ANSWER: Your coverage is provided through LINECO. LINECO is the Benefit Fund. Blue Cross/Blue Shield is the national provider network. Your provider should bill their local Blue Cross office. Blue Cross in turn works with the LINECO Fund Office, which reviews the claims for final determination of benefits. For coverage details please refer to the relevant Benefit Summary Tab or the SPD.
ANSWER: Please refer to the SPD or the Claims FAQ section for details. In addition, please make sure your spouse and dependent children are enrolled by submitting the Family Enrollment Card and any required documentation to the Fund Office.
ANSWER: There is no "office co-pay" per se. The Plan is a comprehensive major medical plan. You are responsible for paying the annual deductible and the 20-30% co-insurance. However, certain preventive services may be covered at 100% with no deductible if a Blue Cross/Blue Shield provider is used. Please refer to the 12/10 Summary of Material Modifications (SMM).
ANSWER: Yes, benefits are paid directly to providers, except for prescription drug benefits.
ANSWER: Preauthorization is required for all Mental Health services (call the MAP/Member Assistance Program at 1- (800) 332-2191). Bariatric surgery and jaw surgery require pre-authorization by the Fund Office. There is also a pre-certification process for medical in-patient admissions. All services must be medically necessary in order to be considered for benefits. Certain prescription drugs also require pre-approval. Please call the Fund office if you or your provider have any questions.
ANSWER: The Plan does not have a benefit for any nutritional counseling or for weight loss programs.You can call the MAP program for assistance through the Life Coach program.
ANSWER: The Plan benefits would apply if you are outside the US, and the Blue Cross/Blue Shield Network does have a limited international network.
ANSWER: No, the Plan does not cover work-related claims. Refer instead to your employer's worker's compensation program.
LINECO is a multiemployer self-funded, self-administered welfare benefit plan set up to provide medical, dental, vision, and disability benefits as well as Life Insurance for outside members of the International Brotherhood of Electrical Workers working under bargaining agreements between the International Brotherhood of Electrical Workers and the National Electrical Contractors Association.
Descriptions of benefits on this website do not constitute a guarantee of coverage or payment--all claims are subject to eligibility and Plan limitations at the time services are rendered.