FAQ’S FOR PARTICIPANTS
GENERAL
Q. Where can I send correspondence?
A. Boilermakers National Funds
P.O. Box 909700
Kansas City, MO 64190
1-866-342-6555
Q. How do I update my demographic information such as address, phone number etc.?
A. Fill out this form Change of Personal Information and mail to BNF or email to bnf@wilson-mcshane.com.
Q. How do I update my beneficiary Information?
A. Complete the forms below:
Health & Welfare (submit to BNF) - Designation of Beneficiary Card
Annuity (submit to address or fax number listed on form) - Designation of Beneficiary Card
PENSION
Q. How do I add or change direct deposit bank information?
A. Call the Fund Office at 1-866-342-6555 to request the appropriate form.
Q. Will my monthly pension benefit always be available on the first day of the month if I opt for direct deposit?
A. No. Your monthly pension benefit will normally be electronically deposited into your account on the first day of the month. However, if the first day of the month falls on a weekend or a financial institution holiday, the deposit will be made on the next business day. The following are examples of when your pension benefit will not be available on the first day of the month:
· If the first of the month falls on a Saturday or Sunday your pension benefit will be in your account on the following Monday.
· If the first of the month falls on a Saturday and Monday is a holiday (i.e. Labor Day, etc.) your pension benefit will not be in your account until Tuesday (the next business day).
Q. How do I change my Federal Withholding?
A. Complete a W-4P Tax Form or have one mailed to your home by calling the Fund Office at 1-866-342-6555.
HEALTH & WELFARE ELIGIBILITY REQUIREMENTS
Q. Why do I have to complete the Annual Coordination of Benefits (COB) & Information Verification Form?
A. This form provides the Fund with important and legally required information. Until we receive this form, we do not know who your Dependents are or if you or your Dependents have other health care coverage. There are two ways to complete this form: (1) by downloading here and sending to BNF or (2) completing online Coordination of Benefits (COB) & Information and Verification Form
The Fund requires this form to be completed when you become eligible under the Plan and if you are re-establishing eligibility after a break in coverage. Thereafter, a completed form is required every two years to verify that we have accurate information on file for you and your Dependents. Please note: Other business partners will also request this information separately.
Q. Why do I have to provide my social security number?
A. The Fund is legally required to report the Plan’s membership information, including social security numbers, for each Eligible Individual under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) and under the Affordable Care Act Employer Shared Responsibility provisions.
Q. Why do I have to provide documents such as a marriage and/or birth certificates before my Dependents receive benefits?
A. Certain documents are required to determine if your Dependents meet the Plan’s requirements to be considered an Eligible Dependent under the Plan. Our claims history shows that, on average, total health care costs for Dependents is approximately $200,000,000 per year. Covering individuals who should not be eligible raises health care costs for everyone.
HEALTH & WELFARE PLAN BENEFITS
Q. Why am I being denied benefits if my doctor says I need the service, procedure, medication or supply?
A. All services, procedures, medications or supplies must be Medically Necessary and medically appropriate for your diagnosis or condition, unless otherwise stated (There are some exceptions to this requirement such as Preventive Services and advanced care planning.). If you are denied a particular benefit, it may be that there were other alternatives in treating your condition or the service or procedure was considered Experimental and deemed not Medically Necessary for your condition.
EXAMPLE 1: Vasectomies are most generally performed in either an outpatient Hospital or an office setting. Under the terms of the Plan, procedures must be rendered at the lowest level of care available to be considered for benefits. A vasectomy performed in an outpatient Hospital setting would be denied as this procedure can be performed in an office setting which is a lower level of care.
Q. Why do I have to have certain services, procedures, medications or supplies Preauthorized?
A. Preauthorization is sometimes required to determine Medical Necessity or the appropriateness of the requested service, procedure, medication or supply. Through this process you may find out that there are other alternatives that are just as appropriate for your condition but less invasive or not as costly to what was initially prescribed.
In order to receive Preauthorization of the Medical Necessity and appropriateness of services, you or your Provider must call in advance. In the case of an Emergency hospitalization, you or your Provider must, if practicable, call within 48 hours of admission or the first business day after admission (if the admission was on a weekend or holiday). Preauthorization determinations are made, on average, within 48 hours of the request.
Q. What are the alternatives to an Emergency room visit?
A. If you are not experiencing an Emergency but have an urgent need to see a doctor, there may be other, less costly, options to the Emergency room depending on the level of care needed.
- Telehealth Services – Electronic video visit with a doctor by using the web or mobile app for symptoms such as fever, rash, flu, pinkeye, and strep throat. For Telehealth Visits to be payable, services must be provided by certain In-Network providers. Refer to Article 30 in the SPD titled "Important Contact Information". Telehealth benefits are payable at 100% of Covered Expenses which means no cost for you.
- Take Care or Minute Clinics – These clinics can treat the same conditions as telehealth providers. However, you will be responsible for a portion of the cost.
- Urgent Care Centers – Depending on the Facility, additional services may be available such as treatment of sprains, fractures or asthma in addition to other lower levels of care such as flu or bronchitis. Your portion of the cost of care is slightly higher than a clinic visit.
Refer to Article 4 titled "Schedule of Benefits" in the SPD for more information on your cost of care.
Q. Why wasn’t my routine physical paid at the preventive benefit level of 100%?
A. For benefits to be paid under the preventive benefit, claims must be submitted with the required preventive procedure codes and preventive diagnosis codes. Claims submitted with non-preventive codes will be processed at the applicable benefit level. If you believe your claim was incorrectly submitted as non-Preventive Services, contact your Provider to request that they submit a corrected claim so that benefits can be re-processed at the correct benefit level.
Q. What types of genetic testing are not covered?
A. Genetic testing that is not deemed Medically Necessary is not covered under the Plan.
EXAMPLE 1: Jane Boilermaker has had a long family history of heart disease. Although Jane has not shown any symptoms of the disease, her doctor has suggested that she undergo genetic testing to determine if she will likely develop heart disease in the future. Since Jane has not experienced symptoms herself, the genetic testing would be considered not Medically Necessary for Jane and benefits would be denied.
EXAMPLE 2: Mary and Joe Boilermaker are considering having a family. Joe’s oldest son from a previous marriage was born with a genetic disorder. Mary and Joe have decided to have Mary undergo genetic carrier identification testing to determine if she carries the same abnormal gene. This type of genetic testing is considered not Medically Necessary and is not covered under the Plan.
HEALTH & WELFARE THIRD PARTY LIABILITY - SUBROGATION
Q: What is subrogation?
A: Subrogation refers to circumstances in which the Plan has the right to recoup expenses it has paid on a claim where another person should have been responsible for paying at least a portion of that claim (i.e., another person who is at fault or another insurance company that is responsible for your Injury or Illness).
Q: Why am I getting a Subrogation Information form?
A: We will send you a Subrogation Information Form if we receive a claim for benefits that indicate services received may be due to an accident. This form provides us with the information needed to prevent claims from being double paid to Providers.
Q: I have already filled out a form, why am I getting it again?
A: Forms are computer generated and if you are still being treated for the Injury or condition, you will receive additional forms for those dates of service. You do not need to complete the additional forms unless the information you previously provided changes.
Q: Why can’t you see that this wasn’t an accident when I have already explained the circumstances to my Provider?
A: Most generally, we do not have access to medical records. Instead we are only provided with diagnosis code information.
For more information on third party liability, please refer to Article 15 in the SPD titled "Subrogation and Reimbursement".
EMPLOYER CONTRIBUTIONS/HOURS
Q. How do I request a hours and contributions statement?
A. A hours statement can be obtained by logging in to the Participant Portal, by calling 1-866-342-6555 or emailing ec@wilson-mcshane.com. A written authorization is necessary for hours to be sent to anyone other than the participant.
Q. How do I give authorization to send my hours information to a third party?
A. Fill out this form Authorization Form to Release Personal Information and mail to BNF or email to ec@wilson-mcshane.com.
Q. How do I find out if my employer reported my hours and contributions?
A. Please call 1-866-342-6555 and select the option for the Employer Contributions department.
Q. After reviewing a hours statement how do I report the missing hours?
A. Please call 1-866-342-6555 and select the option for the Employer Contributions department or send hours discrepancy detailed information, supporting documentation, and/or pay-stubs to ec@wilson-mcshane.com.
FAQ’S FOR EMPLOYERS
REMITTANCE
Q. What is the Contributions and Remittance Report due date?
A. Contributions and Remittance reports must be received by the 15th of the month, following the month of work.
Q. Where can I get a remittance form?
A. The remittance form is no longer available online. Please contact eremit@bnf-kc.com about reporting via the online portal.
Q. How to report and who to contact for reporting questions?
A. Please contact eremit@bnf-kc.com about reporting via the online portal.
For general reporting questions, please contact ec@wilson-mcshane.com.
Q. Which contributions do I send to Boilermakers National Funds?
A. Boilermaker-Blacksmith National Pension Trust
Boilermakers National Health & Welfare Fund
Boilermakers National Annuity Trust
Boilermakers National Apprenticeship Program (BNAP)
Mobilization Optimization Stabilization and Training (MOST)
Q. What is the Address to mail these contributions?
A. The mailing address is:
Wilson-McShane Corporation
BNF Employer Contributions Department
P.O. Box 909700
Kansas City, MO 64190-9700
To overnight payment, the physical address is:
Wilson-McShane Corporation
BNF Employer Contributions Department
12200 N. Ambassador Drive, Suite 400
Kansas City, MO 64163
Q. Where do I mail M.O.R.E. Work Investment Fund contributions?
A. The mailing address is:
M.O.R.E. Work Investment Fund
12200 N Ambassador Dr., Suite 301
Kansas City, MO 64163
Q. How do I update our employer contact information?
A. Fill out this form Employer Information Request and email to ec@wilson-mcshane.com.
AGREEMENTS
Q. How do I report an Alumni?
A. Fill out this form Boilermakers National Funds Alumni Agreement and email to ec@wilson-mcshane.com.
Q. What is the rate I need to report?
A. Please refer to the Local’s rate sheet where the work was performed for the most current rates (these can be obtained from the Local if you do not currently have one).
COLLECTIONS
Q. How does the Fund calculate for liquidated damages and interest if my reports are late?
A. All delinquent contributions are assessed at 12% liquidated damages and 12% interest.
Q. Can I request a waiver of this late assessment?
A. Yes, email your request to the specialist you received the notice from or to ec@wilson-mcshane.com. Your request will be reviewed with the BNF Leadership Team and you will receive a written response regarding the outcome of your request.
FUND'S INFORMATION & WITHDRAWAL LIABILITY
Q. Are the Plan documents available on the website?
A. Yes, Trust Documents, Plan Documents, SPDs, FASB, Funding Notices, etc. are all available under the Documents & Forms tab.
Q. How do I request a withdrawal liability estimate and other Fund information?
A. Please send your request to ec@wilson-mcshane.com.
