Frequently Asked Questions

If you move, you must let the Members’ Records Department know your new address. This must be done in writing. Simply complete the Change of Address form and mail it to the Members’ Records Department.

Or you may use the online Change of Address form, by clicking here.

In order to add a spouse or child to your benefits you must complete the enrollment form and return it to the Members’ Records Department. If you are adding a spouse, you must provide a copy of your marriage certificate. If you are adding a child, you must provide the child’s birth certificate indicating the participant’s name.

Once a dependent child reaches the age of 19, coverage is terminated under the Dental Benefit Plan of the Electrical Industry and the Dental Benefit Plan of the Elevator Industry, as applicable. However, if the child is a full-time student, coverage may be extended up until the child reaches age 26 if proof of full-time college enrollment is provided every semester. Proof of enrollment generally means an original letter from the college registrar’s office.

Yes, it is very important, especially if you are married. For example, if you are single and name a beneficiary and subsequently marry without changing the beneficiary, your spouse and the named beneficiary will divide all benefits equally. The same situation would apply to a divorced participant who remarries without changing the beneficiary from the former spouse to the new spouse.

Download, update and submit a Beneficiary Designation Form.  You will note that there are specific requirements to be fulfilled if you designate a beneficiary other than your spouse.

Generic drugs are manufactured after the original manufacturer’s patent expires. These drugs are safe, effective and FDA-approved to meet the same rigorous standards for quality, strength and purity as their brand-name counterparts. They are less expensive because the generic manufacturer does not have the investment costs of the developer of a new drug.

Plan-preferred brand-name drugs are those that do not yet have a generic equivalent available and are preferred based on safety, effectiveness and cost. An independent Express Scripts committee of physicians and pharmacists determines which brand-name drugs are preferred. They are included on a drug list know as a formulary.

Non-preferred brand-name drugs are those that do not yet have a generic equivalent, but for reasons of effectiveness or cost, are not on your Plan’s formulary drug list.

Your co-pay is based on the status of your drug (generic, plan-preferred or non-preferred) and the quantity (number of days supply) you receive as well as your status as an active or retired Participant. Your co-pays are shown on the chart of covered services on the Medical Plan page.

Keep in mind that you can minimize your out-of-pocket expense by speaking with your physician about prescribing a generic or Plan-preferred drug for you whenever possible. You can find information about generic drugs and pricing details online at www.expres-scripts.com or by calling Express Scripts Patient Customer Service at (800) 818-0883.

In order to qualify for coverage, certain medications require pre-certification in order to determine the appropriateness of the drug in treating your condition. If you file your prescription through Express Scripts, their pharmacist will initiate the pre-certification review with your doctor. If you visit a retail drugstore, your pharmacist will let you know if your medication requires pre-certification. If so, your doctor must call a special toll-free number at Express Scripts to initiate a review. This process typically takes one or two business days. Once the review is complete, Express Scripts will notify you and your doctor of the decision. If the review is approved, you will receive a letter indicating the length of approved coverage. If the review is denied, the letter will include the reason for denial and instructions on how to submit an appeal if you choose.

The Plan does not cover weight-loss medications (such as Xenical® and Meridia®), erectile dysfunction medications (such as Cialis®, Levitra®, and Viagra®), fertility medications (such as Clomid® and Repronex®), non-sedating antihistamines (such as Allegra®, Clarinex®, and Zyrtec®), and vitamins. If one of these medications is medically necessary, you may call the Joint Industry Board Members’ Records Department at (718) 969-4030 to obtain a form for you and your doctor to complete and submit to the PHBP Medical Plan for medical review.

Yes, if it involves maintenance medication. Once you have filled two prescriptions of the same drug at your pharmacy, you must then use the Express Scripts by Mail service for your prescriptions. Failure to do so will result in your prescription being denied at your local pharmacy.

Yes. The list of maintenance drugs is monitored by Express Scripts and changed periodically. For example, GI drugs (such as Nexium, Protonix, omeprazole) have been added to this list. Insulin is no longer on the list. Express Scripts will now advise you when your medication either goes on or comes off of the maintenance drug list. Once a drug comes off the list, you may purchase it at your retail pharmacy. Prescriptions for maintenance medications must be mailed to Express Scripts after the first fill and one refill.

If this occurs, you can call the Joint Industry Board Members Records Department at (718) 591-2000, Extension 2491 to obtain a form to initiate a review to determine if the preferred brand co-pay applies.

Yes. In this case, you can make a request to override the rule that only allows the first fill and one refill for a maintenance drug at a local pharmacy. Call the Joint Industry Board Members’ Records Department at (718) 591-2000, Extension 2491 to obtain a form to initiate a review.

Please refer to the chart of covered services on the Medical Plan page for co-pay amounts.

Yes.

Under the PHBP Medical Plan, all hospital admissions and surgical procedures performed in a hospital facility or surgi-center require pre-certification through MagnaCare. Other services requiring pre-certification include:

• Specialized radiology procedures such as MRI, MRA, CAT, SPECT and PET Scans if determined by MagnaCare to be medically necessary to be performed in a hospital setting. If these services are not deemed to be medically necessary to be performed in a hospital, these services will not be covered in a hospital setting. They can be done in a free standing facility.
• Initiation of dialysis center placement
• Home health care or hospice in conjunction with a hospital discharge
• Durable medical equipment in conjunction with a hospital discharge
• Discharge planning
• Out-patient therapies, including physical, occupational, speech, cardiac, and respiratory therapies

The toll-free phone number for any pre-certification through MagnaCare is (877) 624-6210. Listen to the message prompts and press the selection for pre-certification.

Services that are not part of discharge planning require pre-certification directly through the Plan. These include:

• Home health care and hospice unrelated to a hospital discharge
• Sleep apnea treatment requests
• Durable medical equipment including but not limited to canes, crutches, wheelchairs and oxygen supplementation

To receive pre-certification for the above services, contact the Plan at (718) 591-2000, Extension 1350 or send a fax request to the Managed Care Coordinator at (718) 591-1107.

If you believe you have a serious medical or surgical problem, such as new onset of chest pain or severe pain in your abdomen that has been getting worse over the past several hours and you cannot reach your doctor, it is reasonable to go to the Emergency Room for assistance. The hospital must do a medical screening evaluation prior to determining your medical coverage (as mandated by federal law). Emergency room visits for non-emergency conditions will not be approved as medically necessary and will not be covered by the Pension, Hospitalization and Benefit Plan.

Examples of true emergencies include premature labor, significant bleeding from any site, broken bones, losing consciousness, new onset of seizures or seizures that are not being controlled, and difficulty breathing.

As long as the admission is precertified and determined to be medically necessary through MagnaCare, your in-patient or Emergency Room hospital bills will be covered. All applicable co-pays will apply to such admissions.

It is the hospital’s responsibility to pre-certify all admissions by calling (877) 624-6210 once you have given them the information by presenting your ID card. Remind your provider to call for pre-certification when you know that you will be admitted. If it is an emergency visit, the facility may call within 24 hours after the admission. If the hospital or surgi-center fails to call and give MagnaCare the required information, the facility will not receive payment from the Plan. The hospital/surgi-center can appeal to MagnaCare to receive payment but it must provide all of the documentation pertinent to your hospital admission. Scheduled procedures performed in a hospital should be pre-certified by the physician.

Participants covered under the PHBP Medical Plan who are on Workers’ Compensation can remain covered for up to two years from the date of their first Workers’ Compensation check, providing they are still collecting Workers’ Compensation. Participants who are on disability will remain covered for up to 26 weeks and may extend coverage up to two years if continuing proof of disability is provided.

Charges rendered by a Psychiatrist, PhD, or Social Worker ("MSW") are covered for active and retired eligible Participants for individual therapy. Reimbursement will be at the network allowance, less the co-pay.

All covered visits, both in and out-of-network, are subject to the $35 co-payment.

You may locate a MagnaCare participating mental health care provider by visiting their website at www.magnacare.com. or by calling them at (877) 624-6210.

A maximum of 30 office visits to a chiropractor will be covered in a calendar year for each family member.

If you go to a physician for a non routine visit and diagnostic tests are prescribed by the physician, the tests are covered if the physician's visit is covered.

Sometimes in such cases, the physician does not put the diagnosis codes on the request you take to the drawing station, and the lab marks it as a routine diagnostic test. The claim may then get denied as a not covered routine test.

To guard against this possibility, please make sure the physician requesting the diagnostic tests is writing the appropriate diagnosis code on the request he sends you with and the drawing station records it.

In spite of all precautions, if you are in a situation where the physician's claim is paid but the diagnostic claim has been denied, please call the MagnaCare customer service line at 1-877-624-6210 and mention that you have a "diagnostic denial" claim issue. Please have ready the name of the physician you visited who prescribed the diagnostic tests and the date of the visit.

For in-network claims, you will be responsible for only four (4) co-payments of $35 per incident or illness.

Out-of-network claims are paid according to the MagnaCare fee schedule and are subject to the same co-payments as in-network claims. All remaining balances are the participant's responsibility.

You may locate a MagnaCare participating physical therapist by visiting their website at www.magnacare.com. or by calling them at (877) 624-6210.

All therapies must be pre-approved by MagnaCare. Please call (877) 624-6210. Claims will not be paid unless prior approval from MagnaCare is obtained.

In addition to hospital and out-of-network coverage, non-Medicare eligible retirees and their families that live in all states will have access to in-network medical, physician and surgical benefits. All retirees who have not become eligible for Medicare or who have non-Medicare eligible dependents should receive a card pertaining to the Preferred Provider Organization ("PPO") in their state. If you live out-of-state and have not received this card, you may call the Joint Industry Board, Members Records Dept. at (718) 591-2000, Extension 2491.

All Participants should call MagnaCare's dedicated Local Union No. 3 service line at (877) 624-6210. Submit claims to MagnaCare at P.O. Box 1001, Garden City, NY 11530.

You can call MagnaCare Advocacy Services for assistance at (866) 624-6260.

No, but if you have a Health Reimbursement Account, you may submit to that Fund.

There is no need to submit claims when Medicare is your primary insurance for dates of service rendered on or after 8/1/2011. Secondary claims are paid by MagnaCare on an automatic crossover.

For dates of service on or after August 1, 2011, you should call MagnaCare's dedicated Local Union No. 3 service line at (877) 624-6210.

Yes, paper claims need to be filed for the following services: Covered services rendered by the Veteran's Administration; the shingles (Zostavax) vaccination; hearing aid devices; diabetic needles and syringes; foreign travel claims; and coordination of benefit claims.

Your co-pay is based on the status of your drug and the quantity (number of days supply) you receive. Your co-pays are shown on the ESF Medical plan page.

You can minimize your out-of-pocket expense by speaking with your physician about prescribing a generic or Plan preferred formulary drug for you whenever possible. You can find information about generic drugs and pricing details online at www.express-scripts.com or by calling Express Scripts Member Services at (800) 413-7402.

Generic drugs are manufactured after the original manufacturer’s patent expires. These drugs are safe, effective and FDA-approved to meet the same rigorous standards for quality, strength and purity as their brand-name counterparts. They are less expensive because the generic manufacturer does not have the investment costs of the developer of a new drug.

Plan-preferred brand-name drugs are those that do not yet have a generic equivalent available and are preferred based on safety, effectiveness and cost. An independent Medco committee of physicians and pharmacists determines which brand-name drugs are preferred. They are included on a drug list know as a formulary.

Non-preferred brand-name drugs are those that do not yet have a generic equivalent, but for reasons of effectiveness or cost, are not on your Plan’s formulary drug list.

In order to qualify for coverage, certain medications require pre-certification in order to determine the appropriateness of the drug in treating your condition. If you file your prescription through Express Scripts, their pharmacist will initiate the pre-certification review with your doctor. If you visit a retail drugstore, your pharmacist will let you know if your medication requires pre-certification. If so, your doctor must call a special toll-free number at Express Scripts to initiate a review. This process typically takes one or two business days. Once the review is complete, Express Scripts will notify you and your doctor of the decision. If the review is approved, you will receive a letter indicating the length of approved coverage. If the review is denied, the letter will include the reason for denial and instructions on how to submit an appeal if you choose.

The Plan does not cover weight-loss medications (such as Xenical® and Meridia®), erectile dysfunction medications (such as Cialis®, Levitra®, and Viagra®), fertility medications (such as Clomid® and Repronex®), non-sedating antihistamines (such as Allegra®, Clarinex®, and Zyrtec®) and vitamins. If one of these medications is medically necessary, you may call the Joint Industry Board Members’ Records Department at (718) 969-4030 to obtain a form for you and your doctor to complete and submit to the PHBP Medical Plan for medical review.

Yes. Once you have filled two prescriptions of the same drug at your pharmacy, you must then use the Express Scripts Mail service for your prescriptions. Failure to do so will result in your prescription being denied at the pharmacy.

Yes. The list of maintenance drugs is monitored by Express Scripts and changed periodically. For example, GI drugs (such as Nexium, Protonix, omeprazole) have been added to this list. Insulin is no longer on the list. Express Scripts will now advise you when your medication either goes on or comes off of the maintenance drug list. Once a drug comes off the list, you may purchase it at your retail pharmacy. Prescriptions for maintenance medications must be mailed to Express Scripts after the first fill and one refill.

If this occurs, you can call the Joint Industry Board Members Records Department at (718) 591-2000, Extension 2491 to obtain a form to initiate a review to determine if the preferred brand co-pay applies.

The vision benefit entitles you, your legal spouse and eligible children to an eye examination once each year by an optometrist or an ophthalmologist and, if prescribed, one pair of eyeglasses each year. You may receive vision care services in the following ways:

• Optical services (optometrist for examination and optician for eyeglasses) at JIB Medical, P.C.  If you go to JIB Medical, P.C., there will be no charge to you and you do not have to file a claim form with: 
  
      Electrical Industry Center,
      158-11 Harry Van Arsdale 
      Jr. Avenue, Room 201
      Flushing, NY 11365 
  
  To schedule an optical appointment, contact JIB Medical P.C. at (718) 591-2014 from Monday-Friday, 8:00 A.M. to 5:45 P.M. and Saturday from 8:00 A.M. to 3:00 P.M. Appointments should be made approximately 2 weeks in advance.
• You may also use a provider who belongs to the Vision Screening Optical Group. These providers offer optometric eye care to participants, their legal spouses and eligible children living in New York, New Jersey and Florida. Their service includes one eye examination by an optometrist and, if prescribed, a pair of eyeglasses (mono-focal or bi-focal) and a selection of frames once a year. If you use this method and you buy supplies or services for which you are not eligible or covered, you will be responsible to pay these charges, but you will receive a 20% discount. To use a Vision Screening provider, please contact the Fund Office at (718) 591-1100 to request an optical voucher. OR
• You may also use a panel optical provider located in New Jersey. Their service includes one eye examination by an optometrist and, if prescribed, a pair of eyeglasses (mono-focal or bi-focal) and a selection of frames once a year. If you obtain the benefit in this way there will be no charge to you. You do not have to file a claim form. Please contact the Fund Office at (718) 591-1100 to request an optical voucher for a New Jersey panel provider. OR
• You may have an eye examination by any other optometrist or ophthalmologist, licensed and practicing in the United States or its possessions. You may purchase eyeglasses, if necessary, from any licensed facility operating in the United States or its possessions. If you use this method, you must file a claim form with the Fund Office. The Plan will reimburse you or your optical provider according to the Plan’s fee schedule.

This benefit enables you, your legal spouse and eligible children to obtain, once each year, a physical examination for diagnostic purposes only. The Diagnostic Medical Benefit provided by the Plan is available in the following ways:

• You may use JIB Medical, P.C. located at: 
  
      Electrical Industry Center,
      158-11 Harry Van Arsdale Jr. Avenue, Room 201
      Flushing, NY 11365 
  
  To schedule an optical appointment, contact JIB Medical, P.C. at (718) 591-2014 from Monday – Friday, 8:00 A.M. to 6:00 P.M. and Saturday from 8:00 A.M. to 2:30 P.M. Appointments should be made approximately 2 weeks in advance.
• You may use the diagnostic medical services available at a facility located in New Jersey or Long Island through the following: 
  • Morristown Hospital is located at 100 Madison Avenue, Morristown, NJ 079
  • Professional Evaluation Medical Group (“PEMG”) is located in Manhattan, Nassau and Suffolk Counties. Call 516-935-4378 to make an appointment. It is not necessary to file a claim for this benefit. This is a paid in full benefit subject to Plan limitations as described below.

• You may also use any medical doctor or doctor of osteopathy licensed and practicing in the Unites States or its possessions. If you use this method, you must file a claim form. The Plan will reimburse you or your doctor up to a maximum of $125 for a person age 14 and over, and up to a maximum of $60 for a child under age 14.

Retirees who are eligible for Medicare must submit their charges to MagnaCare before submitting them to Medicare for payment.

Review the Plan C highlights brochure. For a complete listing of co-pays, please refer to your Summary Plan Description.

All hospital admissions of any type and all surgical procedures performed in a hospital facility or surgi-center require pre-notification through Anthem-Blue Cross. Anthem-Blue Cross must be notified of any Emergency Room visit within 24 hours after the visit occurs. In addition, some specialized radiology procedures such as SPECT and PET scans and CAT scan, MRI and MRA only if performed in a hospital facility require pre-notification through Anthem-Blue Cross. The toll-free number for any pre-notification through Anthem-Blue Cross is (844) 243-5566. Listen to the message prompts and press the selection for pre-notification. Specially trained nurses are available 24 hours a day, seven days per week.

It is the responsibility of the hospital to pre-notify all admissions by calling (844) 243-5566 once you have given them the information by presenting your ID card. Remind your provider to call for pre-notification when you know that you will be admitted. If it is an emergency visit, the facility may call within 24 hours after the admission. If the hospital or surgi-center fails to call and give Anthem-Blue Cross the required information, the facility will not receive payment from the Plan. The hospital/surgi-center can appeal to Anthem-Blue Cross to receive payment, but it must provide all of the documentation pertinent to the admission.

All claims, for services rendered by both MagnaCare and non-MagnaCare providers, must be submitted to MagnaCare at:

MagnaCare, Inc.
1600 Stewart ave #700
Westbury, NY 11590

MagnaCare providers will submit the claim directly to MagnaCare on your behalf. If you use a non-MagnaCare provider, you must submit an itemized bill attached to a claim form. Expenses must be considered appropriate for insurance purposes. They must be itemized and indicate diagnosis and procedure codes (ICD9 and CPT codes).

Please note that statements that include only a previous balance, a balance due or a collection agency notice are not acceptable.

If you believe you have a serious medical or surgical problem, such as a new onset of chest pain or severe pain in your abdomen that has been getting worse over the past several hours and you cannot reach your doctor, it is reasonable to go to the Emergency Room for assistance. The hospital must do a medical screening evaluation prior to determining your medical coverage (as mandated by federal law). After you are seen, advise the doctor/facility that they must call the Anthem-Blue Cross pre-notification number (844-243-5566) within 24 hours after the visit to provide information about your diagnosis and reason for seeking emergency medical care. This information is indicated on the back of your Anthem-Blue Cross card. Emergency room visits for non-emergency conditions will not be approved as medically necessary and will not be covered by the Employees Security Fund.

Examples of true emergencies include premature labor, significant bleeding from any site, broken bones, losing consciousness, new onset of seizures or seizures that are not being controlled and difficulty breathing.

As long as the admission is pre-notified and determined to be medically necessary through Anthem-Blue Cross, your in-patient or Emergency Room hospital bills will be covered. All applicable co-pays will apply to such admissions.

No. You can use your dental benefits in either of the following ways:

• You may use the dental facilities of DDS, Inc. (“DDS”), a closed panel of participating dentists who agree to accept the Plan’s dental allowances for covered services as payment in full. If you do this, you do not have to file a Dental Benefit Request Form. Call DDS at (800) 255-5681 for information.
• Or, you may use any licensed dental facility in the United States or its possessions. The cost of this treatment is paid for by the Plan up to the limits of the dental allowances for covered services. Any out-of-pocket expenses incurred as a result of using a non-DDS provider will be the patient’s responsibility.

Yes. You and your eligible dependents each have a $1,500 annual maximum on all dental worked performed in a single calendar year. All charges above the $1,500 annual maximum are the patient’s responsibility, regardless of whether or not the service was performed by a DDS provider or a non-DDS provider.

Yes. You and your eligible dependents each have an annual $50 deductible on services that are not preventative or basic.

Yes. All crown, bridge, prosthetics, osseous surgery or root canal services require pre-authorization. A DDS dentist will automatically obtain pre-authorization for you. To obtain pre-authorization for services provided by a non-DDS dentist, have your dentist list the required dental work and fees on a Dental Benefit Request Form. All relevant x-rays must be attached to this form. Sign the form, and send it to DDS, Inc., located at 265 Post Avenue Suite 340 Westbury NY, 11590.  DDS will then review the case, notify the dentist of the total amount that the Plan will pay for the dental work and the portion that the patient will be responsible for. X-rays will be returned to the dentist.

Preventative or basic services include:

• Examinations
• X-Rays
• Fillings
• Prophylaxis
• Pulp Cap Fillings
• Simple Extractions
• Cementing of Crowns and Bridges
• Palliative Treatment to Prevent Pain

Participants covered under this Plan may be covered up to 26 weeks when out on Workers’ Compensation or disability.

Generally, most expenses not paid by your medical or dental plan may be submitted for payment, as well as some over the counter drugs, and Medicare, Long-Term Care and COBRA premiums. Please refer to page five of the Summary Plan Description for a comprehensive list of both covered and excluded items.

No. Both active and retired participants may only receive benefit payments from this Plan for unreimbursed covered medical expenses as allowed under IRS regulations.

Yes. Your maximum account balance is based upon your collective bargaining agreement and is $5,000 unless indicated otherwise.

If your account equals or exceeds the maximum amount, you will not receive any further employer contributions to the HRA until you are paid benefits that are sufficient to reduce your balance below the maximum. However, you will continue to earn interest based on your account balance. Your collective bargaining agreement will state whether the excess contributions, which otherwise would have been made to the HRA and credited to your account, will be deposited in the Deferred Salary Plan or the Annuity Plan.

Your remaining account balance will be distributed to your named beneficiary. Distributions are not subject to taxation.

The fee-for-service plan allows you to go to any dentist of your choice. You or your dentist must then submit a claim form to Blue Cross for reimbursement. The Plan will pay according to its established fee schedule. The difference between the amount the provider bills and the amount the Plan pays is your responsibility.

Download a Dental Plan claim form. Note: It is very important that you complete the correct form for the Plan you are in, as failure to do so will delay the processing of your claim and reimbursement, if applicable.

The Blue Cross Dental Managed Network Program, which is an HMO, requires you to enroll in the program and remain enrolled for a minimum of one year. Once you are enrolled, you may choose your dentist from a panel of participating dentists and then must use only that dentist for you and your family, if applicable. Covered services will be paid in full, and you will not have any out-of-pocket expense. If you use a dentist outside of the program, you will not be covered for those services.

To enroll in the Blue Cross Dental Managed Network Program, contact the Members’ Records Department at (718) 591-2000, Extension 2491.

The DDS, Inc. program allows you to enroll at any time during the year by calling DDS, Inc. at (800) 255-5681. The DDS, Inc. network is a closed panel of participating dentists who agree to accept the Plan’s allowances for covered services as payment in full. Once you have selected your DDS provider, you may make an appointment. No claim forms are required.

Participants in the Empire Blue Cross and Blue Shield Fee-For-Service Program (the “Fee-for-service Program”): You and your dentist will need to complete a Dental Claim Form for all services received. You may obtain a Dental Claim Form online or by contacting the Members’ Records Department. You complete the patient’s portion of the Dental Claim Form and your dentist completes the remainder of the form. Then return the completed form to Empire Blue Cross and Blue Shield Dental Benefits Program, P.O. Box 810, Minneapolis, MN 55440-0810.

Participants in the Empire Blue Cross and Blue Shield Dental Managed Network Program (the “Managed Network Program”): Once you enroll and select a dental office, you will not need to submit any forms or obtain pre-certification for any services. Your dental office will take care of any required paperwork.

Participants in the DDS, Inc. Program: You will not need to submit any forms or obtain pre-certification for any services. The DDS dental office is responsible for any required paperwork.

You are required to submit a Dental Claim Form within one year of receiving dental services. Although not required, you are encouraged to contact Blue Cross Blue Shield in advance of receiving dental services to verify that coverage is available, especially in the case of prosthetic and orthodontic services.

The maximum amount payable is $4,000.00 per lifetime per person. 

The maximum amount payable is $6,000.00 per person per calendar year.

Both Dental Plans cover two cleanings per year (once every 6 months).

For all participants in the Dental Benefit Plan of the Electrical Industry, non-cosmetic dental implants will be covered for charges up to $1,800 (effective October 1, 2023). Associated charges for abutments and bone grafts will also be covered as per the Plan's fee schedule. This benefit is part of the $6,000 annual prosthetic maximum and is part of the fee-for-service program only. Participants in the DDS preferred provider organization and the Empire Dental Managed Network Program are subject to the fee-for-service plan allowances for this benefit only.

Since implant related services are reimbursed according to the Plan's fee schedule, it is strongly recommended that your dentist submit a pre-estimate request on your behalf to either Blue Cross or DDS, Inc. This will help estimate your out-of-pocket costs.

The fee-for-service plan allows you to go to any dentist of your choice. You or your dentist must then submit a claim form to Blue Cross for reimbursement. The Plan will pay according to its established fee schedule. The difference between the amount the provider bills and the amount the Plan pays is your responsibility.

You can download a Dental Plan claim form. Note: It is very important that you complete the correct form for the Plan you are in, as failure to do so will delay the processing of your claim and reimbursement, if applicable.

The Blue Cross Dental Managed Network Program, which is an HMO, requires you to enroll in the program and remain enrolled for a minimum of one year. Once you are enrolled, you may choose your dentist from a panel of participating dentists and then must use only that dentist for you and your family, if applicable. Covered services will be paid in full, and you will not have any out-of-pocket expense. If you use a dentist outside of the program, you will not be covered for those services.

To enroll in the Blue Cross Dental Managed Network Program, contact the Members’ Records Department at (718) 591-2000, Extension 2491.

The DDS, Inc. program allows you to enroll at any time during the year by calling DDS, Inc. at (800) 255-5681. The DDS, Inc. network is a closed panel of participating dentists who agree to accept the Plan’s allowances for covered services as payment in full. Once you have selected your DDS provider, you may make an appointment. No claim forms are required.

Participants in the Empire Blue Cross and Blue Shield Fee-For-Service Program (the “Fee-for-service Program”): You and your dentist will need to complete a Dental Claim Form for all services received. You may obtain a Dental Claim Form online or by contacting the Members’ Records Department. You complete the patient’s portion of the Dental Claim Form and your dentist completes the remainder of the form. Then return the completed form to Empire Blue Cross and Blue Shield Dental Benefits Program, P.O. Box 810, Minneapolis, MN 55440-0810.

Participants in the Empire Blue Cross and Blue Shield Dental Managed Network Program (the “Managed Network Program”): Once you enroll and select a dental office, you will not need to submit any forms or obtain pre-certification for any services. Your dental office will take care of any required paperwork.

Participants in the DDS, Inc. Program: You will not need to submit any forms or obtain pre-certification for any services. The DDS dental office is responsible for any required paperwork.

You are required to submit a Dental Claim Form within one year of receiving dental services. Although not required, you are encouraged to contact Blue Cross Blue Shield in advance of receiving dental services to verify that coverage is available, especially in the case of prosthetic and orthodontic services.

The maximum amount payable is $4,000.00 per lifetime per person. 

The maximum amount payable is $4,000.00 per person per calendar year.

Both Dental Plans cover two cleanings per year (once every 6 months).

For all participants in the Dental Benefit Plan of the Elevator Industry, non-cosmetic dental implants will be covered for charges up to $900. Associated charges for abutments and bone grafts will also be covered as per the Plan's fee schedule. This benefit is part of the $4,000 annual prosthetic maximum and is part of the fee-for-service program only. Participants in the DDS preferred provider organization and the Empire Dental Managed Network Program are subject to the fee-for-service plan allowances for this benefit only. Since implant related services are reimbursed according to the Plan's fee schedule, it is strongly recommended that your dentist submit a pre-estimate request on your behalf to either Blue Cross or DDS, Inc. This will help estimate your out-of-pocket costs.

In most cases, a participant in the Plan who has earned a minimum of five years of vesting service will be eligible to receive a benefit. However, if a participant ended work in covered employment before October 1, 1999 they will typically need 10 years of vesting service in order to be eligible to receive a benefit.

Vesting service means the length of time a participant works for a contributing employer. One year of vesting service requires a minimum of 1,000 hours of covered employment.

There are five different types of pensions available under the Pension Plan. Each type of pension is eligible for the Joint and Survivor payment option if the participant is married. Read our summary for more information on the five types of pensions.

A Joint and Survivor Option (J&S Option) provides continued payment to your spouse in the event you die prior to your spouse, after you retire. The participant’s monthly pension will be reduced when a J&S Option is in place. You can read more about the J&S Option.

If you die before retiring, your benefit will be paid to your surviving spouse according to the 50% Joint and Survivor benefit. The earliest your spouse may collect the benefit is as of your 55th birthday, in which case early retirement reduction factors will apply. If you die after you have retired and started receiving benefits from the Plan, your spouse will continue to receive payments if you elected one of the Joint and Survivor options.

Yes. Participants who work in the construction division, as well as other divisions, may be eligible for a benefit from the National Electric Benefit Fund (“NEBF”) and/or the I.B.E.W. Pension Plan, depending on their collective bargaining agreement and charter status. For information about the NEBF pension, visit their website at http://www.nebf.com/ or call (301) 556-4300. For information about the I.B.E.W. pension, please call (800) 733-4239.

 Participants who work in the Elevator Division should contact the Elevator Division Retirement Benefit Plan at (212) 689-4204.

Yes! It is very important that participants who are disabled read and follow these rules carefully!

If you are collecting Workers' Compensation benefits, you must apply for a Disability Pension from the Pension Plan no later than two years after the effective date of the first Workers' Compensation payment you receive. If you are not receiving Workers' Compensation payments, but are totally disabled and not employed by a contributing employer immediately prior to the application for a Disability Pension, you must apply to the Pension Plan within two years after the initial date of disability.

You should not wait until you have received your total and permanent disability award from Social Security to file your application with the Pension Department. Receipt of the Social Security award may take longer than two years and if you have not applied for the Disability Pension within the two years stated above, you will no longer be eligible for a Disability Pension.

If your pension application is filed more than two years after the effective date of your first Workers' Compensation payment or the initial date of your disability if you are not receiving Workers' Compensation benefits, you will not be eligible to apply for a Disability Pension.

You may contact Empower at (877) JIB-401K or (877) 542-4015, 24 hours a day, 7 days a week to obtain account balance information, to change investment funds, or to request a distribution or loan. Remember to have your PIN number available when you call. You may also obtain your account balance online at www.jib.retirepru.com.

Yes, and it varies by year in accordance with IRS regulations. However, if you are fifty years or older, you are eligible to contribute additional “catch-up” amounts up to the maximum contribution. Remember: These amounts do not include any contributions your employer may be required to make.

You may receive your own full account balance when one of the following occurs:

• You retire;
• You die (in which case, your named beneficiary will receive the distribution);
• You become totally or permanently disabled;
• You terminate employment from and withdraw from the Industry (may be subject to a 10% IRS penalty);
• You reach age 59½ and apply for a distribution; or
• You request a “hardship withdrawal,” which is approved by Empower in accordance with the rules of the Plan for the amount needed. Please see pages 31-33 of the Summary Plan Description for more information about hardship withdrawals.

In addition to the events listed above, you may also receive a distribution from your Employer Contribution Account for any one of the following:

• Supplementary Unemployment Benefits
• Supplementary Workers’ Compensation Benefits
• Supplementary Disability Benefits
• Supplementary Economic Assistance Benefits (medical or dental expenses not covered by insurance and Long-Term Care, Medicare Part B and COBRA premiums)
• Supplementary Financial Assistance Benefits (delinquent rent and mortgage)
• Vacation and Supplementary Vacation Benefits
• Holiday Benefits
• College Tuition Reimbursement
• Child Care Reimbursement
• Non-College Private School Tuition
• Jury Duty Benefits
• Funeral Leave Benefit
• Adoption Expenses
• Wage Replacement/Election Day Benefit
• Picket Duty Benefit
• Inclement Weather Benefit
• Medical Exam Day Benefit

The new benefits are available to participants based on classification and applicable Collective Bargaining Agreement.

The benefits described above will be subject to a 10% IRS penalty if under age 59½.

For all applicable forms, go to Empower online

Yes. Please review our 401(k) Plan Payment Benefit Chart for further details.

No. You can only receive payment of Annuity benefits from the Plan upon retirement, total withdrawal from the industry or total disability.

Effective August 1, 2007, monthly benefits up to $2,500 are paid from account balances greater than $5,000 at the time of application. Account balances less than $5,000 at the time of application are paid in a single lump-sum. While balances less than $1,000 are paid automatically, you must apply for your distribution if the balance is greater than that amount. In addition, if your account balance is over $20,000, the Plan allows for a one-time lump sum distribution of up to $20,000.

You may elect to receive monthly payments at any time between your retirement or withdrawal from the industry and the April 1st following the date you reach age 70½. Federal law requires that the Plan commence payments automatically as of the April 1st following the date you reach age 70½ or your retirement, whichever is later.

Your named beneficiary is entitled to receive monthly distributions of any remaining account balance. In addition, the Annuity Plan pays a maximum death benefit of up to $67,500 to the named beneficiary, which will first be distributed in monthly installments of up to $2,500. The amount is based on your age and years of service. A one-time lump-sum payment, equal to the greater of 25% of the total initial account balance plan plus the death benefit or $20,000, is also available.

In most cases, a participant in the Plan who has earned a minimum of five years of vesting service will be eligible to receive a benefit. However, if a participant ended work in covered employment before January 1, 1999 they will typically need 10 years of vesting service in order to be eligible to receive a benefit.

Vesting service is the length of time a participant works for a contributing employer. One year of vesting service requires a minimum of 1,000 hours of covered employment.

There are four different types of pensions. Each type of pension is eligible for the Joint and Survivor Payment Option if the participant is married. If you're interested, you can read more about the types of pensions.

A Joint and Survivor Payment Option (J&S Option) provides a continued payment to your spouse in the event you die prior to your spouse after you retire. You can read more about the J&S Option in this announcement.

If you die before retiring, your benefit will be paid to your surviving spouse according to the 50% Joint and Survivor Benefit. If you die after you have retired and started receiving benefits from the Plan, your spouse will be paid if you elected the Joint and Survivor option.

Your pension benefit is based on your credited years of service multiplied by the unit benefit amount in effect at the time you retire.

For example, if you are at normal retirement age, have 20 years of credited service and retire from active employment on June 1, 2013, your benefit will be calculated as follows:
20 years of service x $22.50 = monthly benefit of $450*

*If you are married, joint survivor reductions may apply.

Please resubmit your request to be added to the mailing list, with your updated address.

You can take a no credited course that is equivalent to one year of high school algebra in advance, to be prepared when applications become available. These classes are offered by most community colleges.

After acceptance apprentices agree to work throughout all 5 boroughs in the tri-state area. Job locations are nonnegotiable.

Contact the Apprentice Department at (718) 591-2000, Extension 1480.

Providing your application is submitted correctly and you meet all requirements, you will be sent for an aptitude test. The results of your aptitude test will determine whether or not you are sent for interviewing.

In order to register for the Educational and Cultural Trust Fund classes, or enroll your children in Camp Integrity, you must be employed for at least six months by an employer(s) who contributes to the Fund on your behalf. This would include the Citizenship Responsibility course, which prepares you to serve Jury Duty, and enables you to receive the Jury Duty Benefit for any days you serve as a juror.

To be eligible for the Tuition Reimbursement Benefit, you must be employed by a contributing employer for at least three years prior to the start of the semester you submit an application for reimbursement.

College Tuition Loans are available if you are employed by a contributing employer for at least five years immediately prior to your application.

To submit an application for the Scholarship Award Program, you must be employed by a contributing employer for at least five years immediately prior to application; or a retired participant who meets the eligibility requirements.

As a rule, members and spouses are eligible to receive up to a lifetime maximum of $25,000 Tuition Reimbursement for any courses successfully completed while matriculated at an accredited college. You will be reimbursed for any credits earned, which will be applied towards an Associates, Baccalaureate, Masters, Ph.D., M.D. or Jurist Doctorate Degree. However, you may apply for Technical Training Courses as long as these courses are job-related and will be used to enhance your skills for work within the industry.

To be considered for reimbursement for Technical Training Courses, you must submit the proper E&C Trust Fund forms for Technical Training to establish pre-approval before taking the Technical Training Course. Each application form to apply for reimbursement for a Technical Training Course must be completed by the member’s employer.

No. When a participant or a spouse completes their B.A. degree, the Fund will reimburse courses leading to the next degree level, so that the student must pursue a Masters Degree.

In the event an employer fails to deduct for a given week, the borrower shall make that payment directly to the Fund. In cases where you are not employed, the maximum allowable grace period is 30 days. After this 30-day period, you are required to make monthly payments for any weeks not submitted through your employer’s payroll deductions. Subsequent loans will not be approved as long as you are in default and remain delinquent on the current loans.

The applicant must be an eligible dependent, or a legally adopted child of a participating member of Local Union No. 3, I.B.E.W.

Since the inception of the Joint Industry Board in March 30, 1943, funding for benefits has been through labor-management cooperation. The E&C benefits program is solely funded through contributions made by contributing employers to the E&C Fund on their employees’ behalf. When a participant retires from the industry, contributions on the member’s behalf and the participant’s eligibility cease, with the exception of the E&C Scholarship Program. Realizing that some retired members have College-bound dependents, the E&C Fund has extended the Scholarship Program to allow the eligible dependents of pension members, who otherwise meet the eligibility requirements, to enter the competition for a four-year Scholarship.

No. The E&C benefits program is solely funded by employer contributions under the Local Union No. 3, I.B.E.W. Collective Bargaining Agreement with employer members of the New York Electrical Contractors Association and the Association of the New York Electrical Contractors. Ask your Local Union No. 3, I.B.E.W. employee representative, or shop steward for further information regarding your benefits.

To be eligible for E&C benefits, you must be employed or be available for employment. If you are receiving workers’ compensation, the E&C classes are not available to you until your employment is resumed, or you become available for full employment.

However, the Tuition Reimbursement, Scholarship and Loan Program benefits are extended for a period of two years while you are on workers’ compensation. Should you remain on disability after the two-year period, E&C benefits cease until you return to full employment within the industry for a period of six months to one year depending on the amount of time you remained disabled. All requests for benefits go before a committee for eligibility approval.

In order to be fit-tested, you must first complete training in the use of Respiratory Protection Equipment. You will be assigned to a class based on a class pending list. When notified to take a class, you are required to complete a medical surveillance program, which includes a physical examination including a chest x-ray and a pulmonary function test. You are not permitted to take any course that requires the use of a Respirator and fit-testing without a Medical Surveillance Affidavit (M-91) form authorized by an examining physician of JIB Medical, P.C., or your personal licensed physician.

The Educational and Cultural Trust Fund offers a wide variety of OSHA classes to members free-of-charge. In classes involving licensing fees, such as the Asbestos Restricted Handler and the Asbestos Handler classes, all fees are paid by the Educational and Cultural Trust Fund to the D.O.H., D.O.L., and the D.E.P. Classes are conducted evenings at the Electric Industry Center in Flushing, Queens. Most classes require an annual refresher course.

In the case of the Asbestos Restricted Handler or the Asbestos Handler Certification Class, when your state license has expired, the D.O.H. and D.O.L. requires that you take an initial class to renew your license. Since additional fees are required for this initial class, you are required to pay a penalty of $98.50 in order to renew your state and city licenses. The respiratory and lead courses also require an annual refresher. OSHA regulations require that if you complete the Confined Space Initial Course, you must take a refresher course every two years. The confined space, initial course, and the respiratory and lead courses are offered at no charge.

The Educational and Cultural Trust Fund offers classes to all eligible participants; however, apprentices should complete their apprenticeship training before requesting OSHA classes given by the Educational and Cultural Trust Fund.

When you submit the proper proof of certification by the N.Y.S. Department of Labor and the N.Y.C. Department of Environmental Protection, you will be put on a pending list for the refresher course. You must meet the eligibility requirements in order to register for any E&C Fund courses, and must submit the required Medical Surveillance Affidavit (M-91) form authorized by an examining physician of JIB Medical, P.C., or the member’s personal licensed physician prior to taking any OSHA classes requiring the use of Respiratory Protection equipment.

The Plan allows a participant to receive the following benefits, subject to the submission of proper documentation.

• Supplementary Unemployment Benefits
• Supplementary Workers’ Compensation Benefits
• Supplementary Disability Benefits
• Supplementary Economic Assistance Benefits (medical, dental, Long-Term Care, Medicare Part B and COBRA premiums)
• Supplementary Financial Assistance Benefits (delinquent rent & mortgage)
• Vacation and Supplementary Vacation Benefits
• Holiday Benefits
• College Tuition Reimbursement
• Non-College Private School Tuition
• Jury Duty Benefits
• Funeral Leave Benefits
• Adoption Expenses

Simply complete the Application for Benefits and attach the requested documentation.

Upon your retirement or withdrawal from the industry, you may apply for weekly Supplemental Unemployment Benefits until your account balance is exhausted.

For most participants, contributions ceased as of January 1, 2005. However, some participants continued to receive contributions through February 28, 2005.

To determine which plan is the primary plan for any of these benefits, review the payment benefit chart.

Immediately after the accident, report it to your foreman or supervisor who will then file a 24 Hour Report and ADR C2 with E.E.S.I.S.P. You will then receive a letter from from E.E.S.I.S.P. giving you a case number. If you do not receive this letter, contact your employer to make sure the accident report was filed.

Please note, medical bills or payment for lost time will be delayed or not paid without an accident report.

Contact MagnaComp at (888) 336-8773 and they will recommend doctors in your area. Please note, you must use a doctor in the MagnaComp network or payment of bills will be denied.

If you require immediate or emergency treatment following an injury, you may go to any hospital or walk-in clinic. If additional treatment is required, you must contact MagnaComp for a referral to an in-network provider.

If all forms have been filed correctly, you should receive your first check approximately 12-14 days after your first full day out of work.

The statutory portion of the benefit is two-thirds of your average weekly wage for the year prior to the date of your accident with a maximum of two-thirds of the New York State average weekly wage. Under most circumstances, you will also be entitled to a collectively bargained supplementary benefit up to a maximum of $155 per week. The supplementary benefit is subject to different criteria than the statutory benefit.

No, payment is only made by check.

The inactive letter tells you that you are currently not losing time from work and that you are not under treatment for that claim. The claim has been closed, but if further treatment is needed, contact E.E.S.I.S.P. for information on how to reopen the claim.

To file a disability claim, for a non-work-related illness or injury, contact E.E.S.I.S.P. at (718) 591-2800 for a telephone interview. You must file a DB-450 form.

The DB-450 should be mailed to the Workers' Compensation Board if you become disabled and have been on unemployment for four (4) weeks or more prior to your disability. 

You should complete Part A of the form and your doctor will complete Part B of the form.

The DB-450 should be sent to E.E.S.I.S.P. when you become disabled due to a non-work-related illness or injury while employed, or if you become disabled prior to four (4) weeks of unemployment. This form is sent to:

E.E.S.I.S.P.
158-11 Harry Van Arsdale Jr. Avenue
Flushing, NY 11365.

All active participants who work for a contributing employer and have been employed or available for employment for at least four consecutive years immediately prior to incurring an eligible expense.

The only other family member who is eligible for the Legal Services Plan is the legal spouse who is living with and not separated from the covered participant. Legal Services for children, parents or grandparents are not covered.

The Legal Service Plan includes the following services:

• consultations
• real estate matters
• landlord/tenant matters
• uncontested adoption proceedings
• wills and health care proxies
• document reviews
• names changes
• elder law/estate planning.*

For more details about these covered services, as well as a list of non-covered services, please refer to the Legal Services Plan SPD.

* The Plan covers a portion of the services only. Please consult your referred attorney or the Plan for covered expenses under the elder law/estate planning benefit.

The Legal Services Plan covers the panel attorney fee for covered services only. This benefit is taxable to the participant. Therefore, you will receive a W-2 Form at the end of the year. The Plan will not pay for additional costs associated with the legal service provided. For example, if you purchase a house, the Plan will pay the attorney’s fee, but you will be responsible for other associated costs (i.e. closing costs, appraisals, etc.).

No. The Plan does not cover matrimonial or domestic matters.

No. If you request a panel attorney to represent you in court, the Plan will not cover this expense.

No. Panel attorneys are referred to participants who live in New York, New Jersey, Connecticut and Pennsylvania only.

Vacation, holiday, furlough and unemployment benefits are payable provided you have a sufficient account balance. No other benefits can be paid from this plan.

Payroll, Federal, State and City taxes are withheld from the weekly employer contributions received by the Joint Industry Board. As a result, no taxes are withheld when you receive your benefits.

Yes. You will receive a W-2 Form for every year a contribution is made to your account. You will also receive a 1099INT Form for interest earned during the year on your account balance.

Yes. Upon retirement or withdrawal from the industry you may withdraw your remaining balance in a lump sum. This amount will not be subject to taxation because you already paid the taxes when the money was contributed to your account.

Your remaining account balance will be distributed to your named beneficiary. Distributions are not subject to taxation.

Yes. When either of these plans does not have a sufficient balance when it is the primary plan, the other plan will automatically act as the secondary plan and pay any remaining balance, if funds are available. 

Effective September 1, 2007, active "A" rated Journeypersons are covered for this benefit, subject to certain eligibility requirements. White Plains Journeypersons are eligible effective May 1, 2009.

Yes. Although your classification may entitle you to participate in this benefit, you must also meet the following eligibility requirements:

Initial eligibility for the Term Life benefit under this plan is established in the following manner:

• Your classification must be one that is defined in your Collective Bargaining Agreement as one that is eligible for the Term Life benefit under this plan.
• You must be actively at work or, if unemployed, available for employment through the Employment Department at the Joint Industry Board.

Once eligibility is established, you will remain eligible for this benefit as long as:

• You remain actively employed in covered employment and are eligible for health benefits*;
• You remain available for employment, if unemployed, and are eligible for health benefits*;
• You are on a workers' compensation or disability leave, but remain eligible for health benefits*.

Eligibility is terminated for any and all of the following reasons:

• You retire;
• You terminate employment and are no longer available for employment; or
• Your workers' compensation or disability leave extends past the time limit when you loose health coverage on a non-contributory basis.

If your benefits are terminated for any reason, they will be immediately reinstated upon return to active covered employment and the reinstatement of health benefits within the applicable classification.

*Health benefits are defined as eligible participation in the health benefit plan or plans as described in the applicable Collective Bargaining Agreement.

The Plan will pay a Life Insurance Benefit of $50,000 to a participant's named beneficiary for all eligible participants under age 65. On the date you reach 65, the Participant's Life Insurance amount is reduced to $32,500. Thereafter, the amount is reduced to $20,000 at age 70 and to $12,500 at age 75. This age reduction also applies to the Accidental Death and Personal Loss benefit described below.

The Plan will pay an Accidental Death Benefit of $50,000 (principal sum) to a participant's named beneficiary in the event a participant dies, while in an eligible classification, and the death was a direct result of a bodily injury suffered in an accident with such death occurring within 365 days after the accident.

The Plan will pay a percentage of the principal sum ($50,000) for a Personal Loss suffered as a direct result of an accident if the loss occurs within 365 days of that accident. 

Accelerated death benefits are benefits offered to terminally ill participants who are in need of money. Any payments made under this benefit will be deducted from the Life Insurance benefit otherwise payable. 

No. This benefit only applies to active, eligible participants.

No. You must complete a separate Mutual of Omaha Beneficiary Form. This may be obtained by contacting the Members' Records Department at (718) 591-2000, Extension 2491.

If you die without a valid Beneficiary Form for this benefit, your beneficiary will be named in the following order:

• Your spouse, if any.
• If there is no spouse, in equal shares to your children.
• If there is no spouse or child, to your parents, equally or to the survivor.
• If there is no spouse, child or parent, in equal shares to your brothers and sisters.
• If none of the above survives, to your executors or administrators.