Welfare Fund

Check out the Benefit Programs' 2009 Accomplishments! 

Spouse Physical Exam
The Board of Trustees is pleased to announce that, effective 11/1/2007, the Health Plan will cover physical exams not only for the member, but also for their spouse. If you have any questions regarding this benefit, please call the Fund office at 419-666-4450 or email us at benefits@electricalfunds.org .

New Benefit for Families with Autistic Children
The Board of Trustees is pleased to announce an enhancement to the Health Plan. A $4500.00 maximum yearly benefit is available for children diagnosed with Autism who are age 12 and younger. This benefit covers therapies not previously covered by the Health Plan. If you have an autistic child, please contact us at at 419.666.4450 or by email at benefits@electricalfunds.org .

Preferred Provider Network
Frontpath Health Coalition is the PPO network chosen by the Trustees to service our participants beginning October 1, 2003. The Frontpath network includes all Toledo Area hospitals and includes more physicians and facilities than our previous PPO.

You can minimize your out-of-pocket expenses, and those paid by the Plan, by utilizing Frontpath providers whenever possible. You may continue to receive care from non-contracting providers, however you will be responsible for charges in excess of the Plan’s Usual, Customary, and Reasonable amount. You may locate contracting providers by visiting www.frontpathcoalition.com, or by calling 419-891-5206 or 888-232-5800.

Education Plan Reinstated
The Education Benefit was reinstated for courses beginning on August 1, 2006. No benefits will be paid for courses started before August 1, 2006. For a complete description, check out our brochure .

Summary of Benefits
A Summary of Benefits brochure with updated plan changes is available . The document is provided as a summary of the benefits available to the eligible members of the Toledo Electrical Welfare Fund. It is not a complete document, nor does it contain all provisions of the plan. Please refer to the Summary Plan Description for important information and complete details.

If you need a copy of the brochure, you may request a copy from the Benefit Office , or download a PDF version . Note you will need Adobe Acrobat Reader, available free from Adobe's web site , to view and print this file.

Frequently Asked Questions: Health Plan

Do I need a referral from a Family Physician to seek services elsewhere?
No

Do I have to get a prior authorization?
Many services do require a pre-certification. We suggest you call HealthCare Strategies at 800.582.1535

How do I get a new identification card?
Call the Benefits Office at 419.666.4450

Do I need separate Prescription and Medical identification cards?
No. One side of your card says Restat-which is your prescription coverage.

The other side has your Medical, Mental Health and Vision information.

What do I need to do if I have a change in family status, such as Marriage, Birth, Divorce?
It is your obligation to contact the Benefits Office to report ANY change in status. Marriage, Births, Divorce must be reported with proper documentation. Enrollment, and Beneficiary forms must be maintained with your current status.

Why do you need this “Green” claim form completed?
When a member/dependent has any injury, we request information on how that injury happened. The Fund is not always liable for payment and we look for the order of responsibility.

Who is HealthCare Strategies? Restat? VSP? Mental Health Network? Frontpath?
HealthCare Strategies is our Medical Management Group. They are a group of licensed Nurses and Doctors that have worked for the Fund over 10 years. Restat administers our prescription drug program VSP stands for Vision Service Plan. VSP administers our vision program. Mental Health Network (MHN) coordinates ALL mental health, substance abuse, and personal assistance services. You must call them at 800.472.4992 or NO benefits are paid Frontpath is our network of physicians and hospitals. Visit their links from this website-go to Helpful Links.

Am I entitled to “Short Term Disability” compensation?
If you have an illness or injury that requires you to be off work and you are not drawing social security disability, workers compensation or unemployment, you may be entitled to a disability benefit.

Why do you require my spouse to carry her own insurance?
Most employers that provide a Health Care Program, require the spouses to participate in separate programs to have the health care programs share the cost of the health care services.

Am I eligible for an eye exam?
To find out if you are eligible for an eye exam you need to contact “Vision Service Plan” at 800.877.7195 or at www.vsp.com and click on the member link.

Do I have to use a specific provider?
If you use a provider in the FrontPath network-you will save yourself and the Fund money. You can access the directory at www.frontpathcoalition.com . Or call the funds office and we can mail you a directory.