The following health trusts have access to our Regence BlueCross BlueShield of Oregon (Regence BCBSO) Preferred Network:

  • U.A. Local Union 290 Plumber, Steamfitter & Shipfitter Health Trust (U.A. Local Union 290) (group #70000003)
  • UFCW Local 555-Employers Health Trust (group #70000005)

Members traveling or residing outside of the Regence service area have access to the BlueCard PPO and Blue Cross Blue Shield Global Core networks.

Reimbursement for these members is based on your Regence agreement and provider servicing for participating providers remains with Regence.

Zenith American Solutions, the third-party administrator (TPA), provides claims administration, medical management and Customer Service for these members.

Identifying members

Easily identify members of these groups by their member cards. Included below are the prefixes and BlueCard suitcase logos that appear on the member cards:

  • U.A. Local 290: OUA (PPO in the suitcase logo)
  • UFCW Local 555-Employers Health Trust: OUF (PPO in the suitcase logo)

U.A. Local 290 sample member card

UA Local union 290 member card front

UA Local union 290 member card back

Eligibility, benefits and claim status

You can access member eligibility and benefits and claim information via the Availity Portal, the same as you do for your other Regence patients.

Note: Massage therapy for UFCW Local 555-Employers Health Trust (group #70000005) members is covered only when services are performed by a Practitioner (as defined by the group), which includes chiropractors, osteopaths and physical therapists. Services provided by a licensed massage therapist or massage therapist are not covered.

Pharmacy benefits

The following companies administer the pharmacy benefits for both retail and mail order prescriptions:

  • U.A. Local Union 290: Express Scripts
  • UFCW Local 555-Employers Health Trust: EnvisionRx

Pre-authorization

Our Commercial Pre-authorization List applies to U.A. Local Union 290 and UFCW Local 555-Employers Health Trust members.  Providers need to obtain pre-authorization from Innovative Care Management for these members online or by phone at (503) 654-9447 or 1 (800) 862-3338.

Claims submission and payment

Submit electronic claims for these patients with your other Regence patients.

Medical management

U.A. Local Union 290 and UFCW Local 555-Employers Health Trust members are excluded from Regence BabyWise, Physical Medicine, Radiology Quality Initiative and Sleep Medicine programs offered by Regence.

Customer service

Our Provider Contact Center and Provider Relations team supports providers for these members.

Non-participating providers should contact Zenith American Solutions at:

  • U.A. Local Union: 1 (866) 796-2305
  • UFCW Local 555-Employers Health Trust: 1 (866) 796-7623

Members should contact Zenith American Solutions at:

  • U.A. Local Union: (503) 486-2104 or 1 (866) 796-2305
  • UFCW Local 555-Employers Health Trust: 1 (866) 796-7623

Appeals

Provider appeals for these members follow the same process as provider appeals for other Regence members.

Appeals requested on behalf of these members need to be submitted to Zenith American Solutions within 180 days of receipt of the written notification of an adverse benefit determination. Please submit appeals on behalf of these members to:

Level 1 member appeals for U.A. Local 290 and all appeals for UFCW Local 555-Employers Health Trust:

Zenith American Solutions
Benefits and Claims department
Attention: Appeals Coordinator
12205 SW Tualatin Road, Suite 200
Tualatin, OR 97062

Level 2 member appeals for U.A. Local 290:

The Board of Trustees
U.A. Union Local No. 290
Plumber, Steamfitter and Shipfitter Industry
Attention: Appeals Coordinator
12205 SW Tualatin Road, Suite 200
Tualatin, OR 97062

For questions about member appeals, contact Zenith at the following phone numbers:

  • U.A. Local Union 290: 1 (866) 796-2305
  • UFCW Local 555-Employers Health Trust: 1 (866) 796-7623

For member appeals, Zenith will send a copy of the written determination to the member and provider. The Appeals for members section of our Administrative Manual includes this information.