I.B.E.W LOCAL 701 BENEFIT FUNDS
ALWAYS AT YOUR SERVICE

28600 Bella Vista Parkway, Suite 1110
Warrenville, IL 60555-1500
Phone (630) 393-1701   Fax (630) 393-3615
info@ibew701fbo.com


 

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Remember using the PPO (Blue Cross Blue Shield of Illinois), Sav-RX  (Prescription Drug Card& Mail Order Programs), NVA (National Vision Administrators) saves you and the Fund Money.

  1. All BCBS PPO Physicians MUST submit ALL Medical Claims to:
    • Blue Cross and Blue Shield of Illinois
    • P.O. Box 805107
    • Chicago, IL 60680-4112
    • Group No: P81221 BS Plan Code: 621 BC Plan Code: 121
    • Non-PPO, Dental and Dental Claims  are mailed to the Fund Office.
    • Vision Claims are sent to NVA Office
      PO Box 2187 Clifton, NJ 07010
      Sponsor #1090
      Phone 1-800-672-7723
  2. We require one completed BLUE Universal Claim Form (entire front side including signatures) on file per calendar year, per family.
  3. Promptly Return Requests for Additional Information.
  4. An itemized bill along with an Explanation of Benefits (EOB) is required for all family members covered by other insurance (including Medicare).
  5. ALL Accidents and Injuries require a completed White Claim Form with accident details (when, where and how the accident occurred).
  6. Original Bills must be submitted; balance due statements are not accepted as a claim.
  7. Dental Claims require an Annual Blue Claim Form on file.
  8. Vision claims require the original bill which indicates full description of vision services and provider tax id with each Claim along with an Annual Blue Claim Form on file..
  9. Full Name(s), Social Security Number(s), Date(s) of Birth, Date of Marriage, and Current Address is required on Health & Welfare Beneficiary Cards.