local 272 welfare fund provider portal

We have served Taft-Hartley Trust . Comprehensive Professional Systems, Inc. Shoppers Pre-Medicare Retiree Assistance Program; UFCW & PE Health and Welfare Fund; UFCW & PE Legal Fund; UFCW & PE Pension Fund; UNITE HERE Local 25; Warehouse Employees Union Local . Employers Login update their provider list. .manual-search ul.usa-list li {max-width:100%;} Reference Laboratory Network effective August 1, 2010. Address Outside Philadelphia: 1-800-626-8144 www.ibx.com You must pre-authorize certain services or penalties will apply. Plumbers Welfare Fund, Local 130, U.A Attention: Health Portal Authorization 1340 West Washington Boulevard Chicago, IL. Pointers Cleaners & Caulkers-66 Insurance & Welfare Fund. Choose from a wide range of health plans customized to your needs. Vision Screening Please refer to the Eligible Medical Expenses chart in the Summary Plan Description for Plan A and Plan B coverage. To determine if the company has properly remitted to the Health & Welfare Fund on your behalf, you should contact the Eligibility Department at 1-800-523-2846 ext. If you are a medicare retiree, you are issued a separate card for your prescription benefit. Any vision care provider interested . For full details on our Prescription Drug Plan, please review the Summary Plan Description. Web Site: www.CignaPlusSavings.com, Medicare Wrap-Around Claims Processor 10236 Lake Arbor Way. The Local 272 Welfare and Pension Funds provide you and your family with health care benefits while you work in covered employment and with retirement benefits when you stop working and qualify for a pension. Milk Drivers Local 246; Operating Engineers Local 77; School Cafeteria Employees Local 634; UFCW Local 1500 Welfare Fund; UFCW Unions & Participating Employers. 1340 West Washington Boulevard The Clerk of the Court is instructed to close this case and . Subsequent claims must be made within 90 days of the week -ending for which benefits are payable. Pipefitters Local Union 597 Mental Health and Substance Abuse Resources, Welfare Fund Summary Plan Description (SPD), Welfare Fund Announcement Letters (since last SPD), Blue Cross Blue Shield of Illinois (Provider Finder). They will assist you in coordinating your mental health, substance abuse or personal assistance services. Local 272 who may be entitled to a Pension. Web Site:http://www.cpshearing.com/ . Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool on the Availity* Portal at https://www.availity.com. Comprehensive Professional Systems, Inc. Livongo Diabetes Management Program: This program provides beneficiaries with a free blood glucose meter, test strips, coaching, and everything else you need to manage diabetes, at no cost to you. 1904. Employee Assistance Benefits. Change your account settings; And much more; To view older claims (from 2016 and earlier), log onto the service portal at magnacare.com. P.O. . Attention: Health Portal Authorization When Payments Start Contact the Local 812 Fund Office for more . You can check an unlimited number of patients in one call. Providers may call the number on the back of the member . Phone: (516) 396-5500 Sprinkler Fitters install, repair and maintain fire sprinkler systems in industrial, commercial and residential buildings to protect lives and property. If the Fund Office receives contributions for 135 hours worked during one month, you will be eligible for benefits for one month, but three months ahead. Federal government websites often end in .gov or .mil. NEW YORK - Trustees to the Teamsters Local 272 Welfare Fund in New York City have agreed to amend the fund to resolve a lawsuit filed by the U.S. Department of Labor, regarding a fund requirement that participants bear 90 percent of the cost of medical and pharmacy claims above certain annual thresholds.. 200 Constitution AveNW P.O. Go to the following website to see if you have a pension coming: The documents below will help you understand the Welfare Fund benefits, The Summary of the Pension Plan will help you understand your Pension Benefits, These documents will help you learn more about the Plan. W33P ; WEPCO Federal Credit Union UFCW Local 27 . Warehouse . Click here for the requirements for reimbursement, Medicare Supplement Plan, Prescription Drug Plan, Mental Health and Substance Abuse Benefits Employee Assistance Program (EAP), Preferred Provider Organization (PPO) Medical Plan, Hearing Aid Plan, Personal Information Changes. All Rights Reserved. This information is intended only to provide highlights of the plans. 220 EAST 23rd STREET, ROOM 909, NEW YORK, NY 10010, PLEASE CONTACT US AT 212-726-9730 AND LISTEN TO THE INSTRUCTIONS. Therefore, it is important you check eligibility for each patient on the provider portal before performing a service. Patient eligibility can be verified using the Automated Information System. About Us. Analyze a variety of pre-calculated financial metrics Do I have to pay the balance on my bill from the doctor? LOCAL 272 WELFARE FUND HOME: WELFARE PLAN SUMMARY: NEWS: UPCOMING EVENTS: FORMS: USEFUL LINKS: ELIGIBILITY VALIDATION: TEMPORARY ID CARD: CONTACT US : . LEAN (Laborers Escaping Addiction Now) Recovery Program: If you or a family member is struggling with substance abuse or dependence, we can help. 50-02 Fifth Street, 2nd FloorLong Island City, New York 11101. 1 Dependent EligiblityYour dependents eligibility will start when your eligibility starts or on the date they become your qualified dependents. In addition to the original Diagnostic Quest, their network now includes the following: For a complete list of providers participating in Empire's reference laboratory networks, members can visit empireblue.com or contact the Provider Services Department at 800-552-6630. @media only screen and (min-width: 0px){.agency-nav-container.nav-is-open {overflow-y: unset!important;}} The U.S. Department of Labor will continue to investigate and seek remedies for potential violations.. Find additional information in our Summary Plan Description for complete details on qualifying events, who is eligible, important deadlines, and the length of time continuing coverage may last. Need to update your information? 202 to talk to a customer service representative. .cd-main-content p, blockquote {margin-bottom:1em;} Trustees Login. All Rights Reserved, UA Local 130 | Developed by. 1600 Stewart Avenue Workers must receive the healthcare benefits guaranteed to them by law. Call 1-866-250-8679 or fill out the form below. Express Scripts administers our prescription drug plan. This information is now available in a machine-readable format (in accordance with the rules.) * Availity, LLC is an independent company . Our medical plan ensures you and your family have the care you need to stay healthy. Go to Cigna's provider portal at Cignaforhcp.cigna.com. New York, New York 10005, Phone: (212) 675-5745 uhc salt lake city. New York Welfare Fund's (Fund) attention that some. Our Health and Welfare Coverage Plans provide unparalleled care at low cost to you. For providers to check claim status, the Provider must enter the Date of Service for the claim, Members ID number and the Providers ID number. Find company research, competitor information, contact details & financial data for Pointers Cleaners and Caulkers Welfare Fund of Rego Park, NY. 1016. Park Ridge, IL 60068-4244 Salt Lake City, UT 84130-0757 Get reviews, hours, directions, coupons and more for Local 272 Pension & Welfare Fund at 220 E 23rd St, New York, NY 10010. Call 1-800-765-4239. 212-924-0002 three rivers provider network. NASI - Welfare Fund - Service Providers Medical Benefits. Welfare Fund Provider/Links. It can help you with family difficulties, marital stress, child and adolescent concerns, illness of a family member, financial pressure, job stress, or alcohol and drug abuse. We know that vision is one of the tools of the trade. Find a vision provider or confirm that your current provider participates in the Davis Vision network: The amount of coverage for exams, lenses, frames, and coatings will depend on whether you are visiting a Davis Vision Care provider or using your own provider. Plans and their trustees must ensure they comply with these important health care protections for workers. To order a new prescription drug card, contact Express Scripts at 1-800-467-2006. 1 Welfare Fund 50-02 Fifth Street, 2nd Floor Long Island City, NY 11101 Phone 718 - 223 - 4313 718 - 835 - 2700. From underground installations to final connections of fixtures and equipment, a plumber is required to have all the physical and mental skills needed to get the job done right the first time. Is a pre-certification required for an inpatient admission? Express Scripts administers the prescription drug benefit. To locate a participating provider or for questions regarding your dental benefits and claims, please contact Careington Dental at (800) 400-8789 or click on the www.careington.com link on the right side of the page to connect to their website. P.O. If you have questions about which drugs require pre-authorization, only your physician should contact Express Scripts at 800-417-8164 or send a fax to 800-357-9577. Plan A and Plan B include identical coverage for prescription drugs. Contact Lower Hudson Valley EAP directly at 914-245-6300 or 800-EAP-2799. The system will provide the results via voice response or fax request. DDS Inc., will continue to. If you go to a non-participating dentist, you must return a dental form (available at DeltaDentalMA.com) within 90 days of the date of service to Delta Dental. SMW 36 Benefits. Phone: (301) 731-1050 Toll Free: (800) 929-EWTF (3983) Fax: (301) 731-1065 . You and your doctor must FULLY complete a Providers Green Claim Form and return that completed form to the Fund Office within 90 days of the date your disability began. Women Health Cancer Rights Act. PLEASE CONTACT US AT 212-726-9730 AND LISTEN TO THE INSTRUCTIONS. Welcome to Local 272 Welfare and Pension Funds Website, WE ARE LOOKING FOR PAST MEMBERS OF LOCAL 272, WELFARE SUMMARY PLAN DESCRIPTION AND SUMMARIES OF CHANGES, Local 272 WF SMM effective December 1, 2022UD (0 (7), Local 272 WF SMM effective March 1, 2023 (007 (1). ASP Benefits provides Teamsters a Health & Welfare and Pension Plan they can count on. EDI Support. Box 853901 Walsh v. Board of Trustees of Local 272 Welfare Fund and Local 272 Welfare Fund, 22-cv-592 (S.D.N.Y August 2, 2022) This case involves a suit filed by the U.S. Department of Labor (DOL) against a Taft-Harley welfare plan and its trustees alleging violations of certain amendments that the Affordable Care Act (ACA) made to ERISA. Matthew Bruccoleri, Secretary-Treasurer HEALTHCARE PROVIDER PORTAL. The Federal Government recently issued rules that require certain group health plans to disclose particular pricing information. Learn more about leasing our PPO network >. You can access it here. Chattanooga, TN 37422-8037, Phone:(800) 244-6224 Your medical benefit . The above options are for your provider. If you use a participating Davis Vision provider, there is no need to file a claim. Copyright 2006-2016 IUOE Local #542. Can I use my Cigna card for prescriptions? Local 272 Welfare and Pension Fund. Providers. Annuity Fund Information. Offer your members high-quality healthcare where they live and work. Chicago, Illinois The Laborers Support Network is available to listen and help you stay strong for your family. Eligible participants and their eligible dependents of the Welfare Fund Plan of the International Union of Operating Engineers, Local 15, 15A, 15C and 15D, are entitled to certain benefits. Local 670 Welfare Fund Provider Portal. Just use our lookup by address feature at the top of the page or click on the our interactive map to access your needed zip code. It does not contain complete Plan provisions. Dental Plan . The App will open a whole new world to your benefits. For the providers listed above contact information go to Links on this website. 250 South Northwest Highway, Suite 340 Please call 1-888-881-5462. Open 8am - 5pm | Monday - Friday. P.O. If you should have any questions concerning your eligibility or coverage under the plan please do not hesitate to contact the Welfare Fund . Box 3223 The consent judgment, filed in the U.S. District Court for the Southern District of New York, followed an investigation by the departments Employee Benefits Security Administration. Get reviews, hours, directions, coupons and more for Local 272 Pension & Welfare Fund. Our new provider, Amplifon Hearing Health Care, offers significant savings on hearing aids and services at convenient locations. Your secure login gives you 24/7 access to your personal benefits details and status, as well as important plan documents and updates. Most employers that provide a Health Care Program, require the spouses to participate in separate programs to have the health care programs share the cost of the health care services. Follow the prompts to obtain the desired information. UA Plumbers Local 5 Medical Fund Health & Wellness Center. Under Plan A and Plan B, the Fund will pay 80% of the providers charge, up to a maximum benefit of $50 per visit, with a limit of 30 visits per calendar year. Suite #4 You must precertify treatment or benefits will not be paid. Vision Benefits Your vision benefit network is provided by VSP. Contact UsLocal 338 members can easily contact staff through direct message, including your Union Representative and members of our Health & Welfare Fund, by logging in to your "My Local 338" account.If you would like to speak to a member of Local 338's staff, please call our main office at (516) 294-1338 and use the appropriate extension listed below. If you visit one of their providers, you will not have to pay anything out of pocket. Welcome to the Plumbers Local Union No. PHONE/FAX. Contact the Fund Office at 914-737-7220 extension 121. The actions by the Teamsters Local 272 Welfare Fund and its trustees denied the funds participants and beneficiaries the healthcare benefits guaranteed to them by law. 718 223 - 4313 Date of Service : January February March April May June July August September October November December 730. Our workforce takes pride in partnering with our signatory contractors in providing sophisticated piping systems to the end user. Health Benefits Information Health Provider Links. Non-spousal Dependent Maternity is not covered. If you use a non-participating pharmacy, you must file a claim within 90 days from the date of purchase. Phone: 419-666-4450 Send your request to [emailprotected] or call 888.624.6202. We currently serve over 250 clients representing over 500 Trust Funds across the United States with participants in almost every state of the US & Canada. Contact Express Scripts for a claim form atExpress-Scripts.com or 800-467-2006. BeneSys has provided Taft-Hartley Trust Fund Administration and I.T. If you are a Home Care Worker, Child Care Provider, Personal Assistant or Nursing Home Worker, contact the SEIU Healthcare IL Benefit Funds office to learn more about your Insurance Health Plan or enrolling. What is the chiropractic benefit after deductible? The credentialing process takes between 6-8 weeks, at which time you will be notified of the determination. Or FAX it to: (312) 421-6724. American Health Holding, Inc. 100 W. Old Wilson Bridge Rd. If you and your doctor do not FULLY complete the claim form, it will be rejected. A MEDICAL PROVIDER CAN CHECK YOUR ELIGIBILITY AND FIND THE STATUS OF A . BEGINNING MARCH 1, 2023, THE COPAYS WILL INCREASE TO $35 FOR ALL MEDICAL VISITS THAT WERE PREVIOUSLY $25 OR $30.. ALL OTHER PROVISIONS OF THE PLAN REMAIN IN EFFECT. Submit your inquiry to [emailprotected]. Welfare Fund Fax: 312.829.0137, Fund Office Get the latest business insights from Dun & Bradstreet. Both plans provide coverage for medical and mental health care, dental benefits, vision care, and prescription drugs. Your prescription information is on one side and the other side is your medical, mental health, and Vision information. Welfare Fund Provider Links. Optum Contact LSN at 1-800-522-6763. The department alleged in the alternative that the 90 percent cost-sharing requirement constituted an annual limit, in violation of ERISA and the ACA. Find a Provider: select the OAP (open access plus) network. ERISA and the ACA generally prohibit annual limits on benefits for participants in group health plans. [email protected], Normal Business Hours The Chicago Journeymen Plumbers Local Union 130 UA, with over 6,000 members, is one of the largest straight-line plumbing locals in the United Association (UA) International Union who represents 350,000+ building tradesmen across the United States and Canada. Within 48 hours, our team will email you our contracting packet that includes the standard individual contract, application, and sample fee schedule. You already have Teladoc as part of your benefits. #views-exposed-form-manual-cloud-search-manual-cloud-search-results .form-actions{display:block;flex:1;} #tfa-entry-form .form-actions {justify-content:flex-start;} #node-agency-pages-layout-builder-form .form-actions {display:block;} #tfa-entry-form input {height:55px;} Pipefitters Local Union 597 Chicago, Illinois Phone: 312.829.4191 Fax: 312.829.0137. services since 1979. Or call the funds office and we can mail you a directory. The site is secure. If you have not received an Explanation of Benefits for the services on the bill, your provider must resubmit the bill. Medicare Retiree Benefit Program. Comprehensive Professional Systems, Inc. P.O. In an effort to control costs and make the most of your healthcare dollars, the Fund thoroughly investigates all medical claims for potential third party liability (i.e. The plan gives you access to the online weight loss and nutritional counseling programReal Appeal. Main Line: 773-385-9300. Get answers to all your benefits questions 24/7 from anywhere! Hopatcong, New Jersey 07843 Basil Castrovinci Associates, Inc Actuaries and Administrators (973) 601-3828 (201) 963-9600 338 magna. The Fund is not always liable for payment and we look for the order of responsibility. Telephone (301) 899-7861, ext. Vision Screening Customer Service ; 410-444-8516. Find a provider; View your ID card; Track your deductibles and out-of-pocket costs; Check your eligibility; Review your plan details, including medical, dental, vision, etc. 11 Hanover Square, 8th Floor IF YOU NEED COVERAGE INFORMATION, PRESS 1 AT THE BEGINNING OF THE CALL PICKUP. If you use a participating retail pharmacy or the mail-order service, you do not need to file a claim. Local 26 IBEW-NECA Joint Trust Funds 10003 Derekwood Lane, Suite 130 Lanham, MD 20706-4811. Rossford, OH 43460 Our Interactive Voice Response system (IVR) is available 24 hours a day, 7 days a week. As a participant of the Welfare Fund, our members have a comprehensive benefit package that is self administered and self funded. Phone: (800) 652-0063 You have the right to appeal any benefit determination-contact the Benefit Office for information on how to do so. Unsure which region to choose? Assistant Mgr (212) 726-9730 . Locate the correct postal codes for North Sumatra in the list above by clicking the destination region you are sending to. The Board of Trustees is pleased to announce an enhancement to the Health Plan. Please refer to your explanation of benefits (EOB) or wait for the provider to bill you. Chicago, IL. NY Welfare Fund - Dental. We have consistently demonstrated cost savings for our clients while maximizing health and wellness for their members. Address Subscribe Unlock nonprofit financial insights that will help you make more informed decisions. First, with the new 90 percent cost-sharing requirement, the fund lost its grandfathered status, then failed to cap participants annual out-of-pocket expenses, as the ACA requires. If you are prevented from working due to an injury or illness, our Weekly Accident & Sickness Benefit may be able to help replace lost income. Whats New. If you go to a provider in the Cigna Network, there is no need to file a claim. local 272 welfare fund magna. Phone: (212) 675-5745 Many services do require a pre-certification. Centereach, New York 11720 29 blasters & drillers & minors. Social Security Administration (SSA), Phone: (800) 772-1213 Need help with verification? div#block-eoguidanceviewheader .dol-alerts p {padding: 0;margin: 0;} Address Web Site:http://www.cpsoptical.com/, Dental Benefits Include your office name, specialty, location, and contact information. If you need clarification on a patients coverage, contact Provider Services at 800.352.6465. EyeMed administers our vision program. Browse for plan benefits and documents, or Login for your detailed Plan information. Health Reimbursement Account (HRA) Local 272 members are spread out, with 7,500 members across 1,500 different garages, but they are bound together by a strong sense of solidarity. Alexis Gonzalez, Trustee, 265 West 14th Street Benefits will be paid at 80% of Cigna PPO allowance (after Deductible). 21st Annual Employee Benefit Fair - Save the Date. Phone: (866) 831-4336 For complete details on any of the following topics, please review the Summary Plan Description. Phone:(877) 521-0244 Fred Alston, President Copyright 2023 Local 272 Welfare and Pension Fund - All Rights Reserved. Vacation & Sick Leave Fund Information. 36 Hopatchung Road. Teamsters Local 282 is a New York City & Long Island based local union dedicated to providing union representation and fund benefits to a wide range of industry workers. Cardiovascular equipment like treadmills and bikes, Strength-training equipment like free weights and weight machines, Gymnastics, tennis, aerobic, spin, barre, or kickboxing. Suite S . 2023, Pipefitters Local Union 597, All Rights Reserved. The Company offers pension, retirement, health, and other related funds. If you still have an issue locating a provider in your area, you can call directly. 220 East 23rd St, Room 801. 2023 Brighton Health Plan Solutions. UFCW National Health and Welfare Fund ; 66 Grand Ave . Technical Support How do I request a new card (medical, dental or prescription drug)? Learn more about EBSA and the Affordable Care Act. .agency-blurb-container .agency_blurb.background--light { padding: 0; } 50-02 Fifth Street, 2nd Floor Log on to our provider portal to research fee schedules, check your participation status, check member eligibility, and more. Eddie N. Rivera, Trustee These services must be pre-authorized or your claim will be denied. Provider EFT Authorization Form. Locating a Sele-Dent provider is fast, easy and simply visit www.Sele-Dent.com or call one of their courteous benefit analysts at 1 . Our workforce takes pride in partnering with our signatory contractors in providing sophisticated piping systems to the end user. local 30 trust fund engineers magna. By accepting our use of cookies, your data will be aggregated with all other user data. 1375 Virginia Drive, Suite 245 Ft. Washington, PA 19034. Address Request information regarding missing hours by contacting the Fund Office Collection Department at: 718 835 2700. You can access the directory atwww.frontpathcoalition.com. Pension Trust Fund Information. Contact [emailprotected] for assistance. Web Site: www.Caremark.com You may also visit www.lowerhudsonvalleyeap.com. In order to check the status of your claims for one or more of our members, you will need to first create an account. (Please talk to your insurance agent about increasing your medical coverage.). If in reviewing any Explanation of Benefits provided to you from MCTWF, or any of its vendors, you identify possible fraud, please contact the appropriate toll free Anti-Fraud Hotline as follows: For Medical Professional or Vision Claims: ( 800) 637-6907. When a member/dependent has any injury, we request information on how that injury happened. We cover both generic and brand-name prescription drugs for delivery and at major retail pharmacies. Web Site: www.visionscreeninginc.com, Vision Benefits A trusted partner to plan sponsors, TPAs, and carriers for more than 30 years, MagnaCare achieves exceptional value for clients and their members through highly customized, innovative healthcare solutions. Annual Certification of Medicare Part D. Medicare Part D RX Creditable Coverage Notice. Telligen Maternity Program: Through this program, you can access support from pregnancy to early childcare, receiving your own dedicated maternity nurse, valuable education and resources, and a personalized action plan to support a healthy mother and baby. Our U.S. board-certified doctors can diagnose, treat, and even prescribe medicine, if needed, for a wide range of medical needs, including the flu, allergies, rash, upset stomach and much more. Legal Services Fund Information pdf Group Life Insurance Policy (174 KB) Board of Trustees. 29 blasters & drillers & minors. For more information on your benefits, please download the Health & Welfare Funds Summary Plan Description. The Trustees retain the right to enhance or reduce benefits and/or eligibility criteria. COVID-19 Information for Participating Providers, Mail: PART_ACCESS - Basil Castrovinci Associates. . Well give you the support you need. Click here to learn more about Real Appeal. Click on the link below and create an account or call us at (312) 970-1122 to get started! For any additional questions, please call (312) 970-1122. Please refer to the appropriate Summary Plan Descriptions for important information and complete details. If a response is not received, payment for your related medical claims will be retracted and you will become responsible for the full amount. Your spouse or adult beneficiaries can get their own free account, too. When retired, our Health & Welfare plan (if eligible) requires you and/or your spouse to have Medicare A & B when eligible. Phone: (844) 884-1852 Your provider should submit the claim to the HMC Healthworks at the following address: HMC HealthWorks Teamsters Local 272 represents workers in parking garages within the New York City region. uhc onalaska. Toll-Free: 877-734-8543 (877-SEIU-KID) Pension (Nursing Home Workers only), dial ext. Let us know when you: get Married or Divorced, have a child, or move. Garden City, NY 11530. Empire Blue Cross & Blue Shield A full-service health club with a variety of exercise equipment, including: You can also be reimbursed for class fees at a studio with instructor-led group classes such as: You cannot receive the fitness reimbursement for expenses towards personal training, lessons, coaching, equipment, clothing, or any of the clubs below: The Plan provides coverage for medical nutrition counseling with a 12 visit per calendar year maximum. ol{list-style-type: decimal;} This benefit covers therapies not previously covered by the Health Plan. Local 272 Welfare Fund provides welfare funds. (Ex. 41-61 Kissena Blvd. 4755 Walden Lane. .h1 {font-family:'Merriweather';font-weight:700;} You may continue to receive care from non-contracting providers, however you will be responsible for charges in excess of the Plans Usual, Customary, and Reasonable amount. If your provider has to file an inpatient and/or outpatient claim for substance/alcohol abuse, or nervous/mental illness, you must have the service pre-authorized by HMC HealthWorks. As always, please feel free to contact the Benefit Office at (800) 741-9249 if you have any additional questions or concerns. Web Site: www.Caremark.com .table thead th {background-color:#f1f1f1;color:#222;} Teamsters Local, 272 et al, No. Summary of Benefits and Coverage Plan A, Summary of Benefits and Coverage Plan A (Portuguese), Summary of Benefits and Coverage Plan A (Spanish), Summary of Benefits and Coverage Plan B, Summary of Benefits and Coverage Plan B (Portuguese), Summary of Benefits and Coverage Plan B (Spanish), Fitness Reimbursement (English & Spanish), Laborers Recovery Program Continental Portuguese, Buprenorphine / Naloxone Prior Authorization Form, HMC (Member Assistance Program)- Username: MALAB.

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