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Welfare

No Surprises Act 

Effective July 1, 2022, Participants and Dependents receiving No Surprises Services will only be responsible for paying their In-Network cost sharing, and cannot be balance billed by the provider or facility for emergency services.

Read Summary of Material Modifications Here

Transparency in Coverage Compliance 

This Plan is required to provide certain information on a public website pursuant to the Federal Transparency in Coverage Final Rule published in the Federal Register on November 12, 2020.

This Rule is intended to make information about the prices charged for health care available to the general public, particularly researchers. These experts can use pricing information from this Plan and others to better understand the health care system and its costs and, hopefully, create new policies that improve competition and lower health care spending.

The Rule requires that the Plan post links to machine-readable files that contain information about the price of health care services. A machine-readable file is written in computer code and is an extremely large file.  It is not intended to be downloaded or read by participants but to be used in research studies. The files do not contain Protected Health Information (PHI) about you or your family.

Links on this website (below) provide machine-readable files for the Plan’s in-network negotiated rate and historical allowed amounts for out-of-network charges. The files attached to the links are maintained by the Plan’s third party administrator, BlueCross/BlueShield. BlueCross/BlueShield will update the file attached to the links automatically each month.

If you have any questions about the Rule, you can read more information at https://www.cms.gov/newsroom/fact-sheets/transparency-coverage-final-rule-fact-sheet-cms-9915-f

INDEPENDENCE ADMINISTRATORS (machine-readable files)

Information For

 

Welfare Documents

Welfare

Medicare and You 2025
Private Health Information Authorization Form
Active City Carpenters Reimbursement Claim Form 2024
Retired City Carpenters Reimbursement Claim Form 2024
Active City Carpenters Reimbursement Claim Form 2025
Retired City Carpenters Reimbursement Claim Form 2025
Dental Claim Form- Empire
Provider Nomination Form- Dental
Independence Administrators- Coordination of Benefits
Independence Administrators- Medical Claim Form
Paid Family Leave- Bonding Application
Paid Family Leave- Family Member Application
Paid Family Leave- Self Covid-19 Related Application
Paid Family Leave- Dependent Covid-19 Related Application
Paid Family Leave- Military Application
Required Documents for Eligible Dependents
Prescription Mail Order Form- English
Prescription Mail Order Form- Spanish
Short-Term Disability Form
Short-Term Disability Form- City Carpenters
SBC Uniform Glossary

Other

NYCDCC Health Enrollment and Beneficiary Designation Form
Change of Address Form
To request any forms or documents that you do not see available on the website, please call the Benefit Funds Call Center at (800) 529-FUND (3863) or (212) 366-7373.

Frequently Asked Questions (“FAQs”):

FAQs

How does Paid Family Leave work and how much will I get paid if I qualify?
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To learn more about New York's Paid Family Leave, you can read answers to several Frequently Asked Questions (FAQs) HERE.
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What are my co-payments for coverage offered through Independence Administrators?
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Your co-payments are $20 for Primary Care visits, $25 for Specialist visits , and $200 for Emergency Room visits (fee waived if admitted).
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I need a new hearing aid, does the NYCDCC hearing plan cover it?
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You and your covered dependents are eligible for a hearing benefit once every four years. When you use participating providers affiliated with Comprehensive Professional Systems (CPS) or General Hearing Services (GHS), you may receive a hearing examination, a new digital hearing aid (with battery), and other services all at little or no cost. Call CPS at (212) 675-5745 or GHS (800) 480-0558 to find a provider near you.
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How do I find covered vision services?
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Our network providers are Comprehensive Professional Systems (CPS) and General Vision Services (GVS). To obtain a list of participating providers, you can contact CPS at (212) 675-5745 or GVS at (800) 847-4661 or visit their websites (cpsoptical.com or generalvision.com). The plan number for Welfare participants covered under GVS is 7501.
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When do I become eligible for Welfare Fund coverage as an Active Participant?
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In general, you are eligible for Welfare Fund coverage as an Active Participant after you have worked 250 hours in Covered Employment. These 250 hours “buy” you a calendar quarter (three months) of coverage.
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What should I do about unpaid medical bills?
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If you are a non-Medicare eligible member, contact Independence Administrators. You can log onto www.MyIBXTPAbenefits.com and register to view your claims that have been processed. If a claim was denied by Independence Administrators, contact them for appeal instructions. If you are Medicare-eligible, contact UnitedHealthcare directly at www.UHCretiree.com or by calling (888) 736-7441.
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How do I check my welfare hours and eligibility?
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  1. Go to nyccbf.org.
  2. Click the “Member Login” button located on the top right corner of the screen.
  3. Log into the website using your Username (UBC #) and Password. (Please note, if logging in with a temporary password, you will be directed to the Registration Page where you will be prompted to enter your temporary password in the current password field, followed by your new password in the new password field.)
  4. Check the box agreeing to the terms of the website and click “Continue.”
  5. After you agree to the website terms, select the “View Active Welfare Eligibility” option and click “Continue.”
  6. Upon entering the “View Active Welfare Eligibility” page, you will be presented with a chart where you will be able to see your Welfare eligibility status and hours by date
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Who is my dental provider and how do I find a dentist in my plan?
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Your dental provider is Anthem BlueCross BlueShield. To search a list of participating providers, go to www.anthem.com, click "Find Care," select "Basic Search as a Guest," and then "Dental Network," followed by the location you are looking to search, etc.
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When do I become Medicare-eligible?
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You become Medicare-Eligible under the following conditions:
  1. When you turn age 65.
  2. Two years after you are awarded Social Security Disability benefits, regardless of your age. You can be awarded Social Security Disability prior to age 65.
  3. You are diagnosed with End Stage Renal Disease (“ESRD”).
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I moved. How can I change my address?
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You can change your address by filling out a Change of Address form and following the instructions located on the form. You can find the Change of Address form here: Change of Address Form
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What happens to my Life Insurance money if I die without a Beneficiary?
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If you are eligible for Welfare Benefits at the time of your death and do not have a Beneficiary on file, payments will be made in the following order:

• your surviving spouse or, if none

• your children in equal shares, or, if none,

• your parents in equal shares or, if none,

• your brothers and sisters in equal shares, or, if none,

• your estate.

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What are the guidelines to retire with medical benefits?
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To be eligible for Welfare coverage as a Retiree, you must satisfy one of the three requirements below:

• You have reached the age of 55 and earned a minimum of 30 Vesting Credits with the New York City District Council of Carpenters Pension Fund (“Pension Fund”).

• You have reached the age of 55, earned at least 20 Vesting Credits under the Pension Fund and, during the 60-month period immediately preceding the effective date of your pension, you are eligible as an Active Employee for at least 24 months; or

• You have reached the age of 55, have 25 years with at least 250 hours worked in Covered Employment, have earned at least 15 Vesting Credits under the Pension Fund and during the 60-month period immediately preceding the effective date of your pension, you are eligible as an Active Employee for at least 24 months.

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How can I add my spouse and/or children to my coverage?
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You can add your dependents by filling out a Health Plan Enrollment Form and submitting the required documents.  
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What should I do about unpaid medical bills?
Show Answer
If you are a non-Medicare eligible member, contact Independence Administrators. You can log onto www.MyIBXTPAbenefits.com and register to view your claims that have been processed. If a claim was denied by Independence Administrators, contact them for appeal instructions. If you are Medicare-eligible, contact UnitedHealthcare directly at www.UHCretiree.com or by calling (888) 736-7441.
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How do I obtain my Independence Administrators or UnitedHealthcare card?
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If you are a non-Medicare eligible member, you can request a card by calling Independent Administrators directly @ 1 (833) 242-3330 or via internet @ www.MyIBXTPAbenefits.com . If you are Medicare-eligible, you can contact UnitedHealthcare by calling (888) 736-7441 or via internet @ www.UHCretiree.com.
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What are the prescription drug copayments?
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Express Scripts is your pharmacy benefit manager. Retail co-payments are $15 for generic, $25 for preferred, and $40 for non-preferred prescriptions. Additionally, mail order co-payments are $25 for generic, $45 for preferred, and $75 for non-preferred prescriptions. *Note that mail-order co-payments represent a three month supply.
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*Disclaimer: The Funds have prepared these informal answers to frequently asked questions for the convenience of our participants and contributing employers.  The Funds have made every effort to provide accurate answers, but they are not legally binding and do not address every possible situation.  The Collection Policy, Trust Agreements, and Collective Bargaining Agreements are official legal documents and supersede any inconsistent statements herein.