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Benefits
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Medical Expense Benefit

When you or your eligible Dependents incur expenses as a result of a non-occupational illness or injury, the Medical Expense Benefit Plan reimburses you or your provider for a portion of the Covered Charges. You or your eligible dependent must first satisfy the deductible or make a required co-payment as shown in the Schedule of Benefits (see links below). After the deductible is met, the Plan pays the percentage of the Usual and Customary Charges shown in the Schedule of Benefits. Once you have met the out-of-pocket limit, the Plan may pay up to 100% of Covered Charges incurred for the remainder of the calendar year up to the calendar year maximum.

Click here to see the Summary Plan Description, 2016 Edition. Medical Expense Benefit description begins on Page 31.

Click below to see the Schedule of Benefits
Schedule of Benefits updated 2017

Click below to see the Summary of Benefits and Coverage
Summary of Benefits and Coverage: What this Plan Covers & What it Costs

To find a Network Physician or Hospital, visit the carriers website
Blue Cross Blue Shield of Illinois at http://www.bcbsil.com/index.htm
Health Alliance at https://healthalliance.org
HFN at http://www.hfninc.com

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For Blue Cross Blue Shield of Illinois and HFN network participants:

for information about medical benefits or to check on the status of a claim, contact:

Professional Benefit Administrators, Inc.
PO Box 4687
Oak Brook, IL 60522-4687

Ph: (800) 435-5694 or (630) 655-3755
Fax: (630) 877-7001

for preauthorization of inpatient hospitalization, outpatient surgeries,
rehabilitation services and transplant benefits, contact:

Medical Cost Management Toll free: 800-367-9938

For Health Alliance network participants:

for information and claim forms regarding medical benefits, and mental health and substance abuse benefits, contact:

Health Alliance Medical Plan, Inc.
102 E. Main St.
Urbana, IL 61801-2744
phone: 217.337-8400 or toll free: 800.322-7451
fax: 217.337-8008

for preauthorization of inpatient hospitalization, outpatient surgeries,
rehabilitation services and transplant benefits, contact:

Health Alliance Medical Plan, Inc.
toll free: 800.322-7451

For preauthorization of BCBS & HFN Mental Health and Substance Abuse treatment, contact:

Member Assistance Program (MAP)
Employee Resource Systems (ERS)
www.ers-eap.com
toll free: 800-292-2780


Prescription Drug Benefit

Click here to see the Summary Plan Description, 2016 Edition. Prescription Drug Benefit information begins on Page 53.

To see a list of participating SavRX pharamacies, or to find out if a drug is covered, visit SavRX at http://www.savrx.com/


Vision and Hearing Care Benefits

Click here to see the Summary Plan Description, 2016 Edition. Vision and Hearing Care Benefit information begins on Page 60.

for information about vision and hearing benefits, or to check on the status of a claim, contact:

Professional Benefit Administrators, Inc.
PO Box 4687
Oak Brook, IL 60522-4687

Ph: (800) 435-5694 or (630) 655-3755
Fax: (630) 877-7001


Dental Benefit Plan

Click here to see the Summary Plan Description, 2016 Edition. Dental Care Benefit information begins on Page 56.

for information about dental benefits, contact:

Delta Dental of Illinois
Claims Address: PO Box 5402 Lisle, IL 60532
Ph#1-800-323-1743
Group# 20141


Other NCILHWF Benefits

For information regarding the Loss of Time Benefit, see page 62 of the 2016 Edition of the Summary Plan Description. Questions regarding Loss of Time claims can be directed to:

Professional Benefit Administrators, Inc.
PO Box 4687
Oak Brook, IL 60522-4687

Ph: (800) 435-5694 or (630) 655-3755
Fax: (630) 877-7001

For information regarding the Death and Accidental Death and Dismemberment Benefits, see 2016 Edition page 66 of the Summary Plan Description. Questions regarding Death and Accidental Death and Dismemberment claims can be directed to:

North Central Illinois Laborers' Health & Welfare Fund Office
4208 W. Partridge Way Unit 3
Peoria, IL 61615

phone: 309.692-0860 or toll free: 866.692-0860
fax: 309.692-0862

For information regarding Retiree Benefits, see the Summary Plan Description, 2016 Edition beginning on page 30. Questions regarding Retiree Benefits can be directed to:

North Central Illinois Laborers' Health & Welfare Fund Office
4208 W. Partridge Way Unit 3
Peoria, IL 61615

phone: 309.692-0860 or toll free: 866.692-0860
fax: 309.692-0862

Please note: NCILHWF is not responsible for the content of external internet sites.

 

North Central Illinois Laborers' Health & Welfare Fund
4208 W. Partridge Way Unit 3
Peoria, IL 61615
Telephone: 309.692-0860
Toll Free: 866.692-0860
Facsimile: 309.692-0862
email: ncil@ncil.us