Front of Card

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EWTF (Electrical Welfare Trust Fund)

Group health plan name

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Member ID

The entire number is the provider’s claims submission information; the last 6 digits are the member’s Alternate ID

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Member

Account holder’s first and last name

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Dependents

Any eligible dependents associated with your account (spouse, dependent children, and disabled dependents)

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Business Health Solution

Mental/Behavioral Health and Chemical Dependency Benefits

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Dental (Cigna) Shared Administration

Dental PPO Plus, dental provider network

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EWTF (Electrical Welfare Trust Fund)

Group health plan name

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Group Number

The medical group number that the provider submits on your claims

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CVS Caremark

Pharmacy Benefit Manager (PBM)

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Rx BIN: # and Rx PCN: #

Pharmacy information for submitting claims

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Rx GROUP IBE26

Our prescription group name

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Rx ID

Member’s 6-digit Alternate ID number

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UnitedHealthcare Choice Plus Network

Medical and hospital provider network

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Teladoc

Virtual physicians 24/7 call or video, contact 1-800-835-2362 or www.teladoc.com

Back of Card

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This card does not guarantee coverage

Check your eligibility online (My Benefits Center) or phone (301) 731-1050

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Prior authorization required for inpatient care

Your provider’s responsibility

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For Members

Contact the Fund Office at ewtf.org or 301-731-1050 or 1-800-929-3983 (toll-free)

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Cigna Dental Shared Administration

www.cignadentalsa.com to find participating providers online, or call 1-800-797-3381

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Business Health Svcs

Mental health and chemical dependency www.bhsonline.com or 1-800-765-3277

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For Providers

uhss.umr.com or 1-866-596-8447 only for providers to verify benefits or coverage of services

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Provider Directory

(“link on homepage does not go to provider directory”) Members, use this link: directory.uhis.com, then select UnitedHealthcare Choice Plus to locate participating providers

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Medical Claims

Mailing address for providers to submit medical claims

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Dental/Medicare Claims

Mailing address for providers to submit dental and Medicare claims

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Prescription Claims

Mailing address for providers to submit prescription claims

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MultiPlan

Discount Pricing for Hospitals and Non-Participating Providers

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ER admit

Emergency Room Admission, provider responsible for gaining approval within 48 hours of admission 1-800-850-1418

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Healthy Pregnancy Program

Call 1-800-850-1418 to enroll

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Dental Eligibility

Phone number for dental providers to check member’s eligibility and coverage

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CIGNA

Dental Group number for providers to submit dental claims

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Pharmacists & member

phone number and web address for contacting Caremark with prescription issues