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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