Visit our Benefits Administrator website at www.725benefits.org.
Summary of Benefits
Blue Cross Blue Shield is one of the largest P.P.O Plans in the Country and by utilizing it saves our members and the Health and Welfare Trust Fund a considerable amount of money. You may go on their website at www.bcbsfl.com to see what doctors and medical facilities are in the network or you may call their toll free number which is 1-800-320-7091. Our Group # is 64441001. You may also pick up a Provider Directory for South Florida at the Union Office.
Benefit Services is our benefits administrator for our Medical, Dental, Pension, 401(a) Plans, and the Disability and Life Insurance Claims. Their address is 15800 Pines Blvd., #201, Pembroke Pines, FL 33027. Their phone number is 754-777-7735. Their website is www.725benefits.org.
The following is a list of some of the benefits that you may or may not be aware of. You may not be eligible for some of these benefits while you are under Cobra.
These benefits are for active working members only:
- As part of your benefits, you may be entitled to Loss of Time (Short Term) Disability benefits if you are unable to work due to an illness or a non-work related injury. The loss of Time benefit is payable for up to 26 weeks. If you are in the following job classification your weekly benefit will be:
- General Foreman, Foreman, R5, R1 &MESJ $500.00 per week
- R2 and Apprentice 5th year $360.00 per week
- R3, R4, MES2, MES3, and Apprentice 2nd-4th year $250.00 per week
- While on Loss of Time (Short term Disability), you will receive 100 hours towards your coverage per month, to keep your insurance in effect. Please go to www.725benefits.org to obtain the necessary forms or call 754-777-7735. You are not eligible for this benefit while under Cobra.
- We have a $30,000 Life Insurance Benefit, if die due to an accident, your beneficiary will receive a total of $60,000. You are not eligible while you are under Cobra. We urge you to keep your beneficiary card updated. You can obtain a beneficiary form online at www.725benefits.org.
- Please use our PPO Plan which is Blue Cross Blue Shield of Florida (Blue Choice Plan). By using Blue Cross-Blue Shield of Florida, you will save yourself and the Health and Welfare Trust Fund money when you go to a doctor in the BCBS network. Participant and/or Dependent pays a $45.00 fee per office visit (for primary care physicians, i.e; General Practitioner or Pediatrician only). All Specialists, other than General Practitioner, the Participant and/or Dependent the Plan is 80-20%. If a doctor or medical facility is not part of the BCBSFL Network, than the 60-40% Plan is used. BCBSFL’s website lists doctors and medical facilities in your area: www.bcbsfl.com.
Medical Coverage Rates
- This Medical plan is effective each year effective January 1st.
- The Calendar Year deductible is $500 per person or $1,500 per family
- The doctor office visit co-pay $45 per visit (for primary care physicians only)
- Transplant Policy unlimited or no cap on procedures and drugs combined.
- The co-insurance percentage is:
- PPO service providers is 80/20.
- Non-PPO service providers is 60/40
The prescription drug co-pays are as follows:
The Pharmacy Benefit Manager (PBM) is Prime Therapeutics at 1-888-849-7865 or www.bcbsfl.com. Prime Therapeutics handles the prescription drug portion of our Blue Cross/Blue Shield Policy.
- Generic drug co-pay is $15.00 per prescription
- Name brand formulary drug co-pay is $35 per prescription
- Non-formulary drug co-pay is $65 per prescription
- Mail order (90-day prescription) generic drug co-pay is $30 per prescription
- Mail order (90-day prescription) name brand formulary drug co-pay $70 per prescription
- Mail order (90-day prescription) non-formulary drug co-pay is $130 per prescription
Try to use generic prescriptions because this will help our insurance plan. If ordering maintenance/continuing drugs (prescriptions needed for more than 30 days) the Board of Trustees encourages you to choose the mail order option.
Dental Coverage – PPO with Florida Combine Life (Blue Dental Choice Plus) – Effective August 1, 2019
- Customer Service – 1-888-223-4892
- Group #: 0F583L
- Plan Type #: GROUP
- Up to $2,500. per eligible person in a family.
- Wisdom teeth are covered under dental program (NOT Major Medical)
- It is recommended to use the dental professionals within the Florida Combined Life Dental network
If ordering maintenance/continuing drugs (prescriptions needed for more than 30 days) the board of trustees encourages you to choose the mail order option .
RIGHTWAY – Your Health Concierge Service. Your healthcare experience simplified! All of your healthcare resources in one place. Rightway combines high-tech and high-touch to make healthcare simple for each member.
Please visit www.725benefits.org for more information on this new service.
Upon a member passing away, please have the Spouse and/or Member of the Family, call the Union Hall – 305-681-8596 as soon as possible. The information needed is as follows:
- Date of Death; (DOD)
- Death Certificates – Please submit two (2) ORIGINAL death certificates WITH the cause of death (long form). This should be requested by the Funeral Home;
- A copy of the paid funeral invoice and proof of payment – The invoice copy must note PAID IN FULL and a copy of PROOF OF PAYMENT needs to be submitted. The person noted on this form will the PAID IN FULL receipt will be issued funds paid by the United Association.
- Upon the Hall receiving the required information of the members death the Benefit Services Office and the United Association will be notified by the Union Hall.