Shared Administration contact list Form

054446 (01-01-2026)

Shared Administration Contact List Prefix
Trust Name Contact Information AGL International Union of Operating Engineers Local 701 • Benefits and Eligibility: 866-697-5750 • Provider Customer Service: 800-713-5373 • Vision (VSP): 800-877-7195 • Pharmacy: 855-295-9140 • Pre-cert (MRC): 800-827-5058 EGN International Union of Operating Engineers Locals 302 and 612 • Benefits and Eligibility: 877-441-1212 • Provider Customer Service: 800-713-5373 • Dental: 800-735-7053 • Pharmacy: 866-887-0234 • Vision (VSP): 800-877-7195 • Telemedicine (SwiftMD): 877-999-7943 • Pre-cert (First Choice Health): 800-986-9156

F3B Frontier • Benefits and Eligibility: 855-258-2604 • Provider Customer Service: 800-713-5373 • Pharmacy (CVS): 800-364-6331 • Pre-cert Medical: 877-867-7604

FIT Northwest Plumbing and Pipefitting Industry Health • Benefits and Eligibility: 866-417-4240 • Provider Customer Service: 800-713-5373 • Delta Dental: 800-554-1907 • Pharmacy: 866-818-6911 • Telemedicine (Teladoc): 855-332-4059 • Pre-cert (Comagine Health): 800-783-8606

HWY North Slope Borough School District • Benefits and Eligibility: 855-265-6465 • Provider Customer Service: 800-713-5373 • Pharmacy: 800-424-0472 www.magellanrx.com • Pre-cert: 877-379-4840

IEH Inland Empire Teamsters Union • Benefits and Eligibility: 800-872-8979 • Provider Customer Service: 800-713-5373 • Pharmacy Help Desk: 888-655-0143 • Pre-cert: 800-862-3338 https://www.innovativecare.com/ • Teladoc: 855-332-4059 INB Inlandboatmen’s Union • Benefits and Eligibility: 800-547-4457 • Provider Customer Service: 800-713-5373 • Moda Health Rx/WPDP: 800-913-4311 • Teladoc: 855-332-4059 • Pre-cert: 800-862-3338 https://www.innovativecare.com/

054446 (01-01-2026)

• Innovative Care Nurseline: 800-971-2680

LIT Puget Sound Electrical Workers Healthcare Trust • Benefits and Eligibility: 866-314-4239 • Provider Customer Service: 800-713-5373 • Dental: 800-735-7053 • Pharmacy (EnvisionRxOptions): 800-361-4542 • Telemedicine (Teladoc): 855-332-4059 • Pre-cert: (Comagine Health) 800-783-8606

MNW Masonry Security Plan of WA • Benefits and Eligibility: 866-312-4591 • Provider Customer Service: 800-713-5373 • Pharmacy Customer Service: 866-818-6911 • Pre-cert: 800-862-3338 https://www.innovativecare.com/

MTU Montana Teamsters • Benefits and Eligibility: 866-312-4593 • Provider Customer Service: 800-713-5373 • Pharmacy Services: 866-818-6911 • VSP (www.VSP.com): 800-877-7195 • Teladoc: 855-332-4059 • Pre-cert: 800-862-3338 https://www.innovativecare.com/

NCT Northwest Metal Crafts Trust Fund • Benefits and Eligibility: 866-312-4592 • Provider Customer Service: 800-713-5373 • Pharmacy: 800-467-2006 • Pre-cert: 800-862-3338 https://www.innovativecare.com/

NQF NW Roofers and Employers Health and Security
• Benefits and Eligibility: 800-331-6158 • Provider Customer Service: 800-713-5373 • Vision (VSP): 800-877-7195 • Pharmacy: 844-265-1719 • Pre-cert: 800-862-3338 https://www.innovativecare.com/ NXW Northwest Ironworkers • Customer Care: 855-847-1025 • Benefits and Eligibility: 866-986-1515 • Provider Customer Service: 800-713-5373 • Vision (www.VSP.com): 800-877-7195 • Customer Care Phone Number: 855-847-1025 www.navitus.com • Telemedicine (Teladoc): 855-332-4059 • Pre-cert: 800-862-3338 https://www.innovativecare.com/

PPS Puget Sound Benefits Trust • Benefits and Eligibility: 800-331-6158 • Provider Services: 800-713-5373 • Teladoc: 855-332-4059 • Pharmacy: 800-467-2006 www.express-scripts.com
• Pre-cert: 800-862-3338 www.innovativecare.com

054446 (01-01-2026)

R3 Teamsters Retirees • Benefits and Eligibility: 800-692-5179 • Provider Services and Prior Authorization: 888-742-1484 o View Clinical Review by Code List o This group does not use eviCore. o This group only uses AIM for Radiation Oncology and Genetic Testing • Mail Order Pharmacy: 855-873-8739 • Pharmacy Benefits: 800-788-2949 • Provider Recognition Program/GoldCard – Programs where Premera collaborates with contracted providers to manage utilization of selected medical services.

S4V Savers Inc.
• Benefits and Eligibility: 833-440-4370 • Provider Services and Prior Authorization: 888-742-1484 o View Clinical Review by Code List o This group does not use eviCore. • Pharmacy (Express Scripts): 800-922-1557 • Member Support: 833-743-3224 • Member Support Espanol: 833-440-1635 • EAP: 888-881-5462 • Premera NurseLine: 800-242-2178 • Provider Recognition Program /GoldCard – Programs where Premera collaborates with contracted providers to manage utilization of selected medical services.
SRR Sound Health & Wellness Trust • Benefits and Eligibility: 206-282-4500 or 800-225-7620 • Provider Customer Service: 800-713-5373 • Pharmacy WellDyneRX Customer Service: 888-479-2000 • VSP Member Service: 800-877-7195 • Delta Dental of Washington: 800-554-1907 • Pre-cert: Telligen 866-758-4010 TMP Washington Teamsters • Benefits and Eligibility: 800-458-3053 • Provider Services and Prior Authorization: 855-784-4561 o View Clinical Review by Code List o This group does not use eviCore. o This group only uses AIM for radiation oncology and genetic testing. • Prescription Benefits: 800-788-2949 • Mail Order Pharmacy: 855-873-8739 • Dental Benefits: 800-554-1907 • Vision Benefits: 800-732-1123 • Provider Recognition Program/GoldCard – Programs where Premera collaborates with contracted providers to manage utilization of selected medical services.

TQA Teck American Incorporated • Benefits and Eligibility: 877-330-3759 • Provider Customer Service: 800-713-5373 • Pharmacy Customer Service: 866-333-2757 • Vision (www.VSP.com): 800-877-7195

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• Dental Providers: 800-942-0854 • EAP: 800-433-7916 • Pre-cert: 855-240-3692

TST Northwest Laborers • Benefits and Eligibility: 800-826-2102 • Provider Services and Prior Authorization: 888-742-1484 o View Clinical Review by Code List o This group does not use eviCore. • Pharmacy Customer Service: 833-307-1465, www.cap-rx.com

• Vision (www.VSP.com): 800-877-7195 • Delta Dental of WA: 800-554-1907 • Willamette Dental: 855-433-6825 • Premera 24-hour NurseLine: 800-755-0011 • Teladoc: 855-332-4059 • Provider Recognition Program /GoldCard – Programs where Premera collaborates with contracted providers to manage utilization of selected medical services.

UMX United Employees Benefit Trust • Benefits and Eligibility: 800-223-2449 • Provider Customer Service: 800-713-5373 • Pharmacy: 877-829-9961, www.VytlOneMembers.com

• Teladoc: 855-332-4059 • Pre-cert (www.innovativecare.com): 800-862-3338 • Innovative Care Nurseline: 800-845-8905

Y2D Laborers AGC Trust of Montana • Benefits and Eligibility: 509-534-0600 or 800-872-8979 • Provider Customer Service: 800-713-5373 • Pharmacy: 800-692-5263, TDD 800-899-2114 • Pharmacist Only: 800-824-0898 • Pre-cert: 800-862-3338 www.innovativecare.com

ZFF Spokane Fire Fighters Benefits Trust • Benefits and Eligibility: 888-563-0665 • Provider Customer Service: 800-713-5373 • Pharmacy (Save-Rx): 800-228-3108 • Teladoc: 855-332-4059 • Pre-cert: 800-862-3338 https://www.innovativecare.com/