PAMCAH-UA Local 675 Health and Welfare

OptumRx – New Prescription Drug Benefits

Effective January 1, 2020, OptumRx replaced EnvisionRx as the PAMCAH-UA Local 675 Health & Welfare Fund administrator of our prescription drug benefits. Please ensure that you show your OptumRx prescription ID card to your pharmacy to ensure that benefits are properly covered. If you try to use your EnvisionRx card, your pharmacy claim will be rejected causing you to pay the full cost of the drug yourself. Please call the Trust Fund Office at (808) 536-4408 if you are having any disruptions in drug coverage, need assistance with reimbursements or have any other concerns regarding your drug plan. You may also contact OptumRx toll free at 1-844-265-1718.

Urgent Care and Emergency Room Coverage

The difference between Urgent Care and Emergency Rooms is the severity of the health problem. If the condition is life-threatening, such as difficulty breathing, stroke, or seizures call 911 or go to the emergency room immediately. If the condition is a minor illness or injury, take advantage of the convenience and affordability of a participating Urgent Care center. Your out of pocket cost for an emergency room visit will be much higher than a visit to an Urgent Care center. Emergency rooms prioritize life-threatening heath conditions while Urgent Care facilities can attend to your needs more quickly if you have a minor medical concern. Our plan covers 90% for both Emergency Room (as of 1/1/2020) and Urgent Care. For a listing of participating Urgent Care centers statewide, you can go on the HMSA's website, and search for "after hours care" for the flier on "Your Guide to After-hours Care."

An updated Summary of Benefits and Coverage was mailed out to each participant last November. For more information about your coverage, or to get a copy of the complete terms of coverage, call 1-808-536-4408.