The Sheet Metal #10 Benefit Fund is a self-funded health plan that provides medical coverage for participants and their dependents.
Questions about claims or eligibility
Need new medical Identification card?
How do I become eligible
Re-qualifing for eligibility
Short Term Disability Intial Report of Claims form
Change Beneficiary Designation
If you are medicare Eligible or approaching age 65
How do I become eligible? 1st time eligible?
If you are a brand new participant in the plan, then you will become eligible for health benefits the 1st of the 2nd month after you have worked 8 hours in a classification that requires contributions to the plan.
Re-qualifying for eligibility
Re-qualifying participants will become eligible for health benefits the 1st of the third month following when your employer reports 145 hours in a classification that requires contribution to the plan. Please note, there are special rules for re-qualifying if you have worked at least 80 hours. Non-bargained employees contact the Fund Office at: 651-770-0991 or 1-800-396-2903
Change Beneficiary Designation
You can make a designation to just the Sheet Metal #10 Benefit Fund, by clicking this link Sheet Metal #10 Benefit Fund Beneficiary Form, or you may click on this link Change in Beneficiary Designation in order to make a change in the designation of your beneficiary for all funds administered by the Fund Office, or e-mail Terry Doerfler at tdoerfler@smwbenefits.com or call 651-770-0991, or 1-800-396-2903 and request a change in beneficiary form.
CDI Mammography Night
Open Enrollment Election Period
Deductible-Out of Pocket Max
CDI Center For Diagnostic Imaging
PNBC Physicians Neck & Back Clinics
90 Day RX
Emergency Room vs. Urgent Care Brochure
Enhanced Stop Smoking
Healthy Start Prenatal Support
Early Retiree Diabetes Program
Bariatric Surgery
Active Health & Welfare Rates
Retriee Health & Welfare Self Pay Rates
Summary Description Plan & Updates
Medicare Retirees
CDI Mammography Night: (Waiting for information)
Mammograms and More Evenings at CDI:
Friday, November 25, 2011 and Wednesday, December 7, 2011
Open Enrollment Election Period Active Participants:
The month of November is the open enrollment period for those Sheet Metal Workers that are offered a choice in their Plan and/or for Single or Family Coverage as applicable to their contract area. Not all contract areas provide for this choice. Forms will be mailed to individuals, but if you have any questions or have not received your form by November 1st, please contact Dyneil (dtadros@smwbenefits.com) at the Sheet Metal Fund office at 1-800-396-2903.
Medicare Retirees:
In addition, the month of November is also the open enrollment period for those Age 65 and older retirees that are covered by the Sheet Metal #10 Benefit Fund and Medicare. You may have an option to change the Medicare supplement that you are currently using. You may contact Sarah (squast@smwbenefits.com) at the Sheet Metal Benefit Office if you have any questions regarding this.
Deductible and Out-of-Pocket Maximum increase effective May 1, 2011
PLAN "A" (Active and Retirees)
CDI Center for Diagnostic Imaging: Click here for more information
You can save yourself money and help the Sheet Metal #10 Benefit Fund control health care costs by using a preferred imaging partner, Center for Diagnostic Imaging (CDI), when you need diagnostic or therapeutic imaging services such as MRI, Open Upright MRI, CT or Digital Mammography.
CDI provides high quality imaging and uses specialized radiologists to ensure that your images are being read by experts in the area of your body that is being imaged. CDI also specializes in injections for the diagnosis and treatment of back and joint pain.
Be sure to tell your doctor you want to go to CDI for your imaging and injection needs. CDI has an appointment line dedicated to union members. Simply call 866.765.7138 to schedule an appointment today.
PNBC Physicians Neck & Back Clinics:
You can save yourself money and help the Sheet Metal #10 Benefit Fund control health care costs by using a preferred provider, Physicians Neck & Back (PNBC). PNBC offer a non-surgical approach to spinal care of patients with chronic back and neck conditions. Click here for more info
90 Day Rx:
Prescription drugs can be expensive. If you have a chronic medical condition, such as high cholesterol, asthma, or diabetes, it is likely that you are taking long-term medications to improve your health. The 90dayRx program is a great way for you and the Plan to save money each time you refill your maintenance medications by taking advantage of special discount pricing, and no dispensing fees, at certain retail pharmacies when you order a three-month supply. Click here for more information
Emergency Room vs. Urgent Care: IT PAYS TO KNOW THE DIFFERENCE! For brochure Click here
Enhanced Stop Smoking Program:
If your or your eligible dependents smoke and desire to quit, enrollment in this program will provide you access to a phone-based "Quit Coach" who ill guide and support your efforts and supply you with Nicotine REplacement Therapy products such as patches, gum and lozenges. The Plan will pay the entire cost for these quit aids. The Enchanced Stop Smoking Program typically experiences higher participation and a higher quit rate than the basic program. Any Plan coverage for smoking cessation aids requires the participant to be enrolled in the Enhanced Smoking Cessation program sponsored by Blue Cross Blue Shield of Minnesota. You may enroll by calling 1-888-662-2583. The Plan will provgide prescription smoking cessation drugs when prescribed by a physician only if you are actively participating in the Blue Cross Blue Sheild Enhanced Stop Smoking Program and under the guideance of a Quit Coach.
Healthy Start Prenatal Support:
Healthy Start is a personalized phone and mailed based prenatal support program for expectant mothers. Mothers who receive consistent prenatal care are more likely to have healthier babies. Specially trained Registered Nurses educate and work with the expectant mother to help her achieve a normal full term delivery.
To enroll in this program, simply call Blue Cross Blue Shield at (651) 662-1818 or toll free at 1-866-489-6948 or via e-mail at HealthyStart@bluecrossmn.com
Diabetes:
If you are an early retiree that has health coverage thru the Fund, and have concerns about DIABETES Click here
Bariatric Surgery:
Effective January 1, 2010 the Board of Trustees resolved to add coverage for Bariatric Surgery to the Fund’ plan of benefits subject to certain conditions. Click here
Health and Welfare rates for 2011:
The active contribution rates and premiums have changed effective with May 1, 2011 work month and applicable coverage month of August 2011
Contribution Rate Premium Amount
Plan A Family $7.60 $1,102.00
Plan A Single $6.10 $884.00
Effective with May work month/August coverage, it will require approximately 145 hours per month in order to maintain coverage.
It is important to note that if you lose eligibility, you do not regain eligibility immediately upon your return to work. There is a two (2) month lag in your eligibility. In other words, the hours you work in Apri don’t actually dictate eligibility until July coverage. Please keep this in mind when making a decision about your health coverage.
Retiree Health and Welfare Self Pay Rates for 2011:Click here for rates
Summary Plan Description and Updates:
Summary Plan Description and Click here
Summary Plan Description updates Click here