Frequently Asked Questions

Healthcare

In order to enroll, please complete and sign an enrollment form. The enrollment form for your plan can be found under the "Forms” tab under the Health & Benefit Plan web page. Return the completed enrollment form along with a copy of your birth certificate and a copy of your Social Security card to the Benefit Fund Office.

Generally, for new employees who have a letter of creditable coverage on file at the Plan office, coverage will begin on the first day of the month following the month in which 160 hours of employer contributions are received on your behalf within a six-month period.

If a new employee does not have a letter of creditable coverage, then coverage will begin on the first day of the month following the month in which 420 hours of employer contributions are received on your behalf within a six-month period.

Refer to the section of the Health and Benefit Plan Summary Plan Description Book or contact the Health and Benefit Office for exact details.

Journeypersons or employees are required to have 420 hours contributed on their behalf during a calendar quarter or make a self-payment equivalent to the monthly cost of the hourly employer contribution requirement.

Apprentices and Indiana Plan participants need 326 hours contributed on their behalf during a calendar quarter or make a self-payment equivalent to the monthly cost of the hourly employer contribution requirement.

If you’re a journey person and your coverage terminates it will again be reinstated on the first day of the first month following the month in which 420 hours of employer contributions are received on your behalf within a six-consecutive month period.

Reinstatement coverage will be for the remainder of the calendar quarter in which you became eligible and the successive calendar quarter.

The same parameters will apply for Apprentices and Indiana Plan participant’s, non-bargaining employees and Owners and Owners in Fact, except the number of required hours needed to be contributed by a signatory employer is 324, 324, 160 and 500 respectively.

Congratulations! Yes, you can add your spouse to this Plan.

Recently married participants will need to complete a new enrollment form and return it to the Benefit Fund Office along with a copy of your marriage certificate and your spouse’s birth certificate and Social Security Card. Provided the enrollment of your spouse occurs within thirty (30) days from the date of your marriage, your spouse will be automatically eligible for coverage effective as of the date of your marriage.

If you fail to timely submit a properly completed enrollment form and the proper supporting documentation as determined by the Plan, your spouse will be enrolled in the Plan on the first day after the Health and Benefit Plan receives and deems complete the enrollment form and all proper supporting documentation. Any bills incurred prior to the Plans enrollment of your spouse prior to that date will remain the sole responsibility of the participant.

It is recommended that when a participant enrolls a spouse, they also take a moment to review their beneficiary elections on file with the various Benefit Plans as well as the Local 697 Union office and if needed, update accordingly.

Yes, however, you will need to complete a new enrollment form and return it to the Benefit Office along with a copy of the child’s birth certificate and Social Security card within ninety (90) days of your child’s birth.

Parents of new-born children will be provided a ninety-day (90) grace period from the date of the child’s birth to both enroll their child into the Plan and submit the proper and required documentation. If you fail to properly enroll your newborn within that time period, any claims incurred prior and after that time will remain the responsibility of the participant.

It is recommended that with each new addition to your family, you take a moment to review their beneficiary elections on file with the various Benefit Plans and Local 697 Union office and if needed, update accordingly.

Children are covered until the last day of the month in which they turn age 26. Children do not have to be students, unmarried, financially dependent or living with their parents in order to be covered.

Coverage will either terminate on the last day of the month of the calendar quarter in which you have earned coverage or on the last day of the month of the month in which you have made a monthly self-payment. After your coverage terminates, the Plan will send you a COBRA election package.

Generally, the cause of the shortage is either one or two things.

  • The employer does not adhere to the common practice of closing out the calendar quarter on the last Sunday of the month. Instead, work performed for part of the last week of the calendar quarter and the first part of the first week of the subsequent quarter, are contributed by the employer at the end of the new quarter. Or,
  • You worked outside the jurisdiction of the I.B.E.W. Local 697. If you did, then the employer’s contributions for the hours you worked were sent to the Local in the jurisdiction you worked and pursuant to your ERTS instructions, they have yet to be forwarded back to the Lake County Indiana NECA – I.B.E.W. Health and Benefit Plan.

Unfortunately, and for the reasons that it neither has any control over the Fringe Benefit payment practices of an employer, nor any control over the reciprocity issuance practices of another Local, there is nothing the Health and Benefit Plan Office can do.

Simply put, the Fund Office cannot credit monies it has not received nor back date contributions because the employer does not adhere to the common methodology of closing the calendar quarter on the last Sunday of the month.

Additionally, Local 697 is signatory to the National Reciprocity Agreement. It is this document that dictates when a I.B.E.W. Local’s Benefit Office is required to remit hours back to the Local pursuant to that participant’s ERTS election. While the Local 697 Benefit Office exceeds those reciprocity remittance requirements, other Locals are more “relaxed” in their adherence to those regulations.

In both cases you will need to check in with the employer to see when they made their Fringe Benefit contributions. If you worked in another I.B.E.W Local’s jurisdiction you will also have to call that Local’s Benefit Fund Office and instruct them to forward those contributions to the Local 697 Benefit Office.

Grand Rounds is a tremendous resource. Specifically, Grand Rounds provides medical guidance. They direct you to a higher level of care, provide second opinions, research and/or supply you with additional information to help you make the right health decision for you and your family.

  • Want to find the highest qualified provider and as such, the “best of the best” within any specialty within the Plans network, or available to you under the terms of this Plan? Of course, you do. Contact Grand Rounds.
  • Do you have concerns about a proposed procedure and want to make sure that the suggested course of action is correct or even necessary? Call Grand Rounds.
  • Are you confused about your treatment options? Call Grand Rounds to discuss diagnoses, symptoms, and treatment plan options.

Grand Rounds is available to only the active and non-Medicare participants of the Plan.

There is NO CHARGE to you for this service. The Health and Benefit Plan will pay the full cost for eligible Health and Benefit Plan participants.

There are three ways in which you can sign up or register with Grand Rounds, they are:

Mobile

  • Search "Grand Rounds" in the Apple App Store or Google Play Store.
  • Download the Grand Rounds app.
  • Enter your e-mail and password, then input your personal information to create your account.

Desktop

  • Log on at grandrounds.com/ibew697
  • Enter your e-mail and password, then input your personal information to create your account.

Phone

  • Call Grand Rounds at 1-800-929-0926 to speak with a care coordinator and set up your account.

Participants who misplaced their medical identification card, can order another one at www.bpatpa.com or can either call the Fund Office or BPA directly and they will order one for you.

A Health Reimbursement Account (HRA) is a tax-advantage personalized health benefit that allows you to pay for a wide range of medical expenses considered to be qualified under IRS Section 213 of the Internal Revenue Code, including self-payment premiums to the Health and Benefit Plan.

The Board of Trustees have chosen Paylocity, an industry leader in innovative payment services with a reputation for excellent customer service, to assist the Plan in providing participants with 24/7 access to the monies within their HRA’s.

Access to your account is only a few clicks away at bat.paylocity.com or through their app.

Didn’t download the app yet? What are you waiting for? Go to your app store. Place the word “Paylocity” within your app store search feature. Click on the icon that states “Paylocity Benefit Account” and follow the instructions to download.

For first time users, the following login instructions will work for either the app or website portal. Or if you prefer, you can view a site tutorial by copying and then pasting within your browser the link directly below:

If you are just in need of sign-on instructions, please be advised that your username is the first initial of your first name, followed by your last name, last four digits of your Social Security Number and your two-letter home state abbreviation.

EXAMPLE Clark Kent, 000-00-1234, Indiana

USER NAME = ckent1234in (not case sensitive)

TEMPORARY PASSWORD - paylocity (all lower case)

Yes. However, you must make sure that the payment is received no later than the mandated due date.

If you do not make the required self or COBRA payment, or make that payment by the mandated due date, coverage for you and any eligible dependent will terminate. If terminated, the following will occur:

  1. Eligibility for dental, health, HRA, life-insurance, pharmaceutical, and vision benefits cease for you and any eligible dependents.

  2. Your HRA (Paylocity) debit card is frozen and you will have ninety days to manually submit claims for reimbursement that were incurred within the twelve months prior to the termination from the Plan.

  3. Regardless of subsequent reinstatement, after ninety days any balance within your HRA account will be forfeited.

HRA accounts are credited at the same frequency in which your eligibility is credited. Meaning: the amount of excess contributions earned in a work quarter will be tallied and subsequently credited to an employee’s HRA account during the corresponding quarter of coverage.

Work Quarter Quarter of Coverage
January, February, March July, August, September
April, May, June October, November, December
July, August, September January, February, March
October, November, December April, May June

Please note that the middle column is deliberately left blank to emphasize the fact that there exists an administrative “lag quarter” that separates a work quarter from its corresponding quarter of coverage. Meaning: Excess contributions in any work quarter does get credited in the subsequent calendar quarter of coverage. Rather, it skips a quarter.

Participants who are unable to find their Paylocity debit card, can order another one at www.batinfo.com or they can either call the Fund Office or Paylocity directly and they will order one for you. Be advised that there is a ten-dollar ($10) replacement fee that will automatically be deducted from the balance of your HRA account upon issuance of the replacement card.

Generally, the following medical services require prior-authorization or pre-certification.

additional information to help you make the right health decision for you and your family.

  • Alcohol dependency
  • Bariatric/gastric bypass
  • Cardiac rehabilitation
  • Cat Scans
  • Chemical dependency
  • Chemotherapy
  • Corrective surgery
  • Dental work performed in a hospital setting
  • Durable medical equipment in amounts greater than $1,000.00.
  • Epidural injections/nerve blockers
  • Genetic testing
  • Home health care
  • Hospice
  • Inpatient care
  • Inpatient rehabilitation
  • Inpatient surgery
  • Mental Health benefits
  • MRI’s
  • Neuropsychological testing
  • Occupational therapy
  • Orthotics greater than $1,000.00.
  • Orthotripsy
  • Outpatient surgery
  • PET Scans
  • Pharmacogenetics
  • Physical therapy treatments greater than 17
  • Private Duty Nursing
  • Prosthetics
  • Pulmonary Rehabilitation
  • Physical therapy
  • Radiation therapy
  • Reconstructive surgery
  • Sclerotherapy
  • Skilled nursing benefits
  • Speech therapy
  • Substance abuse
  • Surgeries of any type
  • Synagis Injections
  • Transplants
  • Trigger point injections
  • Vein therapy

The Plan will not make payment toward services that require pre-certification but did not receive authorization.

Self-payments are always due no later than the close of business on the first business day of the month.

Eligible journeypersons, apprentices, employees and Indiana Plan employees can receive a gross weekly income of up to fifty percent (50%) of their weekly salary (excluding any overtime) up to a maximum of $550.00 per week.

Teladoc is the name of the Health and Benefit Plans telemedicine provider. Teladoc provides you and any eligible dependent with 24/7 telephone, video and web access consultation to a board-certified physician for common and minor ailments such as allergies, sinus infections, ear infections, flu, colds etc.

Teladoc is available to only the active and non-Medicare participants of the Plan.

There are three ways to access Teladoc. You can call 1-800-Teladoc [1-800-835-2362] or go to www.teladoc.com, or you could finally download the Teladoc app to your smartphone. While you do that, please make certain that each of your covered dependents download the Teladoc app as well.

There is NO CHARGE to you for this service. The Health and Benefit Plan will pay the full cost for eligible Health and Benefit Plan participants.