Summary of Benefits
		Election of Coverage and Eligibility Provisions
		Comprehensive Medical Benefits
		Income Protection Benefit
		Dental Benefit
		Dental Schedule of Benefits
		Prescription Drug Benefit
		Vision Benefit
		Life Insurance & AD&D Benefit
		General Exclusions and Limitations

		Summary of Benefits
		Election of Coverage and Eligibility Provisions
		Comprehensive Medical Benefits
		Prescription Drug Benefit
		General Exclusions and Limitations

		How to File a Claim
		When to Call Us
		Request an ID Card
		Continuation of Coverage (COBRA)
		Claim Review & Appeal Procedure
		Coordination of Benefits
		Privacy Practices
		Health Benefits Plan Claim Procedures
		Summary of the Cafeteria Plan
		Forms & Publications

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REQUEST AN ID CARD

Health ID Card. The Health ID Card is used when filling a prescription as well as when obtaining medical treatment.

NMHC/Rx processes Health ID cards when you first become eligible or if you need a replacement or an additional card. NMHC/Rx is the Fund’s Prescription Drug Benefit manager.

To request a Health ID card, call NMHC/Rx at 888-354-0090. They are open 24 hours a day, 7 days a week. Give your UFCW ID # (UID) or your Social Security Number. NMHC/Rx will ask you to provide a few details about yourself (name, address, etc.) and will then send you the Health ID card.

Quest Diagnostics ID Card. To take advantage of the Special Laboratory Benefit available at a Quest Diagnostic center, you will need the UFCW Lab and Drug ID Card—your Health ID Card will not work for this benefit. To request a UFCW Lab and Drug Card (often referred to as a "Quest card"), contact Customer Service at the Benefits Fund Office at 1-800-621-5133 ext 7180.

Check your plan (Plan D5 or Plan B5) for a description of the Special Laboratory Test Benefit and how to use it.