A. HOW TO FILE A CLAIM

Claims are paid in accordance with bills and forms supplied by Hospitals and attending Physicians. A Claim shall be considered to have been filed as soon as it is received by the Plan Office provided it is substantially complete, with all necessary documentation. If the form is not substantially complete, or if required documentation has not been furnished, the claimant will be notified as soon as reasonably possible of what information or documentation is necessary to complete the Claim. Claims must be filed within 24 months from the date of treatment. (See B.2 for definition of “Claim”.)

Have your Physician forward Claims directly to the Plan Office, 720 Market Street, Suite 700, San Francisco, CA 94102-2509; (415) 263-3670.

Medicare-eligible Retirees and their Medicare-eligible Dependents should have their Hospital and Physicians submit claims to Medicare first. After Medicare has made a payment, a copy of the Medicare Explanation of Benefits Worksheet should then be submitted with a Claim to the Plan Office for processing.