Frequently Asked Questions
NOTE: The following FAQs are abbreviated explanations of complicated Plan benefits. Please review the applicable Summary Plan Descriptions if you still have questions, and please note any discrepancy between these FAQs and the Plan Documents will be resolved in favor of the Plan Documents, which are the controlling documents.
I heard I can check my Health Plan eligibility online. How do I do that?
The Benefit Funds offers a Member Self-Service Module (“MSS”) that allows members to access basic benefits information online, in a secure and encrypted manner. On MSS, members are able to check their Health Plan eligibility, as well as review their listed dependents and beneficiaries. Additional benefits of MSS include the ability to check hours received on a month-to-month basis, generate a basic estimate of pension benefits, and record address changes, phone numbers or email addresses.
I heard I can check my Health Plan eligibility online. How do I do that?
The life insurance policy available from the IUOE Local 4 Health and Welfare Plan is a benefit for eligible members. For more information, contact the Benefit Funds Office at [email protected] or by calling 1-508-533-1400. Additionally, the Union offers a life insurance policy that members pay for. Contact the Union for information about that separate policy.
I need a new medical or dental ID card – how do I get one?
Eligible members can order ID cards via the secure BCBS Member Central website: bluecrossma.org. Additionally, the Benefit Funds’ Eligibility Team can trigger new ID cards. To contact the Eligibility Team, call 1-508-533-1400 or email [email protected].
Members can also download the MyBlue Member App from the Apple App and Google Play stores. The App gives members instant access to their ID cards, claims history, copays as well as tools to search for providers.
Does Local 4 have prescription coverage?
Effective January 1, 2025, Optum Rx is the new pharmacy benefit manager for the IUOE Local 4 Health and Welfare Fund. Optum provides safe, easy, and cost-effective ways for members to get the medication they need. To view a list of network pharmacies, use the Optum Rx app or log in to OptumRx.com. To learn if a medication is covered, go to OptumRx.com to check the Plan’s formulary (list of covered medications). Optum Rx offers a no-cost program to help manage diabetes. Eligible members are automatically enrolled and receive a letter with information. One free blood glucose meter and supplies are available. Members should call Optum Rx at 1-855-241-2213 for more information.
Does Local 4 have Vision benefits?
Effective January 1, 2022, eligible members and their covered dependents are enrolled in the Vision Plan with EyeMed. An eye exam and one pair of eyeglasses or contact lenses once every 12 months for members, spouse and covered dependents are available when provided by an EyeMed provider. EyeMed’s network is far larger than the Plan’s last provider. There are many more providers covered in Massachusetts, New Hampshire, and Maine. EyeMed’s network also includes LensCrafters, Pearl Vision, Target, and online retailers such as 1-800-CONTACTS and Glasses.com. Create a member account at eyemed.com or download the Members App on the App Store or Google Play.
I have to file a claim to get reimbursed for my DOT physical / massage / acupuncture / acupressure / homeopathic medicine. How do I do that?
The Subscriber Reimbursement Form is available on the Funds website: local4funds.org under Important Forms and Documents.
I have to file a claim to get reimbursed for my fitness club and/or weight loss benefit. How do I do that?
A claim form is due by March 31 for the prior year. Further questions can be directed to BCBS Member Services at 1-800-401-7690.
Learn more at one of the below forms:
I have more than one BCBS Medical ID card. Which one is valid?
New medical ID cards were mailed during October 2023 to reflect the new Employee Assistance Program benefit through Lyra. Your medical ID card suffix should begin with IUH. The newly issued cards also include information on the front about Plan costs such as deductibles and maximum out-of-pocket costs.
How is my Health Plan eligibility determined?
As a covered employee, you must work 1,000 or more credited hours (1,500 or more hours if you are a participant in Local 4D covered by an Equipment House Contract during a calendar year (January through December) to become eligible for coverage under the Basic Eligibility Rule. You are then covered for the 12-month period beginning the following March 1 through February 28 (or February 29 during a leap year). First-year Local 4D members only require 1,000 hours for eligibility.
If you cannot meet the requirements of the Basic Eligibility Rule, you may become eligible under the Supplemental Eligibility Rule on the first day of the month following the month you work 500 or more credited hours during the calendar year.
I need to take a medical leave – how do I go about this?
As of January 1, 2021, the Massachusetts Paid Family and Medical Leave Act will begin providing up to 20 weeks of paid leave for residents of the Commonwealth with a serious health condition, at up to $850 per week. For more information about the PFLMA, please visit: mass.gov/orgs/department-of-family-and-medical-leave. As such, the Trustees of the Plan have decided to reduce the Loss of Time benefit available under the Plan. Eligible participants must first exhaust any state medical benefits that are available to them, such as the 20 weeks of paid medical leave under the PFLMA. If participants remain disabled after 20 weeks have ended, they may be entitled to up to an additional six weeks of Loss of Time from the Plan, at the customary $500 per week (less FICA). Residents of a state that does not have a paid medical leave, or who are not eligible for state leave benefits, may apply for Loss of Time through the Plan as usual. Contact the Benefit Funds Office to request an application for the Loss of Time benefit.
How are my hours reported to the Benefit Funds Office?
Per the Collective Bargaining Agreement, each participating employer must remit a monthly report to the Benefit Funds Office with hours worked and payment for all fringe benefits. Employer remittance reports are due the 19th of the month following the month in which the work was performed. The Plan sends Reports of Contributions to each active member twice a year which summarizes all hours and fringe benefits reported and paid in on your behalf.
What happens if I get a divorce – will I still need to cover my ex-spouse?
If you are Legally Separated or Divorced, and you are required by your Separation Agreement/Divorce Decree to cover your ex-spouse under your Health Plan, you must submit the Separation Agreement/Divorce Decree to the Health Fund. Your ex-spouse will only be covered until either you or your ex-spouse gets remarried.
What does the Plan need in order to add dependents to my health plan coverage?
In order to add your Legal Spouse and/or your Dependent Child to your health plan coverage, proper documentation validating the relationship between you and your dependent(s) is required under the provisions of the Plan. Birth certificates from the city or town of birth as well as copies of each dependent’s Social Security card are required. Hospital generated birth certificates will not be accepted.
Why do you need my dependent’s Social Security number?
Participants must submit a copy of their Social Security card as well as a copy of all dependent’s Social Security cards who will be covered under the Plan for IRS reporting capabilities. Please be sure that all information matches what appears on your tax filings (including legal names, dates of birth and Social Security numbers). If you do not submit copies of Social Security cards for your dependents, it may cause a delay in coverage.
I am disabled. Can I still get credit toward my eligibility?
Yes, if you meet certain criteria. You must be Totally Disabled as defined by the Plan, eligible for Basic Plan coverage at the onset of the disability, continuously eligible for benefits for at least 12 months prior to the onset of the disability, and apply for credit within 24 months of losing earned coverage. You may be eligible for 30 hours of credit per week for up to 52 weeks of your disability.