UFCW Unions & Employers Midwest Health Benefits Fund

Find all of your Health Fund resources.

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Welcome to the UFCW Unions & Employers Benefit Funds Website!

If you can't find what you're looking for here, please visit the contact page to connect with one of our experts.

FREQUENTLY ASKED QUESTIONS:

How do I order a new health ID Card?
Contact the Fund Office and ask to speak with Accounts Receivable. They will verify eligibility and request a new health ID card. Your new ID card will arrive within 7-10 business days from the date you notify the Fund Office that you need a new card.
How do I locate a health network provider?
Click on any of the Service Provider links to visit their respective websites - BlueCross BlueShield of Illinois, WellDyneRx, ActiveHealth, and Dental Network of America.
How do I view my Explanation of Benefits (EOB)?
If you did not receive an EOB in the mail or need to request a new one, please contact the Fund Office.
How do I file an out-of-network health claim?
If you receive services from a non-participating provider you may have to submit the claim to the Plan. If you need to submit a claim, you will need to request an itemized bill from the provider then complete an Initial Report of Claim Form. Forward the bill and completed form to the Fund Office.
How do I designate a beneficiary for the Life Insurance Benefit?
How do I change my address?
In order to change your mailing address, you must complete a Change of Address Form and mail to the Fund Office.
How do I add a dependent to my health insurance?
To enroll your spouse for coverage under the Plan, submit a completed Family Update Form along with a copy of the marriage certificate to the Fund Office.

To enroll your dependent child for coverage under the Plan, submit a completed Family Update Form along with a copy of the birth certificate or adoption papers to the Fund Office.

Additional documentation may be requested by the Fund Office following receipt of the initial request.
How do I file for disability benefits?
Submit a completed Disability Claim Form to the Fund Office.
How can I find more information about the health benefits offered through my health plan?
The Summary Plan Description is the document that details the benefits of the health plan. The SPD will provide information about the health plan such as covered medical expenses, prescription drug benefits, as well as vision and dental benefits if applicable under your plan classification.
How do I get the health Summary Plan Description Booklet (SPD)?
You can review the Summary Plan Description electronically or you can call the Fund Office to request a hardcopy of the SPD Booklet.
If I get divorced, what happens with my former spouse’s coverage?
You or your spouse must notify the Plan and submit a fully executed copy of your divorce decree to the Fund Office. Once the Plan receives the divorce decree, your former spouse’s coverage will be terminated on the last day of the month in which you and your spouse divorced.
When I retire, what are my options for continuing health coverage?
If you meet certain criteria defined in the health Summary Plan Description you and your family may be eligible to participate in COBRA continuation coverage. Please contact the Fund Office for your options for continuing health coverage under COBRA.
Who do I contact with questions?
If you have any questions about your eligibility, benefits or claims, contact the Fund Office at (847) 720-0008 or (800) 621-5133.

SERVICE PROVIDERS

FORMS

Family Update Form

Change of Address Form

Change of Name Form

Authorization for Release of PHI Form

Designation of Beneficiary for Life Insurance Benefit Form

Dependent Affidavit Form

Initial Report of Claim Form

Subrogation & Reimbursement Agreement

Initial Disability Claim Form

Disability Continuation Form

PLAN DOCUMENTS & NOTICES

Summary Plan Description (SPD)

Summary of Material Modifications (SMM) - July 2021

Summary of Material Modifications (SMM) - August 2022

Summary of Material Modifications (SMM) - August 2023

Summary of Benefits and Coverage Plan D5 – Tier A

Summary of Benefits and Coverage Plan D5 – Tier B & Tier C

Summary of Benefits and Coverage Plan LU

Notice of Privacy Practices

CHIP Notice

Summary Annual Report

Nondiscrimination Notice