If you need a clarification on a response, please contact the Fund office during normal business hours at (301) 731-1050 or via email at email@example.com. Please remember that this web page is governed by the Plan Document. If there is any discrepancy between this web page and the Plan Document, the Plan Document governs.
In March 2009 the Plan was amended to require the social security numbers of any dependents including spouses. This ammendment is the result of the Medicare Secondary Payor (MSP) requirements.
If the dependent’s social security number is not received within 6 months from the date of birth, the date of marriage or the date added, the spouse and/or dependent’s coverage will be terminated.
Your benefits are provided by EWTF and are the result of the collective bargaining process between IBEW Local Union No. 26 and your employer. EWTF pays your claims. UnitedHealthcare or OneNet prices the claim. EWTF is not an insurance company. It is self-funded plan meaning that your employer’s contributions and any earned income from investments of your employer’s contributions pay for the health care expenses that you and your fellow participants incur. NOTE: The EWTF Plan makes the final decisions about what is covered and what is paid. EWTF writes the checks to pay benefits.
If you or an eligible family member is going to seek treatment in one of the following categories, you must obtain prior authorization before beginning any course of treatment. Otherwise, your benefits will be denied.
Home Health Care and Hospice Care
Physical Therapy, Speech Therapy, Occupational Therapy and Chiropractic Care
Contact the Prior Authorization Department at UnitedHealthcare at 1-800-850-1418.
The provider is not supposed to bill you for the discounted amount because they have agreed to the allowed amount as payment in full. This is provided you pay your patient’s portion (20% of allowed amount) and meet your deductible.
For each claim paid, a participant is sent an Explanation of Benefits (EOB). EWTF pays on the UnitedHealthcare or OneNet discounted amount, NOT the billed amount. Payment is 80% of the discounted amount for medical services, psychiatric treatment and basic dental services, subject to the deductible. (There is no deductible on dental claims.)
There are two columns on the right hand side of the EOB. One column is the “Provider Amount” and the other is “Patient Amount”. Monies in the Provider Amount column are the amount that the provider writes off. Any monies in the Patient Amount column are owed by you to the provider.
If you experience an occasion where the doctor, dentist or other medical provider sends a bill for a balance of charges corresponding with UnitedHealthcare or OneNet discounts, it is important that you bring it to the attention of the Fund office. If you did not present your EWTF ID card at the time of service, the provider is entitled to charge you the full amount.
At each visit to a doctor, dentist, lab or any other health care provider, present your EWTF/UnitedHealthcare identification card which also serves as your EWTF prescription card. This card includes all the information that your provider needs to submit your claims to the appropriate party and also ensures that the proper discounts are applied.
If you are a retired participant that has Medicare as the primary coverage, present your EWTF Medicare Supplemental card that also serves as your prescription card to any medical or dental provider.
If UnitedHealthcare is notified within 2 days after an emergency admission, your hospital bill will not be denied due to not getting authorization. The telephone number to the Notification Department is 1-800-850-1418. What is the web address to verify that my doctor participates with UHC or to locate a new medical provider? The web address is http://directory.uhis.com. You are responsible for verifying that your provider/hospital is in the UHC Choice Plus Network. HINT: Do not enter www. prior to “directory” in the web address.
The current deductibles are:
|Type of Benefit||Type of Deductible||Amount of Deductible|
The first $7000 of covered expenses is paid at 100% of the allowance (no deductible) per spell of illness with the remaining covered expense paid at 80% of the allowed amount. This includes outpatient hospital stays as well.
Yes. Your medical provider is responsible for obtaining prior authorization from UnitedHealthcare at least 48 hours prior to an elective hospital stay and within 2 days after an emergency admission. The telephone number is 800-850-1418.
The EWTF Plan rules provide that an individual or family who furnishes proof to the Fund office that the “Out-of-Pocket” expenses that have been paid by the participant exceed the Plan’s “Out-of-Pocket” maximum is entitled to have the remainder of their covered medical expenses paid at 100% of allowed costs for the remainder of that calendar year. The Out-of-Pocket expense maximum is $10,000 per family per calendar year. This means that before anyone can claim 100% coverage for medical expenses exceeding the Out of Pocket maximum, they must furnish documentary proof (receipts, paid invoices, etc.) clearly indicating that the person claiming the benefit has paid Out-of-Pocket medical expenses of $10,000. Claims submitted for the Catastrophic Benefit must be filed with the Fund office within one year from the end of the calendar year for which out of pocket expense is requested.
UnitedHealthcare (UHC) Choice Plus Network is a network with which Electrical Welfare Trust Fund (EWTF) has an agreement to help reduce your out-of-pocket expenses.
The web address is http://directory.uhis.com. You are responsible for verifying that your provider/hospital is in the UHC Choice Plus Network.
EWTF does not have any medical directories to send to participants. If you have access to the internet, you may access the medical provider network by pasting this address in your browser: http://directory.uhis.com If you don’t have access to the web, contact the service representatives at EWTF between 8 am and 4:30 pm to help you. The EWTF office number is (301) 731-1050. The toll-free number from surrounding states is (800) 929-EWTF (3983).
Yes, the provider can collect the estimated financial liability at the time of service.
The EWTF group number with UnitedHealthcare is 78-340001.
Your UHC ID number is a 12 digit number that begins with 304000 (zeroes). The remaining six digits is your ID number and is located on the front of your 4-sided EWTF/UnitedHealthcare hospitalization card.
Yes. Your medical provider is responsible for obtaining prior authorization from UnitedHealthcare before beginning any services. If prior authorization is not obtained from UHC then you run the risk of having the claim denied. The telephone number to the Prior Authorization Department at UHC is 1-800-850-1418.
This free program provides prenatal education and information to all EWTF members and spouses. The focus is on keeping healthy during a pregnancy, and keeping your baby healthy after it’s born.
Call (800) 850-1418 to register. You may notice that this is the same telephone number at UnitedHealthcare for prior authorizations. Identify yourself as a participant of Electrical Welfare Trust Fund and give the current group number (78-340001) so you are enrolled with the correct group. By enrolling in this program, you have the opportunity to take advantage of the following benefits:
Once EWTF is notified that the Healthy Pregnancy program has been completed, EWTF will pay the attending obstetrician an additional 5% of the allowed amount for the delivery charge for a total of 85% paid on the allowed amount. This percentage increase only pertains to the attending obstetrician delivery charge. The increased percentage rate does not include any ancillary charges including the hospital charges, anesthesiologist’s fees, etc.
OneNet PPO is a dental provider network with which Electrical Welfare Trust Fund (EWTF) has an agreement to help reduce your out-of-pocket dental expenses, if necessary. “PPO” is an abbreviation for Preferred Provider Organization. Currently EWTF has an agreement with OneNet to price your dental claims and to use their network of dentists.
Yes. Contact OneNet Member Services at 1-800-342-3289 to find out the name of a dental provider. They are open 24 hours a day. If you already have a dentist, you can call OneNet Member Services to find out if he/she participates with OneNet. If you prefer, follow this link to the OneNet Dental PPO Network to look up a dental provider close to home or work.
When selecting a dental provider please be aware that not all dentists in a group or office may participate with the OneNet Dental PPO network. Dentist participation in the OneNet Dental PPO network is by contract with individual dentists, and not through dental groups or offices that the dentist may be a part of.
Safety Glasses are available under this benefit to actively working eligible Members once each calendar year. Lenses are covered in full. Safety frames are covered up to $65 plus 20% of any out of pocket costs.
The lenses and frame provided are certified as safe for the work environment by meeting the necessary requirements set forth by ANSI (American National Standards Institute).
Contact VSP to find out if you are eligible for an exam and glasses/contacts by calling (800) 877-7195. You can also find out this info on the web.
The Pension Office can print a Pension Credit History for you. These are also mailed to all participants in the plan once each year.
A minimum of 1600 hours must be worked in order to receive a credit for a year of service. 400 hours will prevent a break in service.
Pension credits are earned under specific job classifications. First year apprentices, residential trainees and communication trainees do not earn pension credit.
No, you may apply for a early monthly pension benefit when you reach the age of 55 or, in cases of proven disability, at any age. Normal retirement age is 62.
Vesting means you have worked for 5 years with a minimum of 1600 hours each year. You will be entitled to a Pension once you have reached that status. Your right to that Pension cannot be forfeited.
You will forfeit your earned pension credits.
It goes into the general pension fund.
There are three types of benefits for a surviving spouse or named beneficiary: the Early Survivor Pension, the Lump Sum Death Benefit and the 5-Year Survivor’s Pension. Make sure that a current beneficiary form is on file in the Fund Office.
You must contact these organizations to find out when and what your retirement benefit would be from those plans.
If you leave employment covered by the Plan to go into military service that is required by law, you will generally be entitled to credit for that time, provided you return to your job within three months after your discharge. Therefore, be sure to notify the Pension Office prior to your entry into the military service and promptly upon your return.
Contact the benefits office and request an application three (3) months prior to your anticipated retirement. You will need birth certificates, marriage certificates and if applicable, divorce decrees and property settelements. More information may be requested depending on your individual circumstances.
You are at least age 50 and you permanently leave covered employment. This would be considered your regular retirement age. It normally takes three (3) months after you retire for all hours to be reported and transferred to Fidelity.
You have not worked any hours for which contributions are required to made to the Plan for at least six (6) months.
You become totally and permanently disabled at any age. You will be required to submit medical reports. The Trustees determine approval.
Effective October 1, 2015 there is a provision for a Hardship Withdrawal based on (1) unreimbursable medical expenses or (2) eviction or mortgage foreclosure on a principal residence. See the Hardship Withdrawal description under “What’s New”.
If you meet all the requirements for a distribution, the completed application will be submitted to Fidelity immediately after receipt. The availability of funds will depend on the type of distribution you choose.
When your first contributions are received for your Individual Account Fund you will receive a Welcome Package. In that package there is a Beneficiary Form. It is important that you fill that form out and return it in the envelope provided so that we have a named beneficiary under the plan.
By law, if you are married at the time of your death, your spouse is entitled to a Pre-retirement Surviving Spouse Benefit. The pre-retirement surviving spouse benefit is equal to 50% of your accumulated share determined on the date of your death. The only exception to the 50% rule would be if the total value of your account were less than $3500. If the total value is less than $3500 it will be paid as a lump sum amount. The remaining 50% of your account can be paid to anyone who you name as beneficiary after your spouse has received his/her 50%. Forms must be filled out correctly and notarized if your spouse is waiving his/her rights to receive his/her portion of your benefits.
Yes, all distributions are taxable and will be reported as such unless you choose to rollover or transfer your money into another savings retirement plan.