Health and Benefit Trust

What is our Dental Coverage?

The Fund offers Dental Benefits coverage to all eligible participants and their eligible dependents. Sele-Dent administers all dental and orthodontia claims for the Plan. The Fund has established a Local 94 Network of Participating Providers, as well as the Sele-Dent PPO Network, where eligible participants can receive discounted dental services. For a complete list of providers and for more information about your Dental Benefits, please see the Dental Benefits section of this site.

I gave my Empire BlueCross card to my dentist, and they told me that dental benefits were not covered. Why is my coverage being denied?

The Fund provides medical benefits coverage through Empire BlueCross BlueShield’s PPO medical plan. Your Dental Benefits are administered by Sele-Dent. For more information about your Dental Benefits, please see the Dental Benefits section of this site.

Are prescription medications covered by Empire?

No. The Fund provides Prescription Drug benefits through CVS/Caremark. You should have a separate Prescription Drug ID card. For more information about your Prescription Drug Benefits, please see the Prescription Drug Benefits section of this site.

What is the vision coverage?

The Fund provides benefits for one eye exam and one lens(es) per calendar year. For more information, go to the Vision Care Benefits page.

Why was my coverage cancelled?

Please call the Fund Office for more information. See the Contact Us page for phone numbers.

As an Active Member, what is our Medical Coverage?

The Health and Benefit Trust Fund offers medical benefits to active eligible participants. Medical benefits include coverage for preventive care, doctor visits, hospital stays and other medical services. The Health and Benefit Trust Fund shares most of the cost of medical services when you visit in-network providers, meaning you pay less out-of-pocket for your health care. The Medical Plan is administered by Empire BlueCross BlueShield. For more information, go to the Medical Benefits page.

How do I add my newborn child to my plan?

You must provide the Fund Office with a copy of the child’s birth certificate within 90 days of birth to enroll your child with the applicable date (child’s birthdate).  If you fail to do so, within the applicable 90-day period, dependent coverage will not be available under the Plan for your new dependent child until the first of the month following the date in which you provide the Fund Office with the required documentation or any other verifying information requested.  A Coordination of Benefits Form (COB) must be completed if your child has other coverage.  You should also visit the Life Events page on this site to see what you need to do for your other benefits.

I recently married. How do I add my spouse to my coverage?

You must provide a copy of your marriage certificate within 90 days of marriage to enroll your new spouse with the applicable date (date of marriage).  If you fail to do so, within the applicable 90-day period, dependent coverage will not be available under the Plan for your new spouse until the first of the month following the date in which you provide the Fund Office with the required documentation or any other verifying information requested.  A Coordination of Benefits Form (COB) must be completed if your spouse has other coverage. You should also visit the Life Events page on this site to see what you need to do for your other benefits.

Why did I receive a bill for medical services?

While the Plan offers medical, prescription drug, dental and vision coverage, it does not pay 100% for all of these services. There are co-payments and coinsurance that you or your covered dependents may be responsible for paying. For more information about your benefits, please visit the Health and Benefit Trust Fund section of this site.

My adult dependent child is receiving health insurance through an employer. Who is the primary health insurance carrier?

If your dependent child has other group health insurance coverage through an employer, the Plan will generally consider that coverage to be primary and the Plan’s coverage for such child will be secondary in accordance with the Coordination of Benefit (“COB”) rules which is found in the SPD.

I have questions about the Traditional Generic Step Therapy Program that became effective 7/1/12

Click here for answers to Frequently Asked Questions regarding the Traditional Generic Step Therapy Program effective 7/1/12.

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