Health and Welfare - Changing Plans FAQs

• May I change plans between open enrollment periods?

  No. You may change plans only during the open enrollment period that usually occurs in July, with plan changes taking effect August 1st. The only exception is when you are enrolled in one of the Plan's HMOs and you move outside the service area.

• What if I move outside the service area covered by the Plan?

  If you move outside the service area covered by Blue Shield HMO or Kaiser, you will be immediately enrolled in the Self-Funded PPO Plan.

• What happens to my eligibility for coverage if I travel to another State or outside the Country?

  The Self-Funded PPO Plan covers services rendered in any State or Country. Both Kaiser and Blue Shield HMO, limit coverage outside the service hours to emergency and urgent care only.

  Self-Funded PPO Plan: You should show the provider your San Francisco Electrical Workers identification card so that they can contact Blue Shield for preauthorization of treatment. If the provider or medical facility is non-contracting, Blue Shield may still be able to negotiate more favorable terms as a savings to you and the Plan. If you travel to a foreign country, be sure to save your itemized statements. The Plan Office, when necessary, will convert the amounts payable to American dollars and reimburse you in accordance with the Plan's benefit schedule.

  Kaiser and Blue Shield HMO will cover only the costs for emergency services that are rendered outside of the service areas. If you are a Kaiser member and you are treated on an emergency basis at a non-Kaiser facility, you or a representative should call them as soon as reasonably possible (1-800-777-1370 inside the U.S. or 1-800-225-552-4737 outside the U.S.) for instructions. If you are covered by Blue Shield and are unable to contact either the Plan Office or Blue Shield prior to going to a facility for emergency or urgently needed services, you or your representative must notify Blue Shield within 24 hours (or as soon as reasonably possible) to inform them of the location, duration, and nature of the services provided and for instructions on how to submit a claim for reimbursement.