UFCW Union Local 1995 & Employers Health & Welfare Fund 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 (QLE)?
A Qualified Life Event (QLE) is an occurrence that will allow a special enrollment period. 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 Blue Cross Blue Shield of Tennessee at 1-800-565-9140. 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 wish to add my spouse for coverage. What (Evidence of Marriage) documentation is needed?
A marriage license, spousal affidavit and ‘joint marital document’ may be required. If you have been married for more than three years, the ‘joint marital document’ should be one form of documentation dated within the past 6 months establishing current marital status. (Examples include: a joint household bill, joint bank/credit account, joint mortgage or lease, or front page of your most recent jointly-filed tax return with blacked out financial information).

Why does the Fund request my spouse’s employment info?
The Fund does not provide primary spousal coverage if your spouse has access to healthcare coverage through his or her employment (not including coverage that is paid 100% by your spouse). If interested in discussing the requirements to add your spouse for secondary coverage contact the Fund Office at 1-800-241-2136 or 1-800-241-3473.