DENTAL/VISION/HEARING AND VISION SURGERY (LASIK) REIMBURSEMENT BENEFIT

	The Dental/Vision/Hearing Reimbursement Benefit has been in effect for each insured member and his/her family since September 1, 1994.
	Under this benefit, the member may submit PAID dental, vision and/or hearing bills incurred by the member or the member’s dependent(s) to BAC Local 56 Welfare Fund and be reimbursed for the cost of those expenses up to the annual family maximum.  Insurance deductibles do not have to be met in order to use this benefit.
	The health care provider may not submit claims on your behalf - they will be rejected.  Unpaid bills will also be rejected.
	Effective February 23, 2000, there is a $400 maximum paid per pair of eyeglass frames (not including lenses).
	The annual family maximum is the single amount available to the member for all of the member’s and the member’s dependents’ dental, vision and hearing expenses incurred for the calendar year

THE FAMILY ANNUAL MAXIMUMS ARE AS FOLLOWS :

	1)  Plan A coverage  -  $3,000.00
	2) Plan B coverage - $2,500.00

Effective July 1, 2006: Vision Surgery Benefit (Lasik) is an additional Benefit:   $1,000 lifetime each for member, spouse and covered dependent age 21 and over

  

	CLAIMS MUST BE SUBMITTED WITHIN NINETY (90) DAYS AFTER THE END OF EACH PLAN YEAR (ON OR BEFORE MARCH 31).   Example:  2007 claims will not be paid after March 31, 2008.
	PLEASE SUBMIT  PAID  DENTAL/VISION/ HEARING  CLAIMS  TO:   B.A.C. LOCAL 56 WELFARE FUND  371 S. MAIN PLACE  CAROL STREAM, IL 60188   OR FAX THEM TO 630 653-5975

Most inquiries regarding your claim(s) can be answered by logging into the Blue Cross/Blue Shield web site which is www.bcbsil.com.  Once you have established a log-in password you will be able to gain immediate access to your claims to:

	Check the status of all your claims
	View and print EOBs
	Print temporary ID cards
	Search for Hospitals or Doctors
	Learn about specific disease or conditions

 When additional help is need calls to our office should be directed to the Local 56 Welfare Fund (630) 653-5930, ext. 2.   

Please note:  Only bills that indicate the provision of dental or vision or hearing services and show that all amounts on the bill have been paid, along with billing codes, and an explanation of services, will be considered for reimbursement.  In addition, only dental/vision/hearing benefits, which are described in Section 213(d) of the Internal Revenue Code of 1986 will be available for reimbursement.  This would exclude reimbursement for services that are performed primarily for cosmetic reasons (including teeth whitening).

INCOMPLETE CLAIM FORMS, INCLUDING INSUFFICIENT BILLING INFORMATION,

WILL BE RETURNED TO THE MEMBER WITHOUT PAYMENT.