Obtain a Medical Enrollment Form

When a National IAM Benefit Trust Fund medical plan is negotiated into a collective bargaining agreement, eligible employees must submit a completed Enrollment Form
(PDF)
to be covered under the plan.

The Fund requires only one enrollment form for all benefit plans under which you and your eligible dependents may be covered (including medical, dental, vision, short-term disability, and life and accidental death and dismemberment benefits). Please use one form for all plans in which you have the opportunity to enroll.

When filling out the form, be sure to list all eligible dependents you wish to cover and, if your coverage includes life and accidental death and dismemberment benefits, please list your beneficiaries. If any dependent child has a last name that is different from yours, or is not your biological child, you must fill out a separate Eligible Dependent Certification Form (PDF).

Waiving Coverage

If you pay all or part of the cost to be covered under a health plan, the Benefit Trust Fund will allow you to waive that coverage. However, choosing to waive medical coverage does not depend on waiving other coverage. You may waive medical coverage separately and keep your other coverage. You may also keep medical coverage only and waive other coverage, or you may waive all coverage completely. You may not waive any coverage that is fully employer paid.

To waive coverage, you must submit a completed Waiver Form (PDF) to the Fund Office. You should also send a copy of the Waiver Form to your employer to prevent your employer from making any unnecessary payroll deductions.

If you choose to waive coverage, the waiver will apply for the duration of the current collective bargaining agreement. However, if you waive coverage because you have coverage under another plan and you later lose that coverage due to unforeseen circumstances, you may submit a petition for special enrollment. To submit a petition for special enrollment, you must send the Fund Office a letter explaining your circumstances. The written request for special enrollment, along with a completed Enrollment Form, must be submitted to the Fund Office within thirty days of the date you lose coverage under the other plan.

You can mail or fax completed forms to the Fund Office as follows:

Mail:

National IAM Benefit Trust Fund
1300 Connecticut Ave, NW
Suite #300
Washington, DC 20036

Fax:

202-728-0585

After enrollment forms are processed for a new group, the Fund Office will send participants a packet that provides information about their coverage.

An Enrollment Form should also be completed whenever you want to update the Fund about personal information changes or have a qualifying event. Examples of personal information changes or qualifying events include your change in address, getting married or divorced, adding or deleting a dependent, or changing your beneficiary information.

Whenever you complete an Enrollment Form, be sure to send a copy of the form to your employer to ensure that the appropriate contributions are made for the coverage you select.

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Use the Enrollment Form for all plans for which you have the opportunity to enroll.

Frequently Asked Question (FAQ)

How many different plans does the Fund offer?

The Fund offers multiple Medical, Dental, and Vision plans. Short-Term Disability and Life and Accidental Death & Dismemberment benefits are also available.

How do I notify the Fund of my address change?

If you move, please notify the Fund of your new address. To change your address,
fill out a new Enrollment Form and mail or fax it to the Fund using the mailing address or fax number found on the form. Always complete a new Enrollment Form when you have a change in personal information.

Do Medical Plans include Prescription Drug Coverage?

Yes. Our Plans include excellent prescription drug benefits.

What is a PPO?

A Preferred Provider Organization is a type of medical plan that covers the cost of eligible medical care and services received from network and non-network providers. Network providers (primary care doctors, specialists, hospitals, and other medical facilities) agree to a discounted fee schedule for services provided. When a participant or covered family member sees a network provider for care, the participant pays less out of pocket because of the discounted fees. The Fund contracts with CIGNA Healthcare for the use of their nationwide network of participating providers. There are currently more than 750,000 participating providers in the CIGNA "Open Access Plus" Network—the network used by the Fund’s medical plans.

Are participants required to receive services only from a PPO provider?

No. Participants have the choice of selecting a non-PPO physician. However, receiving services from a physician who participates in the CIGNA network may result in significant savings for participants.

Must participants have a referral from their primary care physician in order to see a specialist?

No. Referrals are not required.

Who processes health care plan claims?

Medical claims are processed by CIGNA Healthcare. Dental claims are processed by Delta Dental Insurance Company, and Vision claims are processed by Fund Office staff.

Do the Fund plans have a waiting period for "pre-existing conditions" under the medical plans?

No. The waiting periods for pre-existing conditions were waived for all plans by the Board of Trustees.

What are the age limits for dependent children?

Children can be covered dependents until they reach age 26 providing they continue to meet provisions for dependent coverage.

Does the Fund offer COBRA coverage for health care?

Yes. The Fund administers COBRA for its Contributing Employers. Upon notification from the Employer that a participant is losing coverage due to a "qualifying event," the Fund will send notification to the participant advising him or her of COBRA rights to continue health care coverage by making payments to the Fund Office.

Does the Fund offer Retiree Health Care Plans?

Yes. Employers that have negotiated a Benefit Trust Plan for their Active employees may also establish a Retiree plan.

How Do I Find a Contributing Employer?

To find a Contributing Employer click on this link to view a map and listings by territory.

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