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FAQ

The answers to frequently asked questions below are general in nature and do not modify the terms of their respective Plans. You should refer to the related Summary Plan Description for more specific information regarding each Fund's Plan.

Top Frequently Asked Questions

Where do I mail my claim form for reimbursement?

Make sure you have signed your claim form. Attached all itemized, current bills and your other coverage EOB (Explanation of Benefits) from your insurance company and mail to:

 

I.A.T.S.E. National Benefit Funds

417 Fifth Avenue, 3rd Floor

New York, NY  10016

Attn: MRP Claims

 

Or, you can also upload your claims via the Fund’s website at www.iatsenbf.org. Be sure to include all documents listed above and sign the electronic consent certificate on the Fund’s website.

Can I submit insurance premiums for my dependent who is not enrolled in employer or union sponsored group health coverage?

No. All dependents must be enrolled in an employer or union sponsored group health coverage plan for each to be eligible to submit claims for reimbursement.

Can claims incurred while I’m enrolled in a Plan C option (C1, C2, C3, C4, MRP or Triple S) be reimbursed if I am now in the Retiree only MRP Plan?

No. A claim must be incurred after the effective date of your enrollment in the R-MRP Plan and during a period that you are still enrolled in the R-MRP Plan for reimbursement from your R-MRP Plan.

How do I submit the MRP Claim form and support documentation to the Fund Office?

You may submit the claim to the Fund Office in one of four ways:

  • By logging on to your website account at www.iatsenbf.org. Scan your document(s) and upload (no MRP claim form is required when uploading via the website)
  • By email as a PDF attachment to psc@iatsenbf.org
  • By Fax to: 646-783-7650
  • By Mail to:

I.A.T.S.E. National Benefit Funds, MRP Claims Department

417 Fifth Avenue, 3rd Floor

New York, NY  10016

You can check the status of your MRP claim by going to our website and logging into your account.

What documentation do I need in order to submit my eligible expenses for reimbursement?

You need to complete a Medical Reimbursement claim form (signed and dated) for each patient (including any dependent enrolled in an employer or union sponsored group health coverage plan that meets the ACA minimum value standard) along with supporting documentation for each expense such as an itemized bill from the provider and the Explanation of Benefits (EOB) from your insurance carrier.

If you are submitting through the website at www.iatsenbf.org:

  • You do not need to complete a claim form however all of the above will be required and you will also be required to check off a box certifying the following:
    • The submitted expenses have not been previously reimbursed and are not reimbursable under any other health plan coverage
    • The submitted expenses are qualified medical expenses as defined by the Internal Revenue Service under IRS Publication 502 (as described in our MRP Guidebook)
    • The submitted expenses are for a dependent enrolled in an employer or union sponsored group health coverage plan that provides minimum value (effective January 1, 2017)
    • If the reimbursements requested are for health insurance premiums, that those premiums were paid on a post-tax basis (eg. Not through a pre-tax flex spending account or pre-tax deductions made by you or your spouse’s employer through payroll deductions).
    • That all the information you have provided in support of the claim you are submitting is complete, true and correct and all charges for which you are requesting reimbursement were paid by you or your dependent, where applicable.

Please note: You must be enrolled in the Plan C-MRP both when the expense is incurred and when you submit a claim for reimbursement. To be eligible for reimbursement under the Plan C-MRP, your expense must be a qualified post-tax medical coverage premium or appear on the list of qualified unreimbursed medical expenses. Please refer to the Medical Reimbursement Guidebook for Plan C  and Plan R-MRP SPD  for a list of qualified expenses.

How do I submit a claim via the website?

1. Log into the website at www.iatsenbf.org


2. Accept the terms and conditions


3. You will be brought to your dashboard. Under the Health & Welfare column is the new "MRP History/New Claim" button.

     Click this button to:

  • Upload a new claim
  • Upload additional information for a previously submitted claim
  • Check the status of a claim
  • View existing claims
  • See what is covered/reimbursable
  • Download a claim form

 

4. When you click on “Submit New Claim” a certification and conditions of reimbursement box appears. You MUST check this box to go to the next step. Check the box and click on proceed.


5. The “New Claim Submission” box will come up.  You must click on the applicable patient you are uploading claims for. Click on the applicable patient and click on the “Step 2” button.


6. You will be asked to verify your address and direct deposit information (if applicable). You can modify both in this screen. If you are currently receiving direct deposit you have the option of switching to paper check and vice versa.


7. After reviewing your address and direct deposit information, click on the “Step 3” button which brings you to the upload claims screen.


8. Click on “browse”, find the document in your computer system and click on “upload”. The files that are uploaded will show below the “Claim Documents”. Once you have finished uploading claims, click on “Submit Claim”. You will receive a web reference # for your submission.


9. You have the option of clicking on “Submit Another Claim” or “Go to MRP Claims Homepage”.


10. If you click on “Go to MRP Home Page” it will bring you back to the initial “My Claims & Reimbursements Summary” screen.

How will I receive my reimbursement?

You will receive a check in the mail along with an EOB (Explanation of Benefits). Or, if you opted for direct deposit, only the EOB will be mailed to you.

 

If you would like to have your payment directly deposited to your bank account, you must fill out a direct deposit form or go to our website, log into your account and click and the “change direct deposit information” tab to enter your banking information. Note, once an MRP direct deposit form/website request is received, a pre-notification file must be sent to your bank first. Once the pre-notification has been successfully sent and your bank confirms that the banking information submitted is correct, the next reimbursement you receive will be sent via direct deposit. The verification of the account can take up to two weeks and can take longer if the account information is not entered correctly the first time. Please be sure to update your direct deposit information immediately if your banking information changes. Direct deposit information cannot be updated over the phone. Your payment will be directly deposited to your account once the claim has been processed and a separate explanation of benefits will be sent via mail. The explanation of benefits is also viewable online via the website at www.iatsenbf.org.

 

Before you fill out the direct deposit form, be sure you know your bank’s routing number and your account number. If you have a checking account, this information can be found on the bottom of a check (see image).

sample check

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What eligible expenses can be claimed for reimbursement?

You may refer to the Plan C-MRP Guidebook and R-MRP Summary Plan Description for a detailed list of qualifying expenses that are eligible for reimbursement in accordance with the IRS definition and Publication 502. Some of the most common eligible expenses are:

  • Medical co-payments, prescription co-payments, co-insurance amounts and deductibles
  • Insurance premiums (post-tax and employer/union sponsored health plans only)
  • Dental expenses
  • Vision expenses

How long will it take for my claim to be processed?

All claims are processed within 30 days of the receipt date of the MRP claim.

Is there a fee for processing my reimbursement claim?

Yes. An administrative fee is charged for processing all MRP claims. The chart below details the current fees:

 

Amount of Claim Eligible for Reimbursement

Administrative Charge as % of Claim

$1-$249

5.0%

$250-$499

4.5%

$500-$999

3.5%

$1000-$1,999

2.5%

$2000 or more

2.0%


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