Local 204 Top FAQ’s

Why does my paycheck appear to have 2 deductions for health coverage, with “AR”?

When a participant 1st qualifies for health coverage, they obtain an ‘eligibility date’, when the enrollment package is received it will provide an ‘enrollment window’. Once enrolled, your weekly deduction should begin on the date you first became eligible for coverage, not on the date you enroll. Since your eligibility date and your enrollment date differ, you will see a weekly rate and an arrearage, marked with “AR” on your paycheck until the amount is satisfied based on your eligibility date.

My dependent went to the doctor and was told they have no coverage. I added my dependent to my coverage. Why does it appear they don’t have coverage?

The Fund Office may require additional documentation to confirm your dependents. They may be placed in a pended status until the requested documentation is received. If relating to spousal coverage, a marriage license, joint marital document and spousal affidavit may be required. If relating to dependent child(ren) coverage a birth certificate, court order or divorce decree may be required. Contact the Fund Office at 1-800-241-2136 or 1-800-241-3473 to inquire if specific documentation is required.

 

Atlanta Top FAQ’s

 

If my employment terminates, when will my insurance benefits terminate?

When you separate from the Company, your benefits will terminate on the last day of the month that you leave the Company. Upon termination of benefits participants will receive a COBRA Continuation Election Notice to elect other continuation coverage options that may be available to continue coverage with the Plan depending on the circumstances for which your coverage is terminating.

What if I have coverage elsewhere and want to waive coverage under the Fund?

You may waive your coverage under this Fund by selecting that option during the enrollment process. However, if you elect to waive coverage or fail to enroll during your enrollment period you may be required to wait until the next open enrollment period, unless you experience a Qualified Life Event, as permitted by the Notice of Special Enrollment Rights.

What is a Qualified Life Event (QLE)?

A Qualified Life Event (QLE) is an occurrence that will allow a special enrollment period, outside of the normal ‘open enrollment’ window. Examples of QLEs are marriage, divorce, birth or adoption of a dependent child, or loss of other health insurance coverage. Please contact the Fund Office at 1800-241-2136 or 1800-241-3473 for more details on QLEs and the required notification periods.

I have received a bill for an unpaid claim. How do I submit an inquiry to review claim status? How do I determine if the claim has been processed?

Contact Anthem Blue Cross Blue Shield at 1-855-397-9267 for claim inquiries. Please be prepared to provide specific patient information such as name, date of birth and date of service to retrieve claim details. Please be advised, if attempting to obtain information for someone other than yourself, HIPPA authorization may be required.

I have submitted a claim for weekly disability benefits. I have mailed in my claim form. When will I receive a disability check?

Provided the claim form is completed correctly and submitted with the appropriate information, checks are usually processed within 3 to 5 business days from the date the submission is received. Contact the Fund Office at 1-800-241-2136 or 1-800-241-3473 to confirm receipt of your weekly disability benefits paperwork or to inquire on any additional concerns. Contact your human resources employer department for all other concerns relating to medical Leaves of Absences (LOA’s).

I would like to enroll for my benefits. Can I enroll over the phone?

Phone enrollment is only available  during the annual Open Enrollment window which typically occurs November 1 – December 15. When attempting to enroll outside of the annual open enrollment period, phone enrollment is not available. Please contact the Fund Office at 1800-241-2136 or 1800-241-3473 to request a paper enrollment form or to obtain additional enrollment options.