First, all claims MUST be submitted through your health insurance under Wisconsin Electrical Employees Health & Welfare Plan (the “Fund”). You will receive an Explanation of Benefits (EOB) when the Fund Office process’s your claim. This EOB must be attached to the Flexible Benefit Reimbursement Form. If you have secondary insurance, their EOB must also be included. If you do not have the optional benefits (dental or vision) and wish to file for reimbursement under your flex account you can handle it one of two ways:

1. Run the claim through the Fund Office and receive an EOB stating the claim was denied as you do not have this benefit or;
2. Submit your Flexible Benefit Reimbursement Form with a copy of the itemized bill and state on the front page that you do not have the optional dental and/or vision benefit and require reimbursement.

If filing for prescription co-pays just attached the copy of the prescription receipt which should indicate the co-payment amount you paid. Refer to pages 38 through 39 in your Summary Plan Description Booklet for additional limitations and exclusion under the Flexible Benefit Reimbursement Program.

1. A better option for child immunization shots, even adult flu shots, is to get these shots at your County Health Office where they cost $6 to $9 as opposed to over $100 at your Doctor's office. As you can see there is quite a cost difference, although always remember where you receive your health care is your decision.
2. Notify your Provider that you have a routine benefit and your diagnosis must be coded as such, otherwise your claim will be processed under your medical benefits and subject to your deductible and co-pay. In order to be changed from medical to routine, the Fund Office requires the treatment notes for that date of service with a "Corrected Claim" sent to our attention for reconsideration. The Fund will not pay for those records.