Laborers’ Local 341 Forms
Please feel free to download and use the forms located on this page. Note that we will continually update these forms to reflect the updates/changes when there are new revisions. To make sure you always have the latest version of a form, do not download the form to your computer, but instead visit this page and and retrieve the form from here.
When you send in a Mail In Sheet, it needs to be post marked from the Area that you live in on the envelope that you send. This ensures that everyone is treated equally on the local hire list.
Claim Filing Tips
Answer all the appropriate questions and sign the claim form.
Always send your claim form and an itemized statement of charge which includes:
1. Employee name
2. Patient name
3. Provider name & Tax ID number
4. Dates of service
5. Diagnosis (preferably with code number)
6. Types of service (preferably with code number)
7. Charges for each type of service
Batch your claim submissions (send several itemized bills at one time).
If you have insurance coverage, please remember to submit the claim to the primary insurance plan first. (Refer to your health benefit booklet, “coordination of benefits” section to determine which plan is primary). When you receive the “explanation of benefits” statement back from the primary plan, submit the claim to the secondary plan by sending that plan’s claim form, a copy of the bill and a copy of the primary plan’s EOB (explanation of benefits statement).
Exception: The Administration Office will internally coordinate the processing of a claim, if both plans are administered by WPAS.
Always pre-certify “non-emergency surgeries and/or hospital confinements” by calling PRO-West at (800) 783-8606
Have your dentist submit a “pre-treatment dental plan” for all claims expected to exceed $400 to the Administration Office. This will let you know your “out-of-pocket expenses” before services are rendered.
Never send a “balance forward bill” to the Administration Office.
Make certain you know who is going to file your claim. Do not submit a claim yourself, if your health care provider tells you they will submit the claim for you. Duplicate claim filing adds to the administrative expense of operating our plan.
Minor Care – Wellness Program
The Minor Care – Wellness Program benefits are available to you when you are eligible for coverage under the Alaska Laborers-Construction Industry Health and Security Fund. The Trust can offer you this program and obtain discounted rates for these services by virtue of its association with the Health Care Cost Management Corporation of Alaska (the Coalition). You are not required to use the Minor Care – Wellness Program, but by using this program, you may pay less out-of-pocket expenses, reduce your waiting time and eliminate claim forms.
Summary of Clinic Services
Routine and Minor Care: including treatment for colds, flu, minor illness or accident, general minor medical care and x-rays or lab tests.
Preventive Care for Adults: including physical exams (member only, up to $500 once every 5 years), mammograms and prostate-specific antigen testing, annual pap smears and associated lab and x-rays. Preventive care testing is available according to the frequency recommended by the American Medical Association.
Preventive Care for Children age 2 and over: including physical exams and children’s immunizations.
Costs for Service
$30 per person per visit
Charges for services will not apply to your annual deductibles, reimbursement percentages or out-of-pocket limits.
Services not Covered
Occupational accidents or illnesses.
Treatment of infants under the age of one or health maintenance exams for children under the age of two.
Treatment for substance abuse.
Treatment for chronic conditions.
Note for Medicare Eligible Participants
Medicare-covered expenses are not covered by the Minor Care – Wellness Program. Preventive care benefits not covered by Medicare are available through the program. Medicare eligible participants will not be asked to pay the co-payment at the time of services. If the services are not covered by Medicare, the co-payment will be billed to you.
If You Have Questions
Remember, the above is just a summary of some of the important points in the Minor Care – Wellness Program.
If you have any questions, please contact Local 341 at (907) 272-4571, Local 942 at (907) 456-4584 or the Administration Office at (800) 331-6158, Option 9.