Atlanta Top FAQ’s

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 or by failing to enroll. However, if you choose to waive coverage you may not have an opportunity to enroll for benefits until the next enrollment period unless you experience a Qualified Life Event. If you waive coverage, you may still be eligible for life insurance and a Beneficiary Designation Form should be completed.

What is a Qualified Life Event?
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 1-800-241-2136 or 1-800-241-3473 for more details on QLEs and the required notification periods.

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.

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 the Fund Office at 1-800-241-2136 or 1-800-241-3473 to inquire on claim status. You may also submit an inquiry via email to 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, HIPAA authorization may be required.

I am out on Medical Leave of Absence (LOA) or Short-Term Disability/Time Loss. 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 Short-term disability paperwork or to inquire on any additional concerns. Contact your human resources department for all other concerns relating to medical Leaves of Absence (LOA’s).

I would like to enroll for my benefits. Can I enroll over the phone?
You can now enroll over the phone during the annual Open Enrollment window. When your phone enrollment is complete, a copy of your confirmation number will be mailed to your address on file for your records. Please be advised, if you grant permission to someone else to help assist you with phone enrollment, you must be present during phone enrollment to give consent and to receive final confirmation of enrollment.

I have dropped down to the Ancillary plan. How do I become eligible for medical and prescription coverage again?
In accordance with your collective bargaining agreement, you must average at least 24 hours per week during the measurement period from 10/7/18 through 10/5/19 to qualify for Part Time benefits which includes Medical and Prescription coverage. If the average amount of hours is maintained benefits will become effective for the health benefit year in 2020. Contact your human resources department to confirm/review your eligibility.

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 also 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 policy. 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 ‘pending’ 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.