SMBPAC



	Current Eligibility Period: Today's Date: Eligibility Information Current Status Patient Name Member ID Vision Plan Anthem Blue View Vision 866-723-0515 Dental Plan No Plan Medical Benefit Information In Network Out of Network Individual Deductible - $300 In Network / $600 Out of Network $ $ Family Deductible - $900 In Network / $1,800 Out of Network $ $ Individual out-of-pocket - $3,400 Max (In Network)- $3,900 Max (In Network) $ Family out-of-pocket - $6,800 Max (In Network)- $7,800 Max (In Network) $ Summary Plan Description: Plan A Plan B Retirees & Retirees with Medicare Unable to determine plan to show SBC Verification is not a guarantee of benefits or payment. Benefits are determined once the claim is received for processing. Benefit Plan Information Medical Plan Anthem Blue Cross PPO Network Group No. 170224M001 170224M002 No Plan Dental Plan No Plan Vision Plan Anthem Blue View Vision 866-723-0515 Pharmacy Benefits Express Scripts 800-340-3780 Medical Benefit Breakdown Dental Benefit Breakdown Verification is not a guarantee of benefits or payment. Benefits are determined once the claim is received for processing. Claims Mailing Addresses Services rendered inside of California and Nevada, mail claims to Anthem Blue Cross P.O. Box 60007 Los Angeles, CA 90060 Services rendered in states outside of California and Nevada, mail to Sheet Metal Workers' Health Plan of So. Cal., AZ & NV P.O. Box 10067 Manhattan Beach, CA 90267 Look up another patient Invalid Call Lookup Patient Eligibility Enter Patient Information Enter the ID number and birth date of a patient below to view current eligibility information. Member ID ID number (SM1XXXXXX) Patient Date of Birth MM/DD/YYYY Select a Patient The combination you have entered produced more than one possible patient. Please select the correct patient from the list below. To change patients, you will have to reenter their credentials on the search section and select the correct patient name. Important! If you make an incorrect selection, you will have to go back and re-enter the patient info.
Trust Fund Office Sheet Metal Workers' Health and Pension Plans of Southern California, Arizona & Nevada 111 North Sepulveda Boulevard, Suite 210 Manhattan Beach, CA 90266 P.O. Box: P.O. Box 10067 Manhattan Beach, CA 90266-8563 Phone Numbers: Toll-Free: (800) 947-4338 Direct Line: (310) 798-6572 Fax: (310) 798-0766 Loading Please wait while your PDF is loaded.