Your Benefits Resources
We want to ensure our members and their families to get the most out of the benefits we provide them by providing the most up-to-date library of resources.
Health & Welfare
How do I find an in-network doctor or dentist?
Last Updated: 05/02/2023While on the Benefits home page of the website, our Network Partners’ logos are located at bottom of the page. Each logo on this page links you to that particular provider’s website. Each site has links to find doctors/dentists/specialists in our network, when applicable. To find an In-Network provider with one of our partners, links have been included here to assist you.
How do I add my spouse to my health insurance coverage?
Last Updated: 01/04/2023Your “spouse” is your legal partner in marriage by a civil or religious ceremony performed in accordance with the laws of the state in which you reside. For the purposes of the Plan, “spouse” includes a common law spouse only in the State of Kansas with administrative review and approval. To add a spouse to your Health and Welfare coverage, you are required to complete an Enrollment form with its required documentation as outlined on page 2 of the Enrollment form, Beneficiary Designation form, Spousal Verification form and HIPAA Authorization. All these forms may be found on our website here.
How do I add my children to my health insurance coverage?
Last Updated: 01/04/2023To add any child up to age 26, you need to complete an enrollment form, as well as provide the necessary documents as outlined on the second page of the Enrollment form. The Enrollment form may be found on our website here.
My spouse has changed employment. Do I need to let you know?
Last Updated: 01/04/2023If your spouse’s employment status changes (affecting group health coverage), a Spousal Coverage Verification form needs to be completed and returned to our office as soon as possible to ensure continued coverage. You may find this form on our website here.
What are my preventive care benefits?
Last Updated: 01/04/2023Your preventive care benefits, which are included in your Carpenters’ Health Plan coverage at no cost to you, the participant, are best detailed on government’s health care website. Click here for a detail of these benefits.
I want to save money and order my prescriptions through express scripts home delivery. How do I do this?
Last Updated: 01/04/2023There are two (2) ways to manage your medications easily with Express Scripts Home Delivery.
What do I need to do if I become legally separated or divorced?
Last Updated: 01/04/2023Upon legal separation or divorce, the Plan must be notified to remove a spouse from coverage. A copy of the legal separation court document or divorce papers is required. Your spouse (and any stepchildren) will be removed from coverage on the last day of the month in which your divorce or legal separation is finalized. In order for your ex-spouse (and any stepchildren) to be eligible for COBRA continuation coverage, notification to the Plan must be done within 60 days of the date of divorce or legal separation. If your spouse was appointed as your beneficiary, we encourage you to complete a new Beneficiary Designation form and HIPAA Authorization form, which may be found under the Health Plan Resources page of this website. We have provided samples of a Qualified Domestic Relations Order (QDRO) which discuss division of pension benefits – Pre-Retirement QDRO, Post-Retirement QDRO and a QDRO checklist. All Pension-related documents may be found on our website here. It is also important to contact Carpenters’ Retirement Services to find out if additional information is required. See also Pension FAQ.
What do I need to do in the event of the death of a covered family member?
Last Updated: 01/04/2023The Benefit Plans Office requires a certified copy of a death certificate in order to process the life insurance benefits.* Refer to the information below for death benefits related to each covered family member. ParticipantThe certified death certificate is required for self-pay refunds (if applicable), possible vacation benefits, surviving dependent’s benefits, and for Retirement Services to process any benefits due under the Annuity Plan or St. Louis Pension Plan. Contact Carpenters’ Retirement Services to find out if their office requires additional information. Please note: When multiple beneficiaries are not designated as either primary or secondary, all beneficiaries listed are considered primary by default. SpouseThe certified death certificate is also used by Retirement Services to process Pension information. If your deceased spouse was the beneficiary of your life insurance benefit, you will need to appoint a new beneficiary. You may do so by completing a new beneficiary designation form and HIPAA authorization form which may be found on our website here. Also, please contact Carpenters’ Retirement Services to find out if their office requires additional information. Dependent ChildrenThe Benefit Plans Office requires a certified copy of the dependent child’s death certificate in order for the beneficiary to obtain the dependent’s life insurance benefit.* If your deceased child was the beneficiary of your life insurance benefit, you will need to appoint a new beneficiary. You...
How much life insurance do I have if I’m covered under the health plan?
Last Updated: 01/04/2023Life insurance on the life of a member is $8,000. Life insurance on an eligible dependent is $2,000. The Accidental Death and Dismemberment death benefit for members only is $8,000. Policies are under the Metropolitan Life Insurance Company (MetLife), a commercial insurance company. For additional Life Insurance and Accidental Death and Dismemberment information, please refer to the Life Insurance and Safety Enhancement Benefits section of our health plan document which may be found under Health Plan Resources on this website or call our Participant Service Department.
When will I become covered under the health plan? How will I know if I’ve earned coverage?
Last Updated: 01/04/2023Members earn coverage based on the classification to which they belong. Typically, Outside Eligibility pertains to most carpenters and electricians under the Carpenters’ Plan. Inside Eligibility refers to millwright coverage. There are exceptions to these general guidelines. Newly covered participants will receive a new member packet from the Benefit Office as soon as they reach their minimum hours of work. For information on Active Eligibility, please refer to the Eligibility section of this website.
What do I do if I run out of health coverage?
Last Updated: 01/04/2023You have two options under the Plan if your coverage is terminating due to low or no hours worked.
Am I responsible for pre-certifying any surgeries or medical services?
Last Updated: 01/04/2023If you see an In-Network provider for your care, your network provider will handle any pre-certification required by the Plan. If you see an Out-of-Network provider for your care, you must ensure that the pre-certification has been obtained as required by the Plan by contacting UMR at 866.494.4502 or www.umr.com.
Why do I have to have an x-ray before I can have the cat scan my doctor ordered?
Last Updated: 01/04/2023CAT scans expose you to more radiation. X-Rays use less radiation and can often tell the doctor what he/she needs to know. In addition, overall cost to the member (coinsurance) and the Plan for X-ray services are less expensive than the cost for a CAT scan. If a member meets medical necessary for a CAT scan, the doctor can provide additional information to UMR to explain why a CAT scan is needed instead of an X-ray.
Where does the money go that is put into the health and welfare fund after the minimum work hours are met?
Last Updated: 01/20/2023Understanding eligibilityContributions are received into the Plan for each hour that is worked. Health & Welfare contributions go into the Fund which are used to pay medical, dental, vision and prescription claims for all covered participants and covered dependents. Hours are what drives eligibility for an individual and that individual’s covered dependents. If one of the hourly requirements are met, then the coverage can be extended for a Benefit Quarter. The maximum extension would be if the Plan Year Rule of 1560 uncapped credit hours was met, coverage would be extended for six months of the same year. For example: 1560 uncapped hours worked from May 1 through April 30 would extend coverage for July-December of the same year. How “understanding eligibility” affects understanding this responseThe money paid in for each hour worked goes into a pot (the Health & Welfare Trust Fund) for all covered individuals to use. A participant who works more than the maximum hours extension (1560) offsets the cost for coverage for those who do not receive the full Journeyman contribution rate, such as Apprentices, and for dependents for which working members pay no additional money to cover. Each working member does not have his/her own “account” of money. All gets put in one pot to be invested and grow to help the overall Fund. If...
I am getting divorced. How much do I pay for my children to have health coverage?
Last Updated: 01/20/2023The contribution rate is paid in per hour worked. There is not break down per covered person. If the participant works the required amount of hours, then the participant and any covered dependent, whether 1 or 10, would have coverage. In other words, participants pay $0 for health coverage for dependents. Coverage is determined by work hours for the participant and family as a whole.
What are Site of Care Incentives?
Last Updated: 04/08/2024In May 2023, the health plan adopted Site of Care Incentives to promote the use of independent labs and freestanding, independent radiology facilities. When covered individuals use these independent facilities, it drives out of pocket cost down for you, and the overall cost for the plan is significantly less. Site of Care: LabsWhen using labs, participants receive significant discounts for using independent labs, such as Quest or LabCorp. Both LabCorp and Quest facilities provide access in our most of our participant-populated areas. When participants and families use LabCorp and Quest labs, personal out-of-pocket cost are eliminated, with $0 copay AND 0% coinsurance. Facility labs, such as hospital-owned labs, are covered under the health plan with covered individuals paying the deductible and 20% coinsurance. Site of Care: RadiologyWhen using radiology facilities for X-ray, MRI or other diagnostic imaging, independently owned, freestanding facilities, such as Metro Imaging or Diagnostic Imaging Centers in St. Louis and Kansas City, require a standard $25 copay w̳i̳t̳h̳ ̳n̳o̳ ̳d̳e̳d̳u̳c̳t̳i̳b̳l̳e̳. This includes Carpenters Wellness Center referrals to Metro Imaging. Please note: The site of care radiology incentive for x-rays, MRIs and similar, receive a $25 copay only when they are independently owned, freestanding imaging facilities (not hospital or physician group owned). If you have any questions or would like to check if an in-network radiology facility near...
What is a site of care radiology facility?
Last Updated: 04/08/2024In May 2023, the health plan adopted Site of Care Incentives to promote the use of independent labs and radiology. When covered individuals use these independent facilities, it drives out of pocket cost down for you, and the overall cost for the plan is significantly less. However, there has been a lot of confusion regarding which independent, freestanding radiology facilities are a part of the site of care incentive benefit. Some hospital-system radiology centers refer to their facilities as “freestanding,” but they are not contracted as and do not bill as freestanding facilities; they bill as a hospital system. In addition, some non-hospital radiology facilities are owned and operated by physician groups, which further complicates the definition. What you need to knowThe site of care radiology incentive for X-rays, MRIs and similar, receive a $25 copay only when they are independently owned, freestanding imaging facilities (not hospital or physician group owned). If you have any questions or would like to check if an in-network radiology facility near you meets the site of care incentive standards, please contact Participant Services.
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