Welfare Fund

Welcome to the PTSMN Welfare Fund Page. Please select the links below to explore important information as well as health & wellness tools.

PTSMN

Using the Delta PPO and Delta Premier Networks:

Contact Information:
Delta USA Dental Service Center
P.O. Box 59238
Minneapolis, Minnesota 55459-0238

Customer Service Phone Numbers:

(651) 406-5901
(800) 448-3815

Phone hours Monday Through Friday - 7:00am to 7:00pm

Website - www.deltadentalmn.org

Dental benefits are not provided to Support Workers, Pre-Apprentices, Helpers, MES Operators, & Retirees.

The following reflects benefit improvements to the plan made as of 5/1/2015

Diagnostic and Preventive benefits will be paid at 100%  of the Delta allowable amount.
The plan allows for two routine exams and cleanings each calendar year.

Basic Restorative services will be reimbursed at 100% of the Delta allowable amount.
Major Restorative services will be reimbursed at 80% of the Delta allowable amount.

Endodontic, Periodontic, and Prosthetic services will be paid at 60% of the Delta allowable amount.

The Plan pays to a maximum of $2500 for each Covered Person per calendar year.

Orthodontic services are paid at 100% up to a separate $2000 Lifetime Maximum per Covered Person.

These benefits also apply If a person chooses to use a Non-Contracted dental provider, but there will be no discounts to the charges and payment will be made to the member.  The member will be responsible for paying the dentist.
Patient’s will be responsible for the amount that a Non-contracted provider charges over the Delta allowable amount.

VSP Benefit Flier

Your Coverage from a VSP Doctor Payment Percentage and Limitations
WellVision Exam

Covered in Full......Every Calendar Year

Prescription Glasses 

Lenses.....Every Calendar Year

-Single Vision, Lined Bifocal, Lined Trifocal and progressive Lenses covered in full.

-Polycarbonate Lenses covered in full.

Frame......Every Calendar Year

-$175 Allowance for frame of your choice

-$195 Allowance for featured frame brands

-20% off the amount over your allowance

~OR~

Contact Lens Care......Every Calendar Year

When you choose contacts instead of glasses, your $175 allowance applies to the cost of your contacts and the contact lens exam(fitting and evaluation).

Current soft contact lens wearers may be eligible for a special program that includes an initial contact lens evaluation and initial supply of replacement lenses.

Extra Discounts and Savings

Glasses And Sunglasses

-Average 20-25% savings on all non-covered lens options

-20% off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last WellVision Exam.

Contacts

-15% off cost on contact lens exam(fitting and Evaluation)

Laser Vision Correction

-Average 15% off the regular price or 5% off the promotional price. Discounts only available from contracted facilities.

 VSP Choice Doctors  To ensure that your VSP provider is in the CHOICE network, simply go to VSP.com/choice
Your Coverage from a non-VSP Doctor

Payment Percentage and Limitations

Out-Of-Network Reimbursement

-A total Allowance up to $250 per person is available every calendar year. This allowance can be used for exam, lenses, frame, contact lenses, and fitting.

*Any remaining allowance may be used for additional services at a later date, within the same eligibility period.

-You'll pay the provider in full and have a full 12 months to submit a claim to VSP for benefit reimbursement. Out-Of-Network Reimbursement Form

Reminder: Support workers are not eligible for this benefit.

These benefits are only a summary of the provisions of the Pipe Trades Services MN Health Plan. The participants in the plan have been provided with a summary plan description booklet that more fully explains the benefits.

Deductible

Before the Plan pays benefits for certain types of services,you must first pay a portion of the covered charges. This is called the deductible.

Covered Charges

These are charges for services that are covered under the rules of the plan.

Non -Covered Charges

This is an amount for which the PTSMN Health Plan does not pay benefits, as the terms of the plan do not provide for coverage for this service.

Type of Service

This is a general description of the service you received from your provider.

Copayment

This is a flat dollar amount or percentage payment you must pay as your share of the costs before the Plan makes its payment. For PTSMN the office visit co-pay is $25.00 and the prescription drug co-pay is 20%

Coinsurance

This is a percentage of covered charges you are responsible for paying after you have met any applicable deductibles.

Other Coverage

When you or a covered family member are covered by another insurance plan.

COB

This stands for Coordination of Benefits. If you or any of your dependents are covered by another benefit plan in addition to this one, then benefits will be coordinated between the various plans.

EOB

This stands for "Explanation of Benefits". This is the worksheet you receive after your claims have been processed.

COBRA

This stands for Consolidated Omnibus Reconciliation Act and governs your rights to continue coverage in the Plan after termination.

SPD

Summary Plan Description Booklet that explains the Plan Benefits.

Out of Pocket Maximum (O-O-P)

The out of pocket is the maximum amount of covered expenses, that will be paid by the member before the plan payment goes to 100%.

Contact

To send an e-mail with your benefit questions please click here>


HealthPartners Open Access finding care in your network

HealthPartners Employee Assistance Program