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Pension, Annuity or Vacation,
contact the following:
FREQUENTLY ASKED QUESTIONS ABOUT THE NEW INDIANA HEALTH & WELFARE PLAN:
Q. Where do I call for information or questions concerning our new Health & Welfare Plan in Indiana? A. Zenith Administrators 1-800-700-6756. When calling you will get a prompt for the following options: For questions about Eligibility, Self Payments and COBRA........press 2. For questions about Short Term Disability or Death Benefits.....press 3. For questions about Medical and Dental Claims or Benefits.......press 4. For questions about Medical Reimbursements.............................press 5. For any other questions or if you need further assistance ask to speak with Julie Smith. Information available on their website: www.zenithadm.com
Q. What if I didn't receive my new Health & Welfare cards? A. You should've received new Medical and Pharmacy cards by mail, if not, contact Julie Smith.
Q. Are there Eye and Dental cards? A. No, use the Health & Welfare card at the eye and dental providers.
Q. How can I find out if my Physician, Hospital, Pharmacy, Dentist or Optometrist are in our network? A. Doctor or Hospital: call the # on the back of your H&W card or check the website: www.anthem.com Pharmacy: call the # on the back of your Pharmacy card or check the website: www.medco.com Dentist: check their website: www.maverest.net Optometrist: call 1-877-7195 or check their website: www.vsp.com
Q. What if I use an out of network doctor or hospital? A. Network doctors and hospitals are covered at 75% and out of network are covered at 55%.
Q. Can my deductible, doctor co-pays and pharmacy co-pays be reimbursed? A. Yes, they may be reimbursed at 100% or whichever amount you select on your reimbursement form. Pharmacy reimbursements, must still be accompanied with the receipt for reimbursement and you will need to send in a copy of your EOB (explanation of benefits) form, (the monthly form sent from Zenith that shows detailed charged amounts from your doctors) for Doctor co-pay reimbursements.
Q. Is there a $5.00 charge for each EOB or group of EOB's sent. When will reimbursements be paid? A. There is a $5.00 charge to your bank each time you submit for reimbursement whether you submit only one EOB or a group of EOB's. Requests for bank reimbursements may be filed ONLY twice a year. Your claims will be processed immediately and a check will be sent shortly.
Q. Are annual physicals covered under the plan? A. Yes, physicals for women incl. pap smear and mammograms. Physicals and PSA's for men at 100%.
Q. Is Laser Vision covered under the new plan? A. No, discounts available by going to certain providers through Vision Service Plan. Costs may be reimbursed from your bank.
Q. Will I need to send in a new reciprocity form to transfer my funds? A. YES!!!
Q. If a retiree is on supplementary insurance, (Medicare) do they still have to meet the deductible? A. No, as long as they have Medicare, they do not pay the deductible or co-pays.
Q. Will retirees lose eye and dental benefits when they go on Medicare? A. As long as the participant or their spouse is covered fully under the plan and under the age of 65, they will be covered on the eye and dental plan.
After a reasonable time, if your problem is not resolved, contact either Mark, Mike or Rick.
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