Frequently Asked Questions

The Prudent Buyer Network is a Preferred Provider Organization (PPO) that is owned and operated by Anthem Blue Cross of California. The Prudent Buyer Network (PPO Providers) is an organization that operates under contract with the Administrator to provide hospital, medical and surgical services at agreed upon allowances. Prudent Buyer providers are located in California.

Prudent Buyer Allowances is the dollar amount allowed for each particular type of medical service by Prudent Buyer Providers. Prudent Buyer providers (PPO) have agreed to accept the allowance as full payment for service for Self Funded PPO Plan members, although they will often list a higher fee.

Usual Customary and Reasonable (UCR) is a range of fees which are usually charged and received for the given treatment by doctors of similar training within the appropriate geographic area.

The lifetime maximum is the total “lifetime” amount of available benefits for you under the program. Each of your dependents have their own “lifetime” maximum. The restoration benefit is an amount of $1,500 per year which will be added back (restored) each year you are covered under the plan.

On an annual basis, you may seek the services of your provider to conduct a routine physical. A routine physical is a periodic comprehensive preventive medicine reevaluation and management of an individual.

The eligible reimbursed expenses will vary depending on the age, gender, history, examination, risk factor reduction interventions and ordering of appropriate immunizations, laboratory/diagnostic procedures.

For 2 times the retail co-pay, you receive 3 times the medication by using the Mail Order Service available through SavRX. It is common to use these services for ongoing needed medications.  Please contact SavRX directly at (866) 233-4239 for any questions regarding your prescription drug plan.

Your Administrator, United Administrative Services (UAS), and Anthem Blue Cross of California (Prudent Buyer Network) jointly administer and process certain claims utilizing the Prudent Buyer Network (PPO) discounts. After seeking services through a Prudent Buyer (PPO) network, your provider will send all necessary paperwork to Prudent Buyer (PPO), who will in turn work with UAS to provide the specifics of reimbursement. UAS will process the claim and send an explanation of benefits on how the claim was processed.

1.  You must have been an active eligible Participant in the Health and Welfare Plan for ten (10) out of the last fifteen (15) years and two (2) out of the last five (5) years immediately preceding the date of retirement.
2.  You must be receiving or have recently applied for pension benefits from the San Mateo County Electrical Construction Industry Retirement Trust (IBEW Local 617).
3.  You must be an active eligible participant in the San Mateo Electrical Workers Health Plan as of your retirement date for Retiree Health and Welfare coverage.
4.  You must be at least 55 years of age and eligible to retire under the San Mateo County Electrical Construction Industry Retirement Trust.
5.  If you otherwise qualify for early or regular retirement (except for reaching age 55) because of a total and permanent disability as determined by the Social Security Administration at any age you will be eligible for retiree health and welfare benefits upon paying the required premium.

Please contact the Trust Fund office for more information.

You should apply 90 days prior to your planned requested retirement date. Contact the Fund Office or the Union Office to obtain a retirement application. You must complete the application in full and provide all of the required documentation. Your requested retirement date can be no sooner than the first day of the third (3rd) month following the date the completed application is received by the Fund Office. Once the completed application is received by the Fund Office, it will be reviewed for completeness and your application will be sent to United Administrative Services (UAS). UAS will send you confirmation of your retirement date under the San Mateo Electrical Workers Health Plan. A denial letter will be sent if you do not qualify for the Retirement Plan.

If you have hours remaining in your hour bank when you retire, the hour bank balance is converted to dollars by multiplying the hours left in your bank by the contribution rate in force at the time of retirement. That dollar amount is then sent by the San Mateo Electrical Workers Health Plan to UAS to be credited to your account. UAS is the administrator of the San Mateo Workers Retirement Trust. UAS will contact you directly with the coverage available and the cost of retirement plan coverage.

Please contact United Administrative Services directly at (408) 288-4400 should you have any questions on your claim. Anthem Blue Cross cannot answer questions about your specific claim.