FREQUENTLY ASKED QUESTIONS

The Plan has entered into an agreement with Anthem Blue Cross | Blue Shield of Wisconsin.

For Classes A & C: Your deductible is $500 per person per calendar year- $1,500 per family per calendar year if in-network.
For Class A Reduced Cost: Your deductible is $3,000 per person per calendar year- $9,000 per family per calendar year if in-network.
There is no deductible for Class D (Medicare Supp.).

For Classes A & C: The out-of-pocket limit per calendar year is $2,800 per person and $8,100 per family if in-network.
For Class A Reduced Cost: The out-of-pocket limit per calendar year is $4,300 per person and $9,600 per family if in-network.

You and all of your eligible dependents are covered under your benefits as defined by the Plan.

Visit Anthem, login to your account, then search within the 'Find a Doctor' tool.

The Plan receives limited information from medical providers, and as a result, when the Plan receives a bill with a diagnosis of an accident or a possible accident, the Plan is required to obtain additional information, in writing, from the Participant. The Plan must determine, through the completion of the accident letter, whether the accident was work related, auto related or third-party liability.

All dependent children are eligible to be covered until age 26 whether or not they are full-time students, married, living at home, financially dependent on the eligible employee, or eligible for coverage under any other employer's plan. The current rules for coverage of grandchildren will not change.

If you meet the eligibility requirements there is a weekly disability benefit available for a maximum of 26 weeks. Short-term disability benefits are not payable for alumni and non-bargaining unit employees nor for those under the reduced cost option. Please refer to the SPD or call your claims adjuster for additional information.

Dental and vision benefits are optional and are not available separately. There is an annual open enrolment period in which you can elect these benefits. If you enroll you will be required to keep the optional benefits for a minimum of two years. The payment for this optional benefit can be deducted from your paycheck on a pre-tax basis or deducted from your dollar bank.

• The Plan provides a wide range of EAP services and resources to you and your household at no cost through Anthem EAP:
• Counseling
• Legal consultation
• Financial consultation
• ID recovery
• myStrength
• Dependent care and daily living resources
• Crisis consultation
• Other anthemEAP.com resources

If you receive care at a provider who does not participate with Anthem Blue Cross | Blue Shield of Wisconsin, submit an itemized bill to Local 434 Health & Welfare Fund at Wilson-McShane Corporation, 3001 Metro Drive, Suite 500, Bloomington, MN 55425. The itemized bill should have the employee’s ID and group number as it appears on your medical card. If the provider participates with HealthEOS, the provider will submit the claim for you.

Delta Dental network.

You can see any dentist you wish. However, the Plan uses the Delta Dental Network and the maximum benefit per year is higher if you use a network provider.

The Plan provides life insurance benefits depending on your classification in the Plan. Please refer to the SPD.

If you wish to change the name of your beneficiary, you must send a completed Beneficiary Change Form to the Fund Office.