FAQs

You are eligible for Teamsters Security Fund for Southern Nevada – Local 14 health and welfare benefits if you are:

• An active employee of a participating employer, you have met the initial eligibility requirements (you became eligible the first day of the month after receipt of your employer’s first contribution made on your behalf), and you have maintained continuous eligibility, or
• A retiree of a participating employer, you have maintained continuous eligibility, you are not yet eligible for Medicare, and you were eligible as an active employee, or through COBRA, for 90 of the 120 months immediately before retirement. Note: Up to 30 months of service outside the bargaining unit with the same employer will be counted towards satisfying the 90-month requirement.

Your eligible dependents include:

• Your legal spouse: If you choose to cover your spouse, you will need to submit a Spousal Affidavit.
• Your children up to age 26, including:
  • Natural children
  • Stepchildren
  • Legally adopted children
  • Children placed for adoption
  • Children for whom you are the court-appointed guardian
• Your unmarried disabled adult child

Log in at Benefits Portal and click on "Health Eligibility" in the left menu.

To enroll for health and welfare benefits, complete and return an enrollment form and spousal affidavit (if applicable) to the address on the form. Complete all sections of the form and enclose any required documents for your dependents.

To cover your spouse, you will need to submit a spousal affidavit, included in your enrollment materials, indicating whether your spouse has the option to enroll in other group medical coverage through a current employer.

If your spouse has the option to enroll in other group medical coverage but does not elect it and continues to have the Fund’s medical plan as primary coverage, you will need to pay a $300 monthly spousal premium. An invoice with payment information will be mailed to you.

If your spouse does not have the option to enroll in other group medical coverage or is enrolled in his or her employer’s health plan as primary coverage and in the Fund’s health care plans as secondary coverage, you will not be required to pay a monthly spousal premium, as long as you complete the spousal affidavit.

If you certify that your spouse does not have the option to enroll in other group medical coverage and you enroll him or her in the Fund’s medical plan, then it is later determined that your spouse was enrolled or had the option to enroll in other group medical coverage, you will need to pay the $300 spousal monthly premium for each month it should have been applied. Additionally, you may have to pay the Fund back for any benefits that were improperly paid for your spouse.

This plan is a preferred provider organization (PPO). It gives you the flexibility to see any medical provider. However, you save money when you use in-network providers. Refer to your summary plan description for details on this plan. This plan is self-funded, which means the Fund—not Anthem or Zenith American Solutions—is responsible for claims costs for participants’ eligible health care services.

This plan is a health maintenance organization (HMO). You must always see Health Plan of Nevada providers in order to receive coverage, except for life-threatening emergencies. This plan is fully insured, which means Health Plan of Nevada pays the claims for participants’ eligible health care services.

You can change your benefit elections during open enrollment. Changes you make during open enrollment each year are effective the following January 1. Outside of open enrollment, you are only able to make changes within 60 days of experiencing a qualifying life event, such as getting married or divorced, having a baby, or your spouse losing coverage under his or her own plan.

To enroll dependents, send copies of the following documents along with your completed enrollment form:

• Spouse: spousal affidavit and certified marriage certificate
• Children/stepchildren: certified birth certificate or court-appointed guardianship certificate; divorce decree for stepchildren, if applicable

If your dependents lose eligibility for coverage due to divorce, legal separation, or death, you must notify the Fund by sending a copy of one of the following applicable documents along with an updated enrollment form:

• Divorce decree
• Legal separation papers
• Death certificate

Note that you must list the Social Security number for all dependents on the enrollment form.

When you receive care from either an in-network or non-network provider, show your medical ID card to your provider, who will submit the claim for you. Note that out-of-network benefits will apply for non-network providers.

If your claim involves an accident or injury, the PPO plan administrator needs additional information before it can process the claim, such as how and where the accident or injury occurred and whether anyone else was involved. This can affect who pays the claim. Medical providers do not include this information when they submit their claims, so the administrator will contact you to obtain it.

Log in at Benefits Portal and click on "Claim" in the left menu.

If you visit the emergency room for non-life-threatening treatment, the PPO plan pays $75 of emergency room charges and you pay the balance; the HMO plan pays nothing in this case.

If you’re in the PPO plan:

• See the list of urgent care centers in your enrollment packet, use the Anthem mobile app, or visit anthem.com to find a facility near you.
• Or consider using LiveHealth Online to connect with a doctor 24/7 via two-way video on your smartphone, tablet, or computer. You’ll only pay a $10 copay for this service. Visit livehealthonline.com or download the LiveHealth Online mobile app for free from the App Store or Google Play.
• Or request urgent care services where you need them—at your office, home, or anywhere else. You’ll only pay a $15 copay for this service. Visit dispatchhealth.com, call 702-848-4443, or download the DispatchHealth app for free from the App Store or Google Play.

If you’re in the HMO plan:

• Visit a Health Plan of Nevada contracted urgent care facility listed at myhpnonline.com.
• Or consider using telemedicine. Visit myhpnonline.com and follow the instructions under “24/7 Virtual Visits.”

Under the PPO plan, you can use BlueCard^® to access benefits and receive health care services while traveling or living outside the PPO plan service area. BlueCard links participating providers and Blue Cross Blue Shield Association plans across the United States through a single electronic network for claims processing and reimbursement. For more information, call 702-851-8286.

Under the HMO plan, you have coverage while traveling if you visit a Health Plan of Nevada contracted urgent care facility listed at myhpnonline.com. You also have emergency room coverage, but keep in mind that the HMO plan pays nothing if your visit is for a non-life-threatening emergency.

We encourage all members to get preventive care services, which are covered by both medical plans at 100%. Early detection is often key to treatment of many diseases and conditions that cause serious illness or even death. Spending a relatively small amount of time now can save you a lot of time, money, and discomfort in the future. Both the PPO and HMO plans cover preventive care for you and your family at no charge to you, as long as you see in-network providers. This includes services such as physical exams, certain immunizations, and preventive screenings and services based on your age and risk factors—such as a flu shot, colonoscopy, PSA test for men, or mammogram or Pap test for women. For a list of covered preventive care services, visit anthem.com for the PPO plan or myhpnonline.com for the HMO plan.

Generic drugs have a $5 copay under the PPO plan and are half the cost of preferred brand drugs under the HMO plan. Since generic drugs use the same active ingredients and are proven to work the same way as their brand-name counterparts, they have the same risks and benefits. However, doctors don’t always automatically prescribe generic drugs. Be sure to ask whether a generic is available.

If you take medications on a regular basis for chronic conditions such as high blood pressure, arthritis, diabetes, and asthma, use the mail-order service to save money on prescriptions. Depending on which plan you’re in and the type of drug, your copays for a 90-day supply may be lower than the same supply from a retail pharmacy, plus you get the convenience of home delivery.

Here’s how to get started with mail order:

• PPO plan: Visit elixirsolutions.com or call 866-909-5170.
• HMO plan: Visit myhpnonline.com or call 800-777-1840.

Precertification ensures that your health care services meet or exceed accepted standards of care and that the admission and length of stay in a hospital or health care facility, surgery, drugs, dental service, or other health care services are medically necessary. If you’re in the PPO plan, you will need to precertify certain medical services; see the summary plan description for a complete list. To start the precertification process, contact Innovative Care Management (ICM) at:

P.O. Box 22386
Portland, OR 97269
Phone: 800-862-3338
Website: innovativecare.com

Yes, you must have an appointment to visit the Family Wellness Center. Generally, same-day appointments are available.

To make an appointment online, log in at the Family Wellness Center website. You may also call 702-553-3635 to schedule an appointment at either the Northwest Las Vegas or Henderson location.

No, your private health information is completely confidential and will never be shared with the Fund or your employer.

You and your covered dependents can use the Family Wellness Center providers with no out-of-pocket cost. In addition, you can continue to use your current physician, but you will be subject to the applicable deductibles and copays.

You and, if you’re in the PPO plan, your covered dependents will pay nothing to access the centers, including prescription drugs and labwork received at a center.

The centers stock approximately 50 of the most frequently used generic drugs. A list of available drugs will soon be available.

There are two locations:

• Henderson: 2739 Sunridge Heights Parkway Henderson, NV 89052
  
  
• Northwest Las Vegas: 2831 Business Park Court, Las Vegas, NV 89128

The Family Wellness Centers will be closed on certain holidays.

Not necessarily. The doctor is completely independent. As a result, referrals are based on the facility that can provide the highest-quality and most cost-effective service.

Keep in mind that we have different provider networks for hospital, mental health/substance abuse, prescription drugs, and other types of medical care. When you need services, choose the right network:

• Hospitals: Choose Health Services Coalition providers from the list at lvhsc.org/coalition.
• Mental health/substance abuse treatment: Call the Harmony Healthcare EAP at 702-251-8000 or visit harmonyhc.com/eap/accounts/teamsters-14 for an online provider directory.
• Prescription drugs: Access the Elixir pharmacy locator at elixirsolutions.com or call 800-361-4542.
• All other providers: Visit anthem.com and click “Find a Doctor” at the top right of the screen. Scroll down to “Search using your ID Number or Alpha Prefix” and enter “JTF.” Complete the requested information and click “Search.”

• Visit myhpnonline.com.
• Mental health/substance abuse treatment: Call the Harmony Healthcare EAP at 702-251-8000 or visit harmonyhc.com/eap/accounts/teamsters-14 for an online provider directory.

To find a VSP doctor near you, visit vsp.com, click “FIND A DOCTOR,” and follow the instructions. Or call 800-877-7195. Tell them you have VSP. No ID card is necessary.

To find an in-network dental provider:

• Delta Dental PPO Plan: Visit deltadentalins.com, and use the “Find a Dentist” search box.
• LIBERTY Dental Plan DHMO-EPO (Benefit Plan NV-400): See the provider list in your enrollment packet, or visit libertydentalplan.com, click the “FIND A DENTIST” tab, and then click “NEVADA.” Under “Nevada Dentist Search,” click the Benefit Plan drop-down menu and select “NV-100 through NV-700.” Complete the rest of the requested information and click “Search.” You can also call LIBERTY Dental Plan at 888-401-1128.

If you’re in the PPO plan, use LiveHealth Online to connect with a doctor 24/7 via two-way video on your smartphone, tablet, or computer. You’ll only pay a $10 copay for this service, with no deductible. Visit livehealthonline.com or download the LiveHealth Online mobile app for free from the App Store or Google Play.

If you’re in the HMO plan, visit myhpnonline.com and follow the instructions under “24/7 Virtual Visits.”

The EAP, offered through Harmony Healthcare for all members and their immediate families, includes:

• Mental health and substance abuse treatment authorization
• Confidential counseling visits for personal and family concerns: up to eight free visits

To schedule an appointment, call Harmony Healthcare at 800-363-4874 or 702-251-8000, available 24/7.

Teamsters Security Fund for Southern Nevada – Local 14 provides the following life and accidental death and dismemberment insurance (AD&D) coverage through Ullico:

• Active employees: $25,000
• Dependents of active employees (must be listed on the policy): $10,000
• Retirees who have maintained continuous eligibility and are not yet eligible for Medicare: $10,000

Note that dismemberment coverage may be different than life insurance coverage. For details, contact the Teamsters 14 customer service line at 702-851-8286.

You can apply for life and/or AD&D benefits by contacting the Teamsters 14 customer service line at 702-851-8286.

The Teamsters Security Fund for Southern Nevada - Local 14 provides retiree coverage to eligible non-Medicare participants and their dependents. The retiree must have been eligible as an active employee, or through COBRA, for 90 of the 120 months immediately before retirement. If you live in the Health Plan of Nevada (HPN) area, you may only enroll in the HMO medical plan. If you live outside the HPN area, you may only enroll in the PPO medical plan.

Retiree coverage includes medical, pharmacy, dental, and vision benefits. Life and AD&D insurance coverage of $10,000 is included for members only.

Once you are eligible for Medicare, Via Benefits (formerly OneExchange) is available to assist you in locating medical, prescription drug, dental, and supplemental life and accident insurance plans. Contact them by calling 888-825-2645 or visiting my.viabenefits.com/lasvegasteamsters.

Complete the retiree enrollment form, which you should have received in your retirement packet. Confirm the premium you will pay for your medical and dental plan choices on the retiree enrollment acknowledgement form. Return the enrollment form, the enrollment acknowledgement form, and a copy of your pension benefit award letter to Zenith American Solutions.

If you are enrolled in the PPO plan and have not received your ID card and sleeve in the mail, contact Zenith American Solutions at 702-851-8286 to request them.

If you are enrolled in the HMO plan and have not received an ID card in the mail, contact Zenith American Solutions at 702-851-8286 or Health Plan of Nevada at 800-777-1840 or 702-242-7300.

For claims administration and appeals related to the PPO plan (including prescription drug and behavioral health claims), the Delta Dental PPO plan, and vision care benefits, refer to “Claim Filing and Appeal Information” in the summary plan description. If you receive an adverse benefit determination for one of these claims, you can appeal it to the board of trustees.

For claims administration and appeals under the Health Plan of Nevada HMO plan, the LIBERTY Dental Plan DHMO-EPO, and the Prudential Life and Accident Insurance plan, refer to the official documents of these insurance companies.