UFCW LOCAL 1776 and PARTICIPATING EMPLOYERS
                                  HEALTH and WELFARE FUND
 
Claim Filing Deadlines

In order for a claim to be considered for payment, it must be submitted within a certain time frame. Read the information in the following sections carefully to determine the specific claim filing deadline for each benefit. If you file a claim after the deadline, it will not be paid by the Plan. After you file a claim, it must be approved or denied within 120 days after it is received.

Allergy
Claims must be filed no later than 1 year from the date of service.

Dental
Claims must be filed no later than 1 year from the date of service.

Physical Well-Being Program
Claims must be filed no later than 90 days from the end of the calendar year in which the membership or participation in a program occurred.

Vision
It is the GVA participating provider’s responsibility to file the claim no later than 30 days from the date of service.