Northwest Carpenters Health and Security Plan
Summary Plan Description
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Northwest Carpenters Health and Security Plan
Claims Process
Summary
This section describes how claims are filed with the plan and how those claims are processed. This section applies to all plan benefits, except benefit provided by the plan's Kaiser option. For claims processed under the Kaiser option, refer to the Kaiser plan booklet.
This section also describes the coordination of benefit method used by this plan. If you or your dependents are covered under another health care plan or Medicare, this plan coordinates benefits with the other plan or Medicare. In the event of an illness or injury caused by another person, this plan contains a third-party liability provision which is explained in detail.
Topics Discussed in This Section
- How to File a Medical Claim
- Claims for Prescription, Dental, Vision, Time Loss, Life Insurance, and Accidental Death and Dismemberment
- Timely Filing Requirement
- Coordination of Benefits (COB)
- Facility of Payment
- Trust's Right to Reimbursement
- Right To Receive and Release Necessary Information
- No Waiver of Claim Paid in Error – Recovery by Trust
- Misrepresentation
- Assignment
Last Updated: 01/03/2022