Medical Benefit Plans Offered by the Trust
The Washington Teamsters Welfare Trust offers comprehensive medical coverage to thousands of Plan participants. Please select your Plan below to find out more about your benefit offering.
Premera Blue Cross (Premera) is the Trust’s preferred provider organization (PPO) nationwide. Participants have access to the BlueCard® PPO network, one of the largest national networks available.
The BlueCard® PPO network includes the Heritage and Heritage Plus 1 networks and provides for:
- Medical services, including physician and hospital services
- Behavioral health and chemical dependency services
- Medical supplies and equipment
The BlueCard® PPO network of physicians and other healthcare professionals provides eligible employees and dependents with efficient, cost-effective services and supplies at discounted rates. Although you may see any provider covered by the plan, you receive higher benefits if you use in-network Trust Medical Plan providers.
Find an in-network provider by searching the BlueCard® PPO network online, or call (800) 810-BLUE (2583) and reference the prefix TMP.
Log in or look to your benefits booklets for more information. Booklets are available online at www.nwadmin.com.
Premera Blue Cross is an Independent Licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County.
In addition to the BlueCard® PPO network, the Trust offers Member Assistance. The ComPsych® GuidanceResources® program offers free, confidential counseling, self-improvement tools and other resources to help you take charge of your life, physically and emotionally.
These services are available 24 hours a day, 7 days a week to you and covered household members.
Call (866) 301-0313 or visit GuidanceResources®, using Web ID: WATEAMSTERS. You may also download the “GuidanceResources® Now” app for your smartphone.
The Trust offers participants Premera’s Personal Health Support programs to help members with such things as managing complex medical conditions, a recent surgery, or admission to a hospital. Participants work with a trained Personal Health Support Clinician, who’s primary role is to support you and your entire family through a potentially difficult time.
Personal Health Support services include:
- Helping participants have access to health improvement resources and in following providers’ prescribed treatment plan,
- Coordinating care services as needed,
- Helping to understand your health plan’s coverage,
- Management and assistance with chronic conditions, and
- Finding useful community resources.
Premera’s Personal Health Support teams are made up of trained nurses and other certified health care specialists. Participation is voluntary. To request help from Premera’s Personal Health Support team, call 855-869-6775.
Pre-authorization is the process of determining if services, equipment or supplies are medically necessary and will be covered by your Plan prior to your obtaining them. This process protects you from unexpected costs. With pre-authorization you will have the assurance that the services you receive are medically necessary and eligible to be covered by the Plan prior to incurring the expense.
Some common services that require pre-authorization include:
- All planned inpatient stays
- Admission to a skilled nursing facility or rehabilitation facility
- Admission to behavioral health residential treatment centers
- Non-emergency and elective air ambulance services
- Some outpatient services
- Certain organ transplants
- Purchase of supplies, appliances, DME, and prosthetic devices over $500
- Provider-administered drugs
Doctors who are in the Premera network can request pre-authorization for you. Healthcare providers who are in the Premera network are familiar with the process for getting pre-authorization. Be sure to confirm with your provider that they will be contacting Premera on your behalf. In-network doctors have all of the medical information needed to ask that your medical service be reviewed and approved for coverage.
When you or a covered family member receives care from a participating Premera Blue Cross doctor or facility, your provider will arrange all the care you may need, including getting prior authorization and hospital inpatient precertification, as required.
Through Care Management, a participating Premera doctor or facility may be able to lower your out-of-pocket costs by recommending one of Premera’s preferred facilities, or by helping identify treatments or procedures that may be avoidable. This also keeps you in-network and possibly avoiding out-of-network uncovered costs.
Premera’s voluntary maternity program, BestBeginnings, offers education and support services as well as case management for pregnant participants identified as high risk. BestBeginnings helps educate mothers to-be about normal symptoms of pregnancy, as well as risks and problems, including warning signs.
- Risk assessment to target high-risk pregnancies for case management
- Telephone support for covered persons, available 24/7
- Live chat via secure instant messaging, available Monday through Friday, 5:00 a.m. to 11:00 p.m. PST
- Your Journey Through Pregnancy handbook
- Website that offers educational tools, videos and articles on pregnancy and newborn care
To find out more, or contact a maternity specialist, visit: Premera BestBeginnings.
The Neonatal lntensive Care Unit (NICU) program provides case management for babies admitted to the NICU. The Network Administrator and/or the hospital refers those who are admitted to the NICU or a specialty care nursery to the NICU Program Manager. The Program Manager then contacts the parents to get consent for the baby to participate in the NICU Program. Participation in this program is voluntary.
Services of the program are:
- Coordination of care for newborns throughout their stays in the NICU
- Assistance with management of the baby’s care from discharge to the baby’s transition home
- Comprehensive booklet that educates parents about the NICU and the needs of the child in the NICU
- Measures of health outcomes
With the Kaiser Permanente Plan, when you choose in-network care, you get access to providers at all Kaiser Permanente medical centers. In addition, you have access to a number of contracted community physicians in the area.
If you choose out-of-network care, you can see First Choice Health or First Health network providers at a discounted rate. Or you may see any licensed provider you want, anywhere in the U.S., for most covered services. However, your out-of-pocket costs will be higher, and there may be additional paperwork.
Find an in-network provider online, or call Kaiser Permanente at (888) 901-4636.
Find the complete details of your medical coverage in your Summary Plan Description booklet, available online at www.nwadmin.com, or by contacting Kaiser Permanente.
Eligibility or claims questions? Call the Trust office at (800) 458-3053.
Kaiser Permanente’s Behavioral Health Services pre-authorizes and coordinates non-emergency mental health and chemical dependency care. You do not need a referral from your personal physician to get these services and you can call if you have marital, parenting, or emotional concerns, substance abuse, or addiction concerns. Call (888) 287-2680 or search “Behavioral Health Services” on the Kaiser Permanente website.
Precertification is the process of determining if services, equipment or supplies are medically necessary and will be covered by your Plan prior to your obtaining them. This process protects you from unexpected costs. With precertification you will have the assurance that the services you receive are medically necessary and eligible to be covered by the Plan prior to incurring the expense.
Kaiser Permanente’s Case Management is a free service to help you access the medical care and services you need, and that are most appropriate for you. Case Managers help you stay informed about specific diseases and specific care settings and ensure that you receive access to timely, appropriate medical care.
Case Management teams are made up of trained nurses and other certified health care specialists. Case Managers help with trauma, emergencies, and the following chronic conditions:
- Chronic Heart Failure (CHF)
- End Stage Renal Disease (ESRD)
- Occupational Medicine
- Behavioral Health
Your Case Manager will coordinate access to care, assess chronic conditions, monitor your progress, assist with discharge planning and follow-up, and help ensure that your benefits are used effectively. Most importantly your Case Manager will be there to support you and your entire family through a potentially difficult time.
Complex Case Management, a service targeting recently discharged patients with significant needs, is available to you if you have complex conditions such as diabetes, depression, or conditions that are more severe than the ones mentioned above.
Case Management is a voluntary program. If you or a covered family member is facing a complex medical condition that may require inpatient, outpatient or at-home care you may be eligible. Call Kaiser Permanente at (866) 656-4183 to find out more.