592-8097.
- Call the Fund Office for prior authorization required for all covered transplant services.
- Call the Fund Office for prior authorization required for all bariatric surgery services.
- Call Employee Resource Systems (ERS) for counseling services at 1-800-292-2780.