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July 5th


 

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Frequently Asked Questions

 

When should I contact the Fund?


Government Explanation of Maximum Out-of-pocket Limit


Government Explanation of Cost Sharing


Government Explanation of Out-of-pocket Limit


Are there any specific benefits for which I will need to provide evidence that my dependent child is a full time student?


When is Adult Dependent open enrollment?


Where can I get information about my Pension?


Will I receive a W2 for my disability payments?


How do I get information on my vision plan or request claim forms?


Do I have to do wellness every year and who has to do it?


 

When should I contact the Fund?

You should contact us anytime something in your dynamic changes. Examples are, address, marriage, divorce, new child.. The Fund phone number is 412–363–2700 or use the contact us link.


Are there any specific benefits for which I will need to provide evidence that my dependent child is a full time student?

If you are a participant in a benefit plan which does not provide medical benefits and only provides for dental and vision coverage your dependent child’s eligibility is NOT automatically continued after your child attains age 19. However, when a dependent child attains age 19, the Fund Office will furnish a Student Verification Form which you will need to complete to continue to cover your child for dental and vision benefits until the child’s continued student status ends or the child attains age 25, whichever occurs first. The School Verification forms are issued in August for Fall enrollment and December for Spring enrollment.


When is Adult Dependent open enrollment?

Open enrollment for adult dependent coverage is December 1 – December 31st with coverage beginning January 1.


Where can I get information about my Pension?

Please contact the Pension Fund directly at (412)362-4200.

 


Will I receive a W2 for my disability payments?

No. The income is reported to your employer and included in your W2 from that employer.


How do I get information on my vision plan or request claim forms?

Beginning 1/1/2014, VBA is no longer issuing paper claim forms, just tell your doctor you are a VBA member and they can file a claim online. To see if you’re eligible for benefits, go to www.visionbenefits.com or call 412-881-5521.

 


Do I have to do wellness every year and who has to do it?

Yes. Wellness is required yearly to obtain maximum savings in the following year. The member and eligible spouse must complete both the physical and required blood work. This is to be completed by September 30 yearly.

 


Government Explanation of Maximum Out-of-pocket Limit:

Yearly amount the federal government sets as the most each individual or family can be required to pay in cost sharing during the plan year for covered, in-network services. Applies to most types of health plans and insurance. This amount may be higher than the out-of pocket limits stated for your plan.

 


Government Explanation of Cost Sharing:

Your share of costs for services that a plan covers that you must pay out of your own pocket (sometimes called “out-of-pocket costs”). Some examples of cost sharing are copayments, deductibles, and coinsurance. Family cost sharing is the share of cost for deductibles and out of- pocket costs you and your spouse and/or child(ren) must pay out of your own pocket. Other costs, including your premiums, penalties you may have to pay, or the cost of care a plan doesn’t cover usually aren’t considered cost sharing.

 


Government Explanation of Out-of-pocket Limit:

The most you could pay during a coverage period (usually one year) for your share of the costs of covered services. After you meet this limit the plan will usually pay 100% of the allowed amount. This limit helps you plan for health care costs. This limit never includes your premium, balance-billed charges or health care your plan doesn’t cover. Some plans don’t count all of your copayments, deductibles, coinsurance payments, out-of-network payments, or other expenses toward this limit.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
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