Monterey Culinary Health Plan

Monterey Culinary Health

Plan (175)

Remember! Self-payments due the 15th of each month!

Click on the following to learn more

ClaimsProvidersBenefitsPharmacyPrior authorization & Forms

Our Health Fund

702 Forest Avenue,
Suite B
Pacific Grove, CA 93950

(855) 483-4373 or (213) 201-4690

Phone Hours:
8:30am to 4:30pm Pacific Time

Want to know if a claim is paid?

Register and create an account on uhh.org to check your claims, eligibility and more!

Sign up

Providers

Don’t go out of network! It costs too much money!

And make sure you have a PCP!  A primary care provider (PCP) can be a family physician, internist, pediatrician, physician assistant or nurse practitioner.

Find a doctor
Call (800) 810-2583 or visit BCBS Illinois

Click here to learn how to use BCBS Blue Access for Members.

  

  

 

 

 

 

 

 

 

 

Benefits

Good health starts with knowing your benefits!

Download a copy of your “Benefits at a Glance.” It is an overview of your benefits, but some information may have changed. 

You can also download a copy of your

“Summary of Benefits & Coverage” (SBC)

What is an “SBC?”  Under the Affordable Care Act (“Obamacare”), all insurance companies and group health plans, like UNITE HERE HEALTH, are asked to provide an easy-to-understand summary of benefits and coverage, or “SBC.”  Sometimes, it’s a good overview with lots of charts. 

These documents are summaries of your benefits, but some information may have changed.  

Call us to double-check: (855) 483-4373

View your SPD here: Monterey Culinary Health Plan

After each SPD is published, certain changes may have been made to your benefits. These changes are reflected in a Summary of Material Modifications (SMM) that are mailed to each member. View these SMMs on our library page. (Click your plan button under "California Region".)

Pharmacy

Hospitality Rx now manages your pharmacy benefits! Please view their website for more details.

Copays

  What you pay
When you use a network or mail order pharmacy
Certain preventive drugs/supplies $0
Generic drugs $10 copay
Preferred brand name drugs $25 copay
Non-preferred brand name drugs $60 copay
Mail order (90-day supply) Generic - $20 | Preferred - $50 | Non-preferred - $120
Specialty brand or biosimilar drugs
(effective June 1, 2016)
25% coinsurance
($50 max copay)
Existing out-of-pocket limits continue to apply.

Prior Authorization

Certain types of care require “prior authorization” or approval. This helps us to keep costs low and forces doctors and nurses to talk better to each other about the care you receive.

Click here to see a list of what needs prior authorization.

To submit prior authorizations, have your doctor contact Nevada Health Solutions:
Phone: (855) 487-0353
Fax: (866) 201-5601
www.nevadahealthsolutions.org

Forms

Here are some forms you may want to print and fill out before you visit us in the Fund office. You may also mail some of them.

Call us if you need help understanding these forms: (855) 483-4373

Claim FormLife Insurance Beneficiary

EnrollmentCoordination of Benefits

 

Pharmacy forms

Appeal FormMail Order Form

Prior Authorization Initiation FormReimbursement Claim Form