ATTENTION MEMBERS:
The IBEW Local 292 Benefits Office has recently mailed out the Annual Healthcare Enrollment Forms to all Active Members for the 2023 plan year. These forms are also available under the FORMS tab at https://www.ibew292benefits.org/forms/
These forms MUST be completed to assure the continuation of Health Care coverage for participants of the Health Care Plan and your Dependents into 2023.
Forms include:
I.B.E.W 292 Health Care Plan Information Sheet – Mandatory to complete and return
Spousal Coverage Verification Form – Mandatory to complete and return for spousal coverage
Adult Dependent Enrollment Application – Mandatory to complete and return for all dependent children between the age of 19 and up to 26
Authorization for Release of Health Information Form – Optional to complete and return
All completed forms need to be received by IBEW 292 Benefits Office by December 2, 2022. Please call the benefits office if you have any questions. 763-493-8830
Mail to:
IBEW Local 292 Benefits Office 6900 Wedgwood Rd N ste 425
Maple Grove, MN 55311
Email to: enrollment@ibew292benefits.org
Fax to: 763-416-6196
Optum EAP coming soon
View the information here.
SAV-RX Patient Portal Anywhere
View the instructions here.
Health and Welfare Plan Participants
Coverage of At-Home COVID-19 Tests as of January 15, 2022
Consistent with federal agency guidance, the I.B.E.W. 292 Health Care Plan (“Plan”) will provide coverage for at-home over-the-counter (“OTC”) COVID-19 test kits subject to the following provisions. These provisions only apply to at-home OTC COVID-19 test kits and do not affect previous Plan provisions regarding coverage of COVID-19 tests that are not at-home OTC COVID-19 test kits.
- At-home OTC COVID-19 test kits are covered if purchased on and after January 15, 2022 and through the end of the Public Health Emergency that was declared by the Department of Health and Human Services with respect to COVID-19.
- The Plan will only cover test kits available “over the counter” that have been approved by the FDA for use at home or elsewhere without involvement of a health care provider will be covered under this provision. Please go to www.fda.gov to learn which tests are currently FDA approved or check the packaging on the test kit before purchasing.
- The Plan will cover the cost of at-home OTC COVID-19 test kits without cost-sharing (no Deductible or Copay) if the at-home OTC COVID-19 test kits are purchased through a pharmacy in the Sav-Rx network.
- Many pharmacies in the Sav-Rx network are set up to process test kits in the same manner as a prescription. In these pharmacies, you can present your Sav-Rx Prescription card at the pharmacy counter and the test kit will be covered at 100%. This means that you will not have to pay anything for the at-home OTC COVID-19 test kit.
- Some pharmacies in the Sav-Rx network are not set up to process at-home OTC COVID-19 test kits in the same manner as a prescription. For these pharmacies, you must pay for the at-home OTC COVID-19 test kit at the time of purchase. You will be reimbursed for the entire cost of the at-home OTC COVID-19 test kit if you save your receipt of purchase and submit the receipt along with the “Over-The-Counter (OTC) COVID-19 Test Kit Claim Reimbursement Request” form to Sav-Rx at their address noted on the reimbursement request form. Reimbursement request forms are available at www.savrx.com. A sample claim form is also attached to this Notice.
- Reimbursement for at-home OTC COVID-19 test kits purchased at a pharmacy that is not in the Sav-Rx network will be limited to the cost of the test or $12, whichever is less. Amounts that you pay in excess of $12 for an at-home OTC COVID-19 test kit purchased at a pharmacy that is not in the Sav-Rx network or any other retailer will not count towards your Prescription Drug Benefit Deductible or your Prescription Drug Benefit Annual Out-of-Pocket Maximum.
- Save your receipt of purchase and submit the receipt along with the “Over-The-Counter (OTC) COVID-19 Test Kit Claim Reimbursement Request” form to Sav-Rx at their address noted on the reimbursement request form. Reimbursement request forms are available at www.savrx.com.
- The Plan will cover up to eight (8) at-home COVID-19 test kits per Covered Person under the Plan each calendar month.
- Covered tests include only those for at-home medical use by you or your covered household family members. Tests for employment purposes or resale will not be covered or reimbursed under this program.
Additional COVID Tests Available Directly from the Government
The United States government is also providing free at home COVID test kits. Please visit www.covidtests.gov to order up to 4 free tests per household. The tests kits will ship through the USPS, and are expected to ship out 7 to 12 days to most residential addresses.
Questions
Federal and state agencies are frequently releasing new information and guidance about COVID-19. This means the information above is subject to change. If you have any questions about the Plan’s coverage of at-home COVID-19 test kits or your pharmacy benefits in general, please call the Fund Office at (763) 493-8830 or contact Sav-Rx at (800) 228-3108.
Reimbursement Form
OTC COVID-19 Testing Reimbursement Form
Teledoc Video
Check out the Benefits page for an informational video
See Video
