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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 |
|
UnitedHealthCare Claims |
|
| 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) |
|
N/A |
|
| 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 |
|
Metropolitan Life Insurance Company
Group Life Claims P.O. Box 6100
Scranton, PA 18505-6100 |
|
 |
|
|
|
|
Appeals Reviewers
|
| Benefit |
|
Write to: |
|
Or Call: |
|
| Medical and Hospital |
|
UnitedHealthCare
P.O. Box 30432
Salt Lake City, Utah 84130-0432 |
|
1-800-245-6057 |
|
| 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 |
|
Metropolitan Life Insurance Company
Group Life Claims
P.O. Box 6100
Scranton, PA 18505-6100 |
|
Appeals are only
accepted in writing |
|
|
|
|
|
|
Subrogation Vendor
Ingenix Subrogation Services-ISS
UnitedHelathCare Group Company
MN 002-0220
12125 Technology Drive
Eden Prairie, MN 55344
* 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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