Frequently Asked Questions
I am a new employee, when will I become eligible?
When you have worked at least 125 hours in an eligibility month, you will become covered on the first day of the corresponding benefit month. Example: 125 hours worked in January makes you eligible for March; 125 hours worked in February makes you eligible in April. (There is a lag or reporting month for your employer to submit and for LINECO to process the hours and the contributions for those hours.)
When will my family be eligible?
Your eligible dependents will become eligible on the same date that you become eligible. You must enroll your dependents before LINECO can pay their claims.
How long will my coverage last when I quit working?
Any hours you work in excess of the required 125 hours are carried forward for up to 12 months under the Fund's "Rollback Rule." You may be eligible for several months after you quit working. The rollback rule does not apply to Utility/REA members. Click here to check your eligibility hours or termination date.
I am disabled and cannot work. What will happen to my eligibility?
If you become disabled and qualify for the Fund's "Eligibility due to Disability Rule," you may be eligible for up to 12 months of additional coverage for you and your family. The disability rule does not apply to Utility/REA members.
I have been called to active military duty. What will happen to the coverage I have earned?
You and your family's eligibility will be frozen on the day that you enter active duty. Your coverage will be reinstated when you return to work for a contributing employer. If your dependent enters the armed forces they are not covered until they are released from active duty.
I am attending a JATC school. What will happen to my eligibility?
You will be credited with 8 hours for each day you attend JATC school up to a maximum of 120 hours.
I am taking FMLA (family medical leave). What will happen to my eligibility?
Have your employer send LINECO a copy of the FMLA certification. Your eligibility may be continued up to a maximum of 12 weeks.
I am going to work for an IBEW employer who doesn't contribute to LINECO. What should I do so that my LINECO
coverage does not terminate?
You will need to enroll in the IBEW Electronic Reciprocal System (ERTS) designating LINECO as your home Fund. You will also need to ask the Local Union in whose jurisdiction you are going to work to notify ERTS of where you are working.
What is Short-Hours self payment?
Short hours self-payments are a separate offering of up to 6 months continuation of coverage for employees who do not have sufficient hours in a particular eligibility month. For some employees it may be cheaper to make a Short Hours self-payment than to make a COBRA payment; you can choose which is best for you. A letter is sent to those who may be eligible explaining the rules for Short Hours self-payments along with the Cobra notice. The short hours option is not available for Utility/REA members. For more information on Short-hours self payments and COBRA, click here.
What is COBRA?
Under the COBRA coverage provision, qualifying individuals can make self-payments for continued coverage (called COBRA coverage) if coverage terminates due to a reduction in your hours, termination of your employment (including retirement), your death, your divorce or legal separation, or if a child ceases to meet the definition of a dependent. Please call the Fund office to notify LINECO immediately of a dependent qualifying event or to elect COBRA coverage. Notices are sent automatically to employees who have lost eligibility for a lack of hours.
For more information on COBRA, please refer to the SPD.
I am getting divorced. Is my former spouse entitled to self-pay coverage on their own?
Yes, ex-spouses can be entitled to COBRA coverage if the Plan is notified within 60 days of divorce/legal separation. Please contact the Fund office immediately if you become legally separated or divorced.
My child will soon turn age 26—can my child be eligible for COBRA?
Yes, a child's failure to meet the Plan's definition of a dependent can entitle them for COBRA coverage.
How long can I have COBRA coverage?
Normal COBRA coverage is for up to 18 months (36 months for ex-dependents) if your coverage terminates due to a reduction in your hours or termination of your employment (including retirement).
What type of coverage is available under COBRA?
There are 3 choices of plans: Medical only; Medical/ Dental/Vision; or Medical/Dental/ Vision/Life. For Utility members there are 2 choices of Plans: Medical only or Medical/Dental/Vision.
How do I submit my COBRA self payment?
Once you elect COBRA, coupons will be mailed to you with instructions and due dates; you can also make payments online with a credit card. Please contact the Fund Office with any questions.
What are the COBRA rates?
As of March 2023, the COBRA Rates are as follows:
Construction Utility Medical Only $1,027.00 $1,475.00 Medical/Dental/Vision $1,099.00 $1,557.00 Medical/Dental/Vision/Life $1,106.00 N/A
Are the self payment rates going to change every year?
The self payments rates are reviewed yearly by the Board of Trustees.
Is there a separate Retiree Plan?
Yes, there is a Retiree Plan. It is separate from COBRA coverage, and the two are mutually exclusive. Please refer to the SPD for more details.
What is LINECO's Retiree Plan?
LINECO offers a retiree plan similar to our active coverage. A monthly premium is required to enroll and maintain retiree coverage.
How do I qualify for the Retiree Plan?
For early and normal retirements there are 5 requirements that all must be met. At least age 55; and
- Must be retired from any and all employment in the electrical construction industry; and
- Must be receiving retirement benefits either from a plan negotiated or sponsored by the IBEW, from a qualified retirement plan, or from Social Security; and
- Must be eligible for LINECO benefits on the day immediately preceding the effective date of your LINECO retiree benefits; and
- Must have been eligible for coverage under LINECO due to work hours for 48 of the 60 months preceding the effective date of your LINECO retiree benefits.
Please refer to the Retiree section of the SPD for more information.
What if I am totally disabled?
Being disabled may qualify you for the Retiree plan. The requirements are:
For disability retirements, you must meet ALL of the following requirements:
- Must be receiving disability retirement benefits either from a plan negotiated or sponsored by the IBEW, from a qualified retirement plan, or from Social Security; and
- Must be eligible for coverage under LINECO on the day immediately preceding the day your disability plan benefits become effective.
Please refer to the SPD for more information.
Are there different options for the Retiree plan?
Yes, there are 2 Retiree plans: Medical only or Medical/Dental/Vision. Click here for rates or contact the Fund office.
Are there different rates depending on who will be covered and whether the covered persons have Medicare?
Yes, there are different rates. Rates vary according to number of people covered and whether they have Medicare. The following are rates effective March 1, 2023:
Medical Benefits Only
Medical, Dental, Vision
Both Employee and Spouse have Medicare $ 520.00 $ 560.00 One of them has Medicare $ 989.00 $1,035.00 Neither of them has Medicare $1,458.00 $1,510.00 Single with Medicare $ 260.00 $ 280.00 Single without Medicare $ 729.00 $ 755.00 Single with Medicare (covering at least 1 child) $ 391.00 $ 421.00 Single without Medicare (covering at least 1 child) $ 859.00 $ 885.00
Can I enroll online?
No, at this time to enroll in the retiree plan you need to contact the Fund office to enroll.
What about Medicare Part D prescription drug plans, should I enroll?
LINECO members (including dependents) will automatically be enrolled in the LINECO Medicare Part D prescription program when they become eligible for Medicare. LINECO's prescription coverage was designed specifically to bridge some of the unique rules that Medicare Part D plans have so our members are not impacted by them. Although you have the option of dropping your prescription drug coverage through the Fund and switching to another Medicare Part D plan, most participants will not benefit by doing so and LINECO is not encouraging anyone to switch to a Part D plan on their own. If you are enrolled in a Medicare Part D plan other than LINECO's you will no longer be eligible for LINECO's prescription coverage.
Does the plan coordinate coverage with Medicare?
Yes, LINECO coordinates its Retiree Benefits with Medicare. If you and/or your spouse are eligible to participate in Medicare, this Plan's benefits will be calculated as though benefits under Medicare Part A and Part B have been paid, whether or not you are actually enrolled in both Parts. To avoid being responsible for higher out-of-pocket costs, youand your spouse should enroll in both Medicare Part A and Part B when eligible to do so.
How do I check my eligibility status?
You may check your eligibility (hours worked and corresponding monthly eligibility) by logging in to your MyLineco Portal on this website.
How can I find out the status of my claims?
You can find out the status of your claims by logging in to your MyLineco Portal on this website.
- I am a new employee. When will I receive an enrollment packet and Plan booklet?
Will the plan provide ID cards?
Yes, the plan provides medical and prescription ID cards in the member's name, cards are not issued in the dependents name. The cards are mailed to your home address directly from Blue Cross Blue Shield (medical card) and Express Scripts (drug card). You can access digital copies of your medical ID card in your MyLineco portal. Click here to log in.
- Who is covered under my Plan and how do I make changes?
Does joining the union entitle me to coverage?
Eligibility for coverage is dependent upon both hours worked and contributions made by your employer to LINECO. Please refer to the Eligibility benefit tab for more information.
How do I change my address with the Plan?
You can change your address with the Plan by logging into your MyLineco portal or contacting the Fund Office. Click here to log in.
Who decides what benefits will be provided by the Plan?
The Board of Trustees makes decisions regarding Plan benefits.
Who do I call with questions?
You can call the Fund office at 1-800-323-7268 (Monday through Friday, 8:00-5:00 CST).
I think you should have paid more on my claim. How do I appeal?
If you have questions about the way your claim was processed please call the Fund Office. If you still wish to appeal you can request the Claim Review Form to begin the appeal process.
Do I have LINECO coverage or Blue Cross/Blue Shield insurance?
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 Blue Shield office. Blue Cross Blue Shield 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.
How do I file a claim for benefits?
In the majority of cases your provider will file your claim electronically on your behalf. If your provider is out of network and refuses to bill insurance then you must complete the Member Medical Claim form and include an itemized statement of services rendered and proof of payment. Click here to access that form.
What is my office co-pay?
There is no "office co-pay". You are responsible for paying the $400 annual deductible and the 20-30% co-insurance until you have reached your $2,500 out-of-pocket maximum. 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 SPD.
Are benefits paid directly to my doctor?
Yes, benefits are paid directly to providers for the majority of claims..
When do I need pre-certification or a referral?
In-patient admissions, bariatric surgery and jaw surgery require pre-authorization by the Fund Office. Please call the Fund Office at 1 (800) 323-7268 to start the preauthorization. All services must be medically necessary in order to be considered for benefits. Certain prescription drugs also require pre-approval. The Fund office does not require referrals. Please call the Fund office if you or your provider have any questions.
Am I covered when I travel to another country?
The Plan benefits would apply if you are outside the US, and the Blue Cross/Blue Shield Network does have a limited international network. However, please note that long distance ambulance transportation is limited to the United States, Canada, Mexico, and the Caribbean Islands assuming all other ambulance criteria are met. See the SPD for more information.
Are DOT physicals covered?
DOT physicals are covered under the preventative care benefit. Please refer to the SPD.
If I am injured on the job, will the plan pay for my medical expenses?
No, the Plan does not cover work-related claims. Refer instead to your employer's worker's compensation program. In addition no benefits are available through LINECO for any injuries sustained while performing any side jobs.
Is my dental coverage through Blue Cross or LINECO?
Your Dental coverage is through LINECO. Your dental ID number is the same as medical (found on your BlueCross BlueShield ID card) but we do not use the 3 letter alpha prefix for dental. Dental claims should be mailed to the Fund Office or submitted electronically. Please refer to the SPD for coverage details.
Is there a network of dentists I can use?
Yes, LINECO has an arrangement with a dental network called Dental Network of America (DNoA). These network dentists have agreed to charge negotiated fees that are lower than what these dentists normally charge. You can reach DNoA by calling 1 (866)-522-6758 or going to www.dnoa.com. Choose the labor + option.
What is the annual deductible and maximum?
The annual maximum benefit is $2,000 per covered person. The annual dental deductible is $100 per covered person. There is no deductible for covered Diagnostic and Preventive services (such as exams and cleanings).
What is my co-insurance?
Your co-insurance is 20%. The Plan coverage is 80% of covered services. Exception: For any covered individual under age 21: Preventative services are covered at 100%.
Does my dentist need to send in a pre-estimate?
If the services will exceed $1000 in cost or if dental implants are planned, we strongly suggest that you have your dentist send in a pre-estimate and get the treatment precertified by the Fund Office.
Is Orthodontia covered?
The Plan's Orthodontia benefit is payable up to a $2,000 lifetime maximum per child. There is no orthodontia coverage for an employee or spouse, regardless of their age.
My dentist's office needs my dental insurance information to file my claim.
The plan's dental payor ID is LCB01.Your dental ID number is the same as medical (found on your BlueCross BlueShield ID card) but we do not use the 3 letter alpha prefix for dental. Dentist can file your dental claim electronically through a clearinghouse called WEB MD/EMDEON™, or by submitting it to the Fund Office directly by mail.
Who is our Behavioral Health through?
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 Blue Shield office. For Member Assistance Program benefits see below or the SPD.
Who is Carelon?
Carelon is LINECO's Member Assistance Program (MAP) partner. To contact Carelon call 1-800-332-2191. For more detailed information, please refer to the SPD.
What is the MAP program and how does it work?
LINECO partners with Carelon to provide the Member Assistance Program (MAP) is a free counseling and referral service available to Plan members. MAP can confidentially help covered employees and their families with all types of personal, emotional, work and family matters as well as financial and legal concerns. You can access the MAP by telephone 24 hours a day, 365 days a year. In addition, you can get up to 6 face to face visits per problem with a professional MAP counselor at no cost to you. You don't have to file a claim with LINECO for your free short term MAP counseling visits. The first step is to call the MAP help line at 1-(800) 332-2191. No benefits are payable unless the treatment/services are authorized by Carelon.
What type of coverage does the Behavioral Health Benefit provide (other than the MAP)?
The plan covers Behavioral Health and Substance Use Disorder Benefits the same as other medical conditions, your provider is considered in-network if they are in contract with their local Blue Cross Blue Shield. Pre-certification is required for inpatient, partial hospitalization, or residential services. Contact the Fund office at 1-800-323-7268.
Does the plan pay for eye exams, glasses, or contacts?
Yes, the Plan does have a Vision benefit. The vision benefit is administered through Vision Service Plan (VSP), a network of vision care providers.
Vision Benefit (See Pages 67-68)
Plan Pays VSP Doctor Out-of-Network Vision Exam — every calendar year Covered in full Up to $35 Frame — every two calendar years Covered up to
$175 retail value
Up to $35 Lenses — every calendar year: Single vision Covered in full Up to $30/pair Lined bifocal Covered in full Up to $40/pair Lined trifocal Covered in full Up to $55/pair Contacts, including exam, fitting, evaluation and lenses Covered up to $175/pair Up to $100/pair Safety Glasses — every two years (employees only) Covered in full Not Covered
Please refer to the SPD for more detailed information.
How do I determine which eye doctors participate in the VSP program?
You can contact VSP directly at 1-800-877-7195 or at www.vsp.com.
Can I use any doctor or optometrist?
Yes. However, if you use a non-VSP doctor, you will need to pay your provider in full, obtain an itemized receipt, and then file a claim with VSP. You would then be reimbursed according to the out-of-network schedule of benefits, which is less than the Plan would pay for an in-network provider.
Contact VSP directly at 1-800-877-7195 or at www.vsp.com for information on how to file for reimbursement from an out of network vision services.
Will the plan pay for surgery to correct my vision (Lasik)?
No, the Plan does not have a benefit for surgery to correct vision.
What if I select lenses or designer frames which cost more than the amount allowed by VSP?
If you select lenses or frames which cost more than the allowed amount, you will be responsible for the excess cost.
Who can receive LINECO's life insurance?
Life insurance is available for eligible employees only (not for retirees, utility employees or dependents). For more detailed information, please refer to the SPD.
How do I name a beneficiary?
You can name a beneficiary by filling out the Death Beneficiary section on the online enrollment form.
Can I change my beneficiary?
Yes, you can change a beneficiary by logging in to your MyLineco Portal. To be valid, the change of beneficiary must be received by the Fund office while you are still living.
If I have a reduction in my hours and lose eligibility, can I continue to have life insurance?
If you lose eligibility (except for retirement), you may have the option of continuing Life Insurance coverage under COBRA.
Who can receive Weekly Income Benefits?
Weekly Income benefits are available for eligible employees only. The benefits are not provided for dependents, utility employees, retirees, or persons making COBRA self-payments. For more information see the SPD.
When do the Weekly Income Benefits begin?
Weekly Income benefits will begin on the first day of a disability due to an accidental injury. For disabilities due to sickness, benefits will begin on the eighth day of disability if not hospitalized as an inpatient, or on the first day of an inpatient hospital stay if the admission was before the eighth day of sickness. A disability will not be considered to have started until the first day that you are actually examined or treated by a doctor.
What requirements must be met to receive Weekly Income Benefits?
You must meet the following requirements:
- You must be eligible for Plan benefits from worked hours on the date your disability begins. If your disability begins while eligible under the Plan not from worked hours (e.g., if COBRA or self-payments), this benefit will not begin until the date you become eligible due to worked hours. Any applicable waiting period will begin on your disability date; and
- You must have been actively employed by a contributing employer within 15 days prior to the date your disability began. "Actively employed" means working at a jobsite, not on vacation and not laid off; and
- A doctor must certify that you are totally disabled as a result of a non-occupational accidental bodily injury or sickness and be completely unable to perform each and every duty of your occupation or employement. LINECO will not consider you to be disabled unless and until you are examined in-person by the doctor; and
- You must see a doctor and be disabled within 15 days AFTER your last day worked to qualify for benefits.
- LINECO Will NOT accept disability certifications from Doctors of Chiropractic (D.C.).
What happens if I am injured while working?
If you are injured while working, you will need to file a claim with your Employer's worker's compensation carrier, but you also need to notify LINECO of your disability so that LINECO can determine if you qualify for the Plan's Eligibility Due to Disability provision.
- Does the Plan have a Prescription Drug Program?
What is the difference between getting prescriptions filled through a Mail Order Facility versus a retail
You can fill up to a 30 day supply of medication when you present your Express-Scripts (ESI) card at a local retail pharmacy.* The benefits share the same deductible, coinsurance, and out-of-pocket as your medical benefits. When you fill a prescription through ESI's mail order program you can getup to a 90 day supply of medication usually for a $10, $20, or $35 co-pay. Deductible does not apply to mail order prescriptions and the use of the mail order program is encouraged for maintenance medications (medication you take on a daily, long term basis.)
*Exception: a 90 day supply of most medications is available exclusively at Walgreens locations, mail order co-pay applies.
*Exception: if you are eligible for Medicare (even if LINECO is your primary carrier the use of the mail order program is mandatory starting with the third fill of each medication.)
How do I use the Express Scripts (retail) drug card?
- Present your Express Scripts I.D. card at a participating pharmacy and pay the contracted price for your prescription. You can get up to a 30 day supply at one time at most pharmacies, OR a 90 day supply of non controlled substances at Walgreens.
- After your calendar year deductible has been satisfied, LINECO covers 80% of the contracted price of your covered prescription drugs.
How do I use the Mail Order Program?
To use the Mail Order Program, you or your physician submits the prescription to ESI. You can also use ESI's website to request refills after the initial fill. You can pay by check or credit card. The Major Medical regular deductible and payment percentage provisions don't apply to the mail order program. Instead you pay the following co-pays for up to a 90 day supply of your covered medications.
Generic drugs - $10
Preferred brand name drugs - $20
Non-preferred brand names - $35
If you choose a brand name drug instead of an available generic, you must pay the difference in cost between the brand name drug and its generic equivalent, in addition to the $10 generic co-payment.
What is a "preferred" drug?
"Preferred" (formulary) prescription drugs are brand name medications that have been evaluated by Express Scripts physicians and pharmacists and determined to be the most effective for treatment of certain conditions for most patients, and which are reasonably priced.
What is the requirement if I need a "specialty" drug?
Specialty drugs are high cost injectable, infusion, IV and certain oral medications prescribed for disease such as multiple sclerosis, rheumatoid arthritis, and hepatitis C. These drugs require special storage and handling and are not usually stocked in retail pharmacies. These drugs may be for home use or for use in your doctor's office. You are required to use Accredo Specialty Pharmacy for your specialty drug needs. For more information, call Accredo's at 1-877-476-2267.
What if I am Medicare eligible, can I use the drug plan or should I sign up for Medicare Part D Plan?
LINECO member (including dependents) will automatically be enrolled in the LINECO Medicare Part D prescription program when they become eligible for Medicare. LINECO's prescription coverage was designed specifically to bridge some of the unique rules that Medicare Part D plans have so our members are not impacted by them. Although you have the option of dropping your prescription drug coverage through the Fund and switching to another Medicare Part D plan, most participants will not benefit by doing so, and Lineco is not encouraging anyone to switch to a Part D plan on their own. If you are enrolled in a Medicare Part D plan other than LINECO's you will no longer be eligible for LINECO's prescription coverage
How does the LINECO Drug Plan work for Medicare eligible individuals?
Medicare Eligible means LINECO is primary but you are eligible to participate with Medicare.
When using an ESI participating pharmacy, Medicare eligible individuals pay a 20% co-insurance (no deductible) for a 30 day supply of covered medications.
When using the mail order they pay a $10, $20, or $35 co-pay for a 90 day supply of most medications.
The most a medicare eligible participating participant has to pay for covered prescriptions in one calendar year is $1,000 (whether filling at a local pharmacy or through mail order).
Medicare eligible individuals are required to use the mail order program after the 3rd fill of each medication.
How does the drug program work when LINECO is secondary?
When LINECO is secondary to any other group plan that provides coverage for prescription drugs, the person for whom LINECO is secondary must use their primary plan first and then submit a claim to Express Scripts to process as the secondary carrier.
Exception: if LINECO is secondary to another Medicare Part D prescription plan that individual will not have any prescription coverage through LINECO.
I am a new employee, will the Plan cover my dependents automatically or must I pay for that coverage?
You have family coverage. Once you complete the online enrollment process coverage for your dependents will be backdated to your effective date. LINECO does not directly charge members to enroll their dependents. The Plan covers eligible dependents of employees at no difference in the contribution rate.
How do I add my dependents?
Complete the online enrollment form and upload supporting documentation.
Why do you need my marriage certificate or divorce decree/court order?
The Plan may require this documentation to properly determine coverage dates and also insurance responsibility for dependents.
My child is attending college this fall, will she still be covered under the Plan?
Generally children are covered up through age 25.
Exception: If LINECO is covering your grandchild, sibling, niece, nephew. You will be required to submit proof that they are a full time student once they reach the age of 19 to continue their coverage up to age 25.
My child is totally disabled, will he still be covered under the Plan?
If your child becomes totally disabled prior to age 26, they may remain covered as long as you are eligible, annual verification is required. Please contact the Fund Office for review of the situation.
I am getting divorced, can my former spouse make self payments to continue coverage?
Yes, ex-spouses can be entitled to COBRA coverage if the Plan is notified within the proper time frame. (60 days) Please contact the Fund Office when you become legally separated or divorced.
How do I file a medical claim?
In the majority of cases your provider will file your claim electronically to Blue Cross Blue Shield on your behalf. If your provider is out of network and refuses to bill insurance then you must complete the Member Medical Claim form (available here) and include an itemized statement of services rendered and proof of payment.
Generally, if Medicare is primary for a medical bill, your provider will submit a claim to Medicare. Once Medicare processes they will automatically send the claim to LINECO to process as secondary. On rare occasions you or your provider may be required to send a copy of the Medicare Explanation of Benefits to the Fund Office.
How do I file a dental or orthodontia claim?
Dental claims can be filed electronically through WebMD/Emdeon. Electronic filing can speed up the submission and processing of your claims. LINECO's WebMD/Emdeon payor ID number is LCB01.
Alternatively dental claims can be mailed to the Fund Office.
Line Construction Benefit Fund
821 Parkview Boulevard
Lombard, IL 60148-3230
800-323-7268 8:30 AM - 5:00 PM (CST) Central Standard Time
When you or a dependent need dental or orthodontic care, your dentist may use his own form.
How do I file a vision claim?
If you receive vision services from a provider who is in network with Vision Service Plan (VSP) the provider submits the claim.
If you've received eye care services from an out-of-network provider, you will need to submit a claim to VSP.
A claim can be submitted on VSP's website or it can be mailed in, you'll need the following:
A readable copy of itemized receipts, invoices, or statements that contain all of the following information:
- Name of provider (ex. doctor, office, website, or retailer)
- Name of patient
- Date service was received (ex. date of exam or date glasses were ordered)
- Complete description and amount paid for each service
You typically have 12 months from the date of service to submit for reimbursement. Failure to submit your out-of-network claim within 12 months of the date of service may cause your claim request to be denied. Please allow up to 20 business days (plus mailing time to and from VSP) for us to process your reimbursement. For more information call VSP at 1-800-877-7195.
REMEMBER: DON'T SEND BILLS FOR VISION CARE TO THE FUND OFFICE!
How do I file a claim involving Coordination of Benefits (COB)?
When Another Plan (Carrier) Is Primary and LINECO is the secondary payer on claims, a copy of the other carrier's Explanation of Benefits form must be submitted with the claim.
How do I file a claim for weekly income benefits?
To file a claim for weekly benefits you must complete the three part "Initial Application Weekly Income" Form. (Member section, employer section, and physician sections all must be completed). You should submit the completed form to the Fund office as soon as possible for review.
How are my claims paid if I have other insurance which is primary on myself or my dependents?
LINECO will coordinate benefits, which allows benefits to be paid by two or more Plans up to but not exceeding 100% of the allowable expenses of the claim. If LINECO is secondary, the bill and the other carrier's explanation of benefits is needed.
My spouse has family coverage, I have LINECO—who is the primary carrier on our children?
Usually the parent whose birthday comes earliest in the year is the primary carrier on the children.
Is there a Blue Cross/Blue Shield crossover when both plans use the Blue Cross network?
No, the claims must be filed with the primary carrier first and then with the secondary carrier. Please refer to the FAQs section of this website for details as to how to file a COB claim.
Medicare is the primary carrier on my claim—how do I get LINECO to pay as secondary?
Generally, if Medicare is primary for a medical bill, your provider will submit a claim to Medicare. Once Medicare processes they will automatically send the claim to LINECO to process as secondary. On rare occasions you or your provider may be required to send a copy of the Medicare Explanation of Benefits to the Fund Office.
What is the HRA?
The Health Reimbursement Account (HRA) is funded by employer contributions based on local bargaining agreements; not all employers participate in this program. It can be used to help you pay for unreimbursed qualified medical expenses.
How can I check my balance?
Download the Mobile App (available for download in your app store), log into your MyLineco Portal, or call LINECO 1-800-323-7268.
What can I use it for?
The HRA can be used to pay for the portion of your healthcare that LINECO does not cover. This includes deductibles and coinsurances, co-pays, and amounts over the maximum benefit that LINECO allows. It can be used to pay for COBRA, Short hours, or your retiree premium. Qualified expenses are costs incurred for unreimbursed medical care as defined under Section 213(d) of the Internal Revenue Code. For more information see the SPD.