Here is a list of frequently asked questions by benefit type. If your question is not addressed here, you can contact the Fund Office at 630.887.4150.
Click below to learn more!
How do I get my login user name and password for the Member Portal of this website?
You will receive your login information by mail. If you have not yet received it, please contact the Fund Office. For security reasons, under no circumstances will your login information be provided over the phone. It will only be mailed to the address on file with the Fund Office.
Can I change my address over the phone?
For security reasons, address changes are not accepted online or over the phone. You must submit a signed Change of Address Form, which is available on this website under the Forms and Notices tab. Address changes can only be made by the Member. We cannot honor address changes submitted by the spouse or dependent children.
I have an adult dependent child between the ages of 19 and 25. Is he/she covered under the Plan?
Under the Affordable Care Act, effective January 1, 2014, ALL adult dependent children over the age of 18 are covered regardless if they live at home or not, have other health coverage through their own employment or through their spouse, or are enrolled as a full time student until they reach age 26, as long as you, the member remain as an active member of the Plan. Spouses of dependent children are not covered, nor are children of dependent children.
Prior to January 1, 2014, the Plan covered adult dependent children between the ages of 19 and 25 unless they had other health coverage (such as, through their employment or a spouse’s employment) available to them.
The Fund Office confirmed that they received the proper documents from me to add my dependents and they are now eligible, but the cards I received only have my name on them?
Your cards will only have the member’s name listed, but they are good for all eligible dependents as well.
Where can I find my unique identification number? Why do we need one?
The unique ID is below your name on the Blue Cross Blue Shield identification card. It is also on your prescription drug card next to “ID”. We switched to unique identification to keep your social security number private.
When and where is the annual Health Fair?
Local 731 hosts a Health Fair once a year in our building in Burr Ridge. The Health Fair usually takes place on a Saturday morning in the month of October. You can also visit other locations which will be announced in the mailing that goes out in September.
Prior Authorization Program
What is Prior Authorization (PA)?
Prior Authorization means that approval must be given for certain medications to be covered by your plan. OptumRx works with your doctor or provider to make sure coverage is appropriate.
How does a Prior Authorization Program work?
OptumRx works with your doctor to ensure safe and effective use of select prescription medications. Before your copay can be applied at the pharmacy, the medication must be approved by OptumRx with the help of your doctor. You, your pharmacist or your doctor can call OptumRx to start the prior authorization process. OptumRx will then contact your doctor to get the information needed to determine coverage for your medication.
Why do some drugs need Prior Authorization?
Some medications have a higher possibility of overuse or may be prescribed outside of clinical dosing guidelines. In some cases, there are also specific dosages that should be used based on medical guidelines.
Who decides which drugs to include for Prior Authorization?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which drugs should be included in the Prior Authorization Program.
Who decides which drugs to include for Prior Authorization?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which drugs should be included in the Prior Authorization Program.
How do I know if my prescription needs a Prior Authorization?
Your pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
What if the Prior Authorization request is not approved?
If the Prior Authorization is denied, you will be responsible for the full cost of your prescription at the pharmacy. You may fill your prescription, but your copay will not apply.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on your pharmacy ID card.
Quantity Limit Program
What is a Quantity Limit Program?
A Quantity Limit Program supports the management of your prescription drug plan by confirming that prescribed quantities are consistent with clinical dosing guidelines and medical literature. This program was established to provide safe and appropriate use of certain medications.
How does a Quantity Limit Program work?
If you are currently receiving a quantity of medication below the identified quantity limit, your prescription will be covered under your pharmacy benefits. If your doctor writes a prescription for an amount greater than the quantity limit, you will need to obtain a prior authorization from OptumRx before additional quantities are covered. You, your pharmacist or your doctor can call OptumRx to initiate the prior authorization process. OptumRx will then contact your doctor to get the information needed to determine coverage for your medication.
Why do some medications have Quantity Limits?
Some medications have a higher possibility for overuse or may be prescribed outside of clinical dosing guidelines. In some cases, there are also specific dosages that should be used based on medical guidelines.
Who decides which medications to include in the Quantity Limit Program?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which medications should be included in the Quantity Limit Program.
How do I know if my medication has a Quantity Limit?
The pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
What if the Quantity Limit request is not approved?
If the Quantity Limit request is denied, your pharmacy benefit plan will still cover an amount up to the quantity limit for that medication. You will be responsible for the full cost of any amount above the quantity limit for your prescription.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on the back of your prescription card.
Step Therapy
How do I know if my prescription needs a Step Therapy?
The pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
Who decides which medications to include in a Step Therapy Program?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which medications should be included in the Step Therapy Program.
Why do some medications need Step Therapy?
Some medications are extremely costly. If lower-cost, clinically-effective medications exist, it may be prudent to try these first. In some cases, there are also specific dosages and quantities that should be used based on medical guidelines.
What if I need to skip a step?
Your doctor may contact OptumRx to request prior authorization approval. This is a review between your doctor and OptumRx to determine coverage for your medication.
How does a Step Therapy Program work?
If your doctor writes a prescription for a medication that requires a Step Therapy, the requested medication may not be covered until a more cost-effective medication “step” is tried first.
What is a Step Therapy Program?
A Step Therapy Program is an approach to medication therapy that requires you to first try a more cost-effective medication (typically a generic medication) that has proven effective for most people with your condition before you can receive coverage for a similar, more expensive, brand name medication. These are considered “steps” of therapy.
What if the Step Therapy request is not approved?
If the Step Therapy request is denied, you will be responsible for the full cost of your prescription at the pharmacy. You may still fill your prescription, but your copay will not apply.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on your pharmacy ID card.
Why is my claim not paid?
Check the exclusion code on your Explanation of Benefits. It is located to the right of the member balance column.
I received my medical claim from the Fund Office in the mail, and it said the Fund Office needed information regarding an accident or work related injury. The next week, another claim came for the same emergency room visit and asked me the same question again. Why do I have to keep answering the same question over and over?
You only need to respond once. Sometimes the emergency room or other medical provider bills for services separately and the claims are processed by the Fund on different days. If your response is not yet entered into our system when additional claims are processed, another request is produced asking for the same information again. You can email us to see if we have received your response. Please include your unique identification number with all inquiries.
Are there any time limits with respect to getting benefits from the health plan?
Yes, your medical provider must file a claim within 15 months of your date of service. If the Fund Office needs to obtain more information from you, such as inquire about other insurance, question about if the reason you went to the emergency room or doctor is because of an accident or work related injury, etc., you have 60 days to respond back to the Fund Office. Please refer to the next question regarding appeals.
How do I appeal a denied claim?
You have the right to appeal any claim that has been denied. A notice of appeal must be received by the Fund Office no later than 180 days after receipt by the claimant of a denial of the claim. Your appeal is considered to have been filed on the date the written notice of appeal is received by the Fund Office. The appeal should state why you feel the claim was unjustly denied in accordance with the Plan.
What should I do if I get hurt at work?
Report your injury to your supervisor; also please make the Fund Office Medical Claims department aware that your injury was work related by calling 630-920-1939.
What happens if Work Comp denies my claim?
Please notify the Fund Office Medical Claims department right away of any Work Comp issues. If Work Comp denies your claims, send a copy of the letter of denial to the Fund Office Medical Claims department.
What is Subrogation?
Subrogation is when a third party may be legally responsible for paying medical expenses. This is why we ask you if your claim was related to an accident. The Fund Office Medical Claims department will send a subrogation packet to be completed and signed by the member/attorney in cases where a third party may be responsible. The Fund will not pay benefits on the claim unless the returned subrogation agreement is completely filled out and signed. Please remember to do so within 60 days.
What is pre-cert?
Many health services need to be “pre-certified” before you obtain them. Pre-certification is done by our medical review board, Med-Care Management. Med-Care Management can be contacted by you, your doctor, or the hospital prior to any services by calling 1- 800-367-1934. Such services include inpatient hospitalizations, durable medical equipment (over $100), surgeries, prosthetics, injectable drugs, orthotics, home health care, cardiac rehabilitation, skilled nursing, speech therapy, IV infusion and IV antibiotics, infertility (for related injectables and procedures only). Neglecting to pre-certify when it is required will result in penalties. See your Summary Plan description for further information.
How do I know if my provider is in network?
Contact Blue Cross Blue Shield at 1-800-810-2583 or go to www.bcbsil.com to search for a provider.
How do I apply for Welfare Disability/Loss of Time Benefits?
Please contact the Fund Office at 630-887-4150 to request a disability claim form, or print one out here. The returned disability claim form must be completely filled out and signed by the member, employer and physician in order to be processed.
Can I roll my pension over into a personal IRA?
Our Plans are not the type of programs that have lump sums (see above) to roll over to an IRA.
Can I borrow against my Pension?
Our pension plans are not the type you can borrow from. Our plans are designed to pay a monthly benefit when you are eligible to retire.
Can I get a lump sum payout from my Pension?
Our plans do not permit a lump sum. You will receive a monthly benefit when you have met the age and service requirements for a Pension and are no longer working in disqualifying employment.
Where can I get a scholarship application?
The Fund Office will mail a letter to all members at the beginning of November each year. At that time, applications will be available at www.ibt731funds.org, under the Scholarship Fund tab.
When are scholarships decided?
Applicants will be notified mid-April with a decision.
Where can the app be downloaded?
Simply go to the Google Play Store if you have an Android phone, or the App Store if you have an iPhone and search for “Viveka Health.”
What are some of the features available on the mobile app?
The app allows users to:
- The app offers digital copies of members insurance cards, that can be emailed instantly to doctors, or pharmacists. Members will never have to worry about leaving their insurance cards at home again!
- The app lists Rx history, this is helpful in a doctor’s office in case the member forgets past medication they were on or are currently on.
- Members can save a trip to the Fund office with the apps ability to upload required documents instantly.
- Members can use the built in GPS feature to locate the nearest medical, dental, or vision facility!
- Members can receive electronic updates from the Fund office instead of in the mail.
I have an iPhone 6 and receive the following message when trying to download the app: "This application requires iOS 13.0 or later. You must update to iOS 13.0 in order to download and use this application."
The iOS 13.0 update is only available on iPhone 7s and higher. Apple restricts older models from being updated as they can no longer sync with some of the security updates included newer iOS. Since our app contains benefit information, it’s very important that phones have the latest security updates that come with the iOS-13 update, in order to protect electronic Personal Health Information (ePHI).
How do I add dependents?
On the app homepage you will see a circle with your picture, to the right of that is a green circle with a +, if you click that you will be prompted to enter the dependents DOB and SSN. Please make sure this is entered correctly, if off by one digit it will not allow them to be added.
How do I upload documents the Fund office is requesting?
In the upper left-hand corner of the Viveka app homepage you will see three horizontal lines, tap this and a drop-down menu will appear. Tap:
- Documents
- Take photo and send to administrator
- Select the location of the document
- Add the document
- Select the document type from the dropdown
- Tap OK.
- General / Logging In
-
How do I get my login user name and password for the Member Portal of this website?
You will receive your login information by mail. If you have not yet received it, please contact the Fund Office. For security reasons, under no circumstances will your login information be provided over the phone. It will only be mailed to the address on file with the Fund Office.
Can I change my address over the phone?
For security reasons, address changes are not accepted online or over the phone. You must submit a signed Change of Address Form, which is available on this website under the Forms and Notices tab. Address changes can only be made by the Member. We cannot honor address changes submitted by the spouse or dependent children.
- Health & Welfare
-
I have an adult dependent child between the ages of 19 and 25. Is he/she covered under the Plan?
Under the Affordable Care Act, effective January 1, 2014, ALL adult dependent children over the age of 18 are covered regardless if they live at home or not, have other health coverage through their own employment or through their spouse, or are enrolled as a full time student until they reach age 26, as long as you, the member remain as an active member of the Plan. Spouses of dependent children are not covered, nor are children of dependent children.
Prior to January 1, 2014, the Plan covered adult dependent children between the ages of 19 and 25 unless they had other health coverage (such as, through their employment or a spouse’s employment) available to them.
The Fund Office confirmed that they received the proper documents from me to add my dependents and they are now eligible, but the cards I received only have my name on them?
Your cards will only have the member’s name listed, but they are good for all eligible dependents as well.
Where can I find my unique identification number? Why do we need one?
The unique ID is below your name on the Blue Cross Blue Shield identification card. It is also on your prescription drug card next to “ID”. We switched to unique identification to keep your social security number private.
When and where is the annual Health Fair?
Local 731 hosts a Health Fair once a year in our building in Burr Ridge. The Health Fair usually takes place on a Saturday morning in the month of October. You can also visit other locations which will be announced in the mailing that goes out in September.
- Prescription Drugs
-
Prior Authorization Program
What is Prior Authorization (PA)?
Prior Authorization means that approval must be given for certain medications to be covered by your plan. OptumRx works with your doctor or provider to make sure coverage is appropriate.
How does a Prior Authorization Program work?
OptumRx works with your doctor to ensure safe and effective use of select prescription medications. Before your copay can be applied at the pharmacy, the medication must be approved by OptumRx with the help of your doctor. You, your pharmacist or your doctor can call OptumRx to start the prior authorization process. OptumRx will then contact your doctor to get the information needed to determine coverage for your medication.
Why do some drugs need Prior Authorization?
Some medications have a higher possibility of overuse or may be prescribed outside of clinical dosing guidelines. In some cases, there are also specific dosages that should be used based on medical guidelines.
Who decides which drugs to include for Prior Authorization?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which drugs should be included in the Prior Authorization Program.
Who decides which drugs to include for Prior Authorization?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which drugs should be included in the Prior Authorization Program.
How do I know if my prescription needs a Prior Authorization?
Your pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
What if the Prior Authorization request is not approved?
If the Prior Authorization is denied, you will be responsible for the full cost of your prescription at the pharmacy. You may fill your prescription, but your copay will not apply.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on your pharmacy ID card.
Quantity Limit Program
What is a Quantity Limit Program?
A Quantity Limit Program supports the management of your prescription drug plan by confirming that prescribed quantities are consistent with clinical dosing guidelines and medical literature. This program was established to provide safe and appropriate use of certain medications.
How does a Quantity Limit Program work?
If you are currently receiving a quantity of medication below the identified quantity limit, your prescription will be covered under your pharmacy benefits. If your doctor writes a prescription for an amount greater than the quantity limit, you will need to obtain a prior authorization from OptumRx before additional quantities are covered. You, your pharmacist or your doctor can call OptumRx to initiate the prior authorization process. OptumRx will then contact your doctor to get the information needed to determine coverage for your medication.
Why do some medications have Quantity Limits?
Some medications have a higher possibility for overuse or may be prescribed outside of clinical dosing guidelines. In some cases, there are also specific dosages that should be used based on medical guidelines.
Who decides which medications to include in the Quantity Limit Program?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which medications should be included in the Quantity Limit Program.
How do I know if my medication has a Quantity Limit?
The pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
What if the Quantity Limit request is not approved?
If the Quantity Limit request is denied, your pharmacy benefit plan will still cover an amount up to the quantity limit for that medication. You will be responsible for the full cost of any amount above the quantity limit for your prescription.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on the back of your prescription card.
Step Therapy
How do I know if my prescription needs a Step Therapy?
The pharmacist will let you know when you pick up your prescription at the pharmacy. You may also call the OptumRx Member Services number on your pharmacy card for more information.
Who decides which medications to include in a Step Therapy Program?
A team of independent, licensed doctors, pharmacists and other medical experts review and discuss the latest medical guidelines and research. They decide which medications should be included in the Step Therapy Program.
Why do some medications need Step Therapy?
Some medications are extremely costly. If lower-cost, clinically-effective medications exist, it may be prudent to try these first. In some cases, there are also specific dosages and quantities that should be used based on medical guidelines.
What if I need to skip a step?
Your doctor may contact OptumRx to request prior authorization approval. This is a review between your doctor and OptumRx to determine coverage for your medication.
How does a Step Therapy Program work?
If your doctor writes a prescription for a medication that requires a Step Therapy, the requested medication may not be covered until a more cost-effective medication “step” is tried first.
What is a Step Therapy Program?
A Step Therapy Program is an approach to medication therapy that requires you to first try a more cost-effective medication (typically a generic medication) that has proven effective for most people with your condition before you can receive coverage for a similar, more expensive, brand name medication. These are considered “steps” of therapy.
What if the Step Therapy request is not approved?
If the Step Therapy request is denied, you will be responsible for the full cost of your prescription at the pharmacy. You may still fill your prescription, but your copay will not apply.
Where can I get more help?
Visit www.mycatamaranRx.com . You may also call the OptumRx Member Services number on your pharmacy ID card.
- Medical Claims
-
Why is my claim not paid?
Check the exclusion code on your Explanation of Benefits. It is located to the right of the member balance column.
I received my medical claim from the Fund Office in the mail, and it said the Fund Office needed information regarding an accident or work related injury. The next week, another claim came for the same emergency room visit and asked me the same question again. Why do I have to keep answering the same question over and over?
You only need to respond once. Sometimes the emergency room or other medical provider bills for services separately and the claims are processed by the Fund on different days. If your response is not yet entered into our system when additional claims are processed, another request is produced asking for the same information again. You can email us to see if we have received your response. Please include your unique identification number with all inquiries.
Are there any time limits with respect to getting benefits from the health plan?
Yes, your medical provider must file a claim within 15 months of your date of service. If the Fund Office needs to obtain more information from you, such as inquire about other insurance, question about if the reason you went to the emergency room or doctor is because of an accident or work related injury, etc., you have 60 days to respond back to the Fund Office. Please refer to the next question regarding appeals.
How do I appeal a denied claim?
You have the right to appeal any claim that has been denied. A notice of appeal must be received by the Fund Office no later than 180 days after receipt by the claimant of a denial of the claim. Your appeal is considered to have been filed on the date the written notice of appeal is received by the Fund Office. The appeal should state why you feel the claim was unjustly denied in accordance with the Plan.
What should I do if I get hurt at work?
Report your injury to your supervisor; also please make the Fund Office Medical Claims department aware that your injury was work related by calling 630-920-1939.
What happens if Work Comp denies my claim?
Please notify the Fund Office Medical Claims department right away of any Work Comp issues. If Work Comp denies your claims, send a copy of the letter of denial to the Fund Office Medical Claims department.
What is Subrogation?
Subrogation is when a third party may be legally responsible for paying medical expenses. This is why we ask you if your claim was related to an accident. The Fund Office Medical Claims department will send a subrogation packet to be completed and signed by the member/attorney in cases where a third party may be responsible. The Fund will not pay benefits on the claim unless the returned subrogation agreement is completely filled out and signed. Please remember to do so within 60 days.
What is pre-cert?
Many health services need to be “pre-certified” before you obtain them. Pre-certification is done by our medical review board, Med-Care Management. Med-Care Management can be contacted by you, your doctor, or the hospital prior to any services by calling 1- 800-367-1934. Such services include inpatient hospitalizations, durable medical equipment (over $100), surgeries, prosthetics, injectable drugs, orthotics, home health care, cardiac rehabilitation, skilled nursing, speech therapy, IV infusion and IV antibiotics, infertility (for related injectables and procedures only). Neglecting to pre-certify when it is required will result in penalties. See your Summary Plan description for further information.
How do I know if my provider is in network?
Contact Blue Cross Blue Shield at 1-800-810-2583 or go to www.bcbsil.com to search for a provider.
- Welfare Disability / Loss of Time
-
How do I apply for Welfare Disability/Loss of Time Benefits?
Please contact the Fund Office at 630-887-4150 to request a disability claim form, or print one out here. The returned disability claim form must be completely filled out and signed by the member, employer and physician in order to be processed.
- Pension
-
Can I roll my pension over into a personal IRA?
Our Plans are not the type of programs that have lump sums (see above) to roll over to an IRA.
Can I borrow against my Pension?
Our pension plans are not the type you can borrow from. Our plans are designed to pay a monthly benefit when you are eligible to retire.
Can I get a lump sum payout from my Pension?
Our plans do not permit a lump sum. You will receive a monthly benefit when you have met the age and service requirements for a Pension and are no longer working in disqualifying employment.
- Scholarship Fund
-
Where can I get a scholarship application?
The Fund Office will mail a letter to all members at the beginning of November each year. At that time, applications will be available at www.ibt731funds.org, under the Scholarship Fund tab.
When are scholarships decided?
Applicants will be notified mid-April with a decision.
- Viveka Mobile App
-
Where can the app be downloaded?
Simply go to the Google Play Store if you have an Android phone, or the App Store if you have an iPhone and search for “Viveka Health.”
What are some of the features available on the mobile app?
The app allows users to:
- The app offers digital copies of members insurance cards, that can be emailed instantly to doctors, or pharmacists. Members will never have to worry about leaving their insurance cards at home again!
- The app lists Rx history, this is helpful in a doctor’s office in case the member forgets past medication they were on or are currently on.
- Members can save a trip to the Fund office with the apps ability to upload required documents instantly.
- Members can use the built in GPS feature to locate the nearest medical, dental, or vision facility!
- Members can receive electronic updates from the Fund office instead of in the mail.
I have an iPhone 6 and receive the following message when trying to download the app: "This application requires iOS 13.0 or later. You must update to iOS 13.0 in order to download and use this application."
The iOS 13.0 update is only available on iPhone 7s and higher. Apple restricts older models from being updated as they can no longer sync with some of the security updates included newer iOS. Since our app contains benefit information, it’s very important that phones have the latest security updates that come with the iOS-13 update, in order to protect electronic Personal Health Information (ePHI).
How do I add dependents?
On the app homepage you will see a circle with your picture, to the right of that is a green circle with a +, if you click that you will be prompted to enter the dependents DOB and SSN. Please make sure this is entered correctly, if off by one digit it will not allow them to be added.
How do I upload documents the Fund office is requesting?
In the upper left-hand corner of the Viveka app homepage you will see three horizontal lines, tap this and a drop-down menu will appear. Tap:
- Documents
- Take photo and send to administrator
- Select the location of the document
- Add the document
- Select the document type from the dropdown
- Tap OK.