To protect our members, a Health and Wellness plan has been made available by the Board of Trustees and is administered by the Iron Workers District Council of Southern Ohio and Vicinity Trust Office. Your Benefit Summary Plan Description includes details regarding all of the below plans. The Trust provides the following coverage to eligible members:

Medical Insurance

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are currently eligible or covered under the Medical Plan.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights and much more.

Medical Insurance for Active and Non-Medicare Retired members is provided by Anthem Blue Cross and Blue Shield. Review your Summary of Benefits below and also visit Anthem’s website by clicking on the preceding link to find a network doctor, request ID cards, estimate your cost for procedures or treatment, check claim status, print Explanations of Benefits (EOB’s) and more.

Active Members Summary of Benefits and Coverage
Retiree (Non-Medicare) Plan A Members Summary of Benefits and Coverage
Retiree (Non-Medicare) Plan B Members Summary of Benefits and Coverage
Humana Medicare Retirees Summary of Benefits and Coverage

Call Anthem directly:

If you are active or a non-Medicare retiree call 1-844-610-1938

Call Humana directly:

If you are a Medicare retiree call 1-800-733-9064

Anthem Member Disclosure

Important Message for Medicare Eligible Retirees: If you are enrolled in the Humana Medicare PPO plan and you contact the Center for Medicare and Medicaid Services (CMS) to notify them (CMS) that you want your Medicare benefits back and that you do not want to continue your Humana Medicare Plan, CMS will TERMINATE your Humana plan through the Iron Workers Benefit Trust. You must also contact the IRON WORKERS BENEFIT TRUST OFFICE immediately in order to stop medical insurance premiums from being deducted from your pension check.

Prescription Drug Benefits

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are currently eligible or covered under the Prescription Drug Insurance plan.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights and much more.

Prescription Drug Insurance is for Active and Retired members and their eligible dependents. Your Pharmacy Benefit Manager is CVS Caremark.

If you have questions regarding your prescription drug benefits, call CVS Caremark at 1-888-202-1654.

Health Reimbursement Account (HRA)

Please contact the Benefit Trust Office at 1-800-331-4277 if you have questions regarding your HRA.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, contributions to your HRA, allowable expenses, and much more. The minimum required claim reimbursement amount is $25 unless your HRA balance is less than that, in which case your claim must be for the entire remaining balance.

Claims and Reimbursement Procedures:

You can use your HRA to reimburse yourself for eligible health care expenses. Claims must be filed within twelve months from the date the expenses were incurred.

To file a claim, please complete and return the HRA Claim Form along with all required documentation necessary to process the claim. Any claim that is denied in whole or in part due to a lack of sufficient funds in the HRA must be refiled to receive reimbursement in the future. Claims will not be automatically reprocessed once funds become available.

Authorizing Payment of Premiums:

You can use your HRA to make premium self-payments if you do not elect COBRA when your eligibility as an Active Participant ends, and after the balances in your hour bank and/or money bank are exhausted. Similarly, you can use your HRA to make Retiree premium payments if you do not elect COBRA when you retire. If you do not have enough HRA dollars remaining, you must pay the remainder of your self-payment or retiree premium payment directly to the Benefit Trust Office. To pay premiums out of your HRA, please complete and return the HRA Premium Payment Claim Form.

Dental Benefits - CIGNA

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are a current participant under the Dental Plan. This plan is only available to Active Participants and Dependents. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights, and much more.

Dental Benefits are provided by the Benefit Trust Office, however you may receive an increased benefit by using a network dentist.  To find a network  dentist, contact CIGNA at 1-800-797-3381 or visit CIGNA’s website.

For dental services select the CIGNA Dental PPO Shared Administration Plus network.

In-Network Dentist:

If you have Dental procedures completed by a CIGNA network Dentist, the Dental Plan will pay 100% of covered, eligible charges up to the CIGNA allowable amount up to your maximum annual benefit of $2,000 per covered person per calendar year.

Non-Network Dentist:

If you visit a non-network Dentist, the Dental Plan will reimburse based on the Dental Schedule of Benefits up to the maximum annual benefit of $2,000 per covered person per calendar year and you will owe the Dentist the difference between the allowable amount and the amount the Dentist charged.

Your Dentist (whether in or out-of-network) must complete and submit either an American Dental Association (ADA) Dental Claim Form or the Iron Workers Benefit Trust Dental Claim Form to the Benefit Trust Office.

Vision Benefits

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are a current participant under the Vision Plan. This plan is only available to Active Participants and Dependents. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights, and much more.

Vision Benefits are provided by the Benefit Trust Office.

Your Vision benefit provides coverage for routine vision related expenses. You can obtain vision services from any licensed optical provider.

Eligible Vision Expenses:
  • Refractive Eye Examinations; and
  • Prescription Lenses (single, bifocal, trifocal) and Frames; OR
  • Contact Lenses

Benefits are paid based on reasonable charges for vision care for you and your family. The annual refractive eye exam is covered at 100%. Lenses and Frames OR Contact Lenses are reimbursable up to $200 per eligible covered person per calendar year. You must complete a Vision Claim Form and submit it along with your detailed claim receipt(s) to the Benefit Trust Office.

While the Iron Workers Benefit Trust will accept a vision claim from any licensed vision provider, not all providers are willing to send claims. The map below can be used to find a vision provider that has submitted claims in the past year. You can still go to any provider of your choice, but if the provider is not on the map below, it is likely that you will have to pay the provider in full and send the claim yourself for reimbursement.

Hearing Aid Benefits

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are eligible for benefits under this Plan. This plan is only available to Active Participants and Dependents. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, covered and non-covered expenses, how to file a claim, your appeal rights, and much more.

Hearing Aid Benefits are provided by the Benefit Trust Office.

Services must be performed and a prescription provided by a licensed physician. Expenses are considered to be incurred on the date the service is provided.

Eligible Hearing Aid Expenses:
  • Hearing Aid Exams to determine need for hearing aid(s): Covered once every 24-month period.
  • Hearing Aid Instruments: Covered at 80% up to a maximum of $2,000 once every 36-month period.

Benefits are paid based on reasonable charges for you and your family. You must complete a Medical Claim Form and submit it along with your detailed claim receipt(s) to the Benefit Trust Office.

Life & AD&D Insurance

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are a current participant under this Plan.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, coverage amount, conversion rights, how to file a claim, and much more.

Life Insurance is provided for our members through MetLife.

Active Iron Workers and Iron Workers on Self-Pay:
  • Your Life Insurance Benefit is $7,000
  • Your Accidental Death Benefit is $7,000

Active and Self-Pay Iron Workers are eligible for Accidental Death and Dismemberment (AD&D) coverage in addition to Group Life Insurance benefits. For a detailed list of AD&D benefits, please refer to the Benefit Summary Plan Description.

Retired Iron Workers Covered by the Pension Plan:
  • Your Life Insurance Benefit is $7,000 (unless your Pension is Deferred or Partial Pro-Rata)
  • You are not eligible for AD&D

In the event of a death, beneficiaries should contact the Iron Workers Benefit Trust Office to notify us of the death so we can assist you in filing a claim.

Weekly Disability Income Benefits

Please contact the Benefit Trust Office at 1-800-331-4277 to determine whether you are eligible for this benefit. This benefit is only available to Active Participants. You are not eligible if you are Retired or on Self-Pay.

Your Benefit Summary Plan Description includes details to assist you to determine your eligibility, coverage amount, how to file a claim, and much more.

Weekly Disability Income Benefits are provided for our members through the Benefit Trust Office.

If you become totally disabled, you may be eligible if:
  • You are eligible for coverage under the Plan on the date you become disabled;
  • You become totally disabled as a result of a non-occupational accidental injury or illness;
  • You are under the care of a duly-qualified Physician; and
  • Receive certification of the disability from a qualified Physician.
Benefits begin on the:
  • First full day of disability due to a non-occupational accident; or
  • Eighth day of disability due to illness unless you are inpatient before the eighth day of disability in which case benefits will begin on the day of your inpatient hospital admission.
  • The maximum period of disability benefits is 26 weeks for each period of disability for accident or illness; or three weeks for one period of disability per lifetime for inpatient treatment of drug or alcohol-related treatment.

To file a claim, please complete the Weekly Disability Income Claim Form and submit to the Benefit Trust Office.

If you are disabled on or after 12/1/2015 as a result of an Off-the-Job Accident, you may be eligible for a benefit through IMPACT’s Off-the-Job Accident Plan. For more information regarding eligibility for benefits, and to download a claim form, please visit http://www.impact-net.org/programs/off-the-job-accident or call Welfare & Pension Administration Service, Inc. (WPAS) at 1-800-331-6158.