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Basic Plan SPD >> Claims and Appeals Procedures


See attached Section II for a detailed description of the procedures for filing claims for Plan benefits. It also describes the procedure for you to follow if your claim is denied in whole or in part and you wish to appeal that decision. The Table below shows where to send claims for each of your benefits.

Claims Reviewers

Benefit Filing Address
Medical/Hospital
No claims forms are necessary
MagnaCare
825 East Gate Boulevard
Garden City, NY 11530
Pharmacy (non-participating providers only; no claim forms are necessary for participating providers) Medco Health Solutions, Inc.
P.O. Box 14711
Lexington, KY 40512-4711
Dental (no claim forms are necessary) Building Service 32BJ Dental Center
101 Avenue of the Americas
New York, NY 10013-1991
Vision (non-participating providers only; no claim forms are necessary for participating providers) Building Service 32BJ Health Fund
Health Benefits Processing Group
101 Avenue of the Americas
New York, NY 10013-1991
Life insurance
Accidental Death & Dismemberment
MetLife Recordkeeping
P.O. Box 6169
Utica, NY 13504-6169
1-866 492-6983
   

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Appeals Reviewers

Benefit Write to:   Or Call:
Medical and Hospital MagnaCare
825 East Gate Boulevard
Garden City, NY 11530
  1-877-624-6219
Pharmacy Medco Health Solutions, Inc.
Attention: Coverage Appeals
8111 Royal Ridge Parkway
Irving, TX 75063-2820
  1-800-318-7451
Dental Building Service 32BJ Health Fund*
Board of Trustees Appeals Committee
101 Avenue of the Americas
New York, NY 10013-1991
  Appeals are only
accepted in writing**
Vision Building Service 32BJ Health Fund*
Board of Trustees Appeals Committee
101 Avenue of the Americas
New York, NY 10013-1991
  Appeals are only
accepted in writing
Life insurance
Accidental Death & Dismemberment
MetLife
P.O. Box 3016
Utica, NY 13504-6169
  Appeals are only
accepted in writing
   

* You may appear in person at the Appeals Committee meeting with the Fund, but you do not have to be there. If you do not attend, the Appeals Committee will decide your appeal based on all of the materials you have submitted.

** An appeal of an urgent care dental claim may be filed orally by calling 1-212-388-2099.

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Subrogation Vendor

Meridian Resource Company
P.O. Box 2025
Milwaukee, WI 53201-2025

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