FAQs

What do I do if my address changes, if I get married, divorced, have a child or adopt a child?

If you need to change your address, phone number, or email address click here to go to MySoundHealth. If you have changes to your family coverage, call the Trust at (206) 282-4500 or (800) 225-7620.

How do I file a claim or appeal?

If you wish to file a claim for medical, dental, vision, and weekly disability (time loss) benefits or if you are dissatisfied with an eligibility determination, benefit denial, or partial benefit award or any other adverse benefit determination by the Trust, you must follow the appropriate procedures. Click on the link below for all the details. Call the Trust at (206) 282-4500 or (800) 225-7620 with any questions.

• Procedures for Filing Claims and Appeals (PDF)

What can I do if I am encountering problems viewing the Sound Health & Wellness website?

If you are viewing the website using Internet Explorer 6 or older you may encounter issues viewing the website. Please visit http://www.microsoft.com/windows/downloads/default.aspx to download the latest version of Internet Explorer.

What is MySoundHealth?

This is the password-protected section of the web site for Sound Health & Wellness Trust participants. It allows you to log in once to securely view different types of personal information. This functionality requires you to log in and register for a User Name and Password.

What information can I view with MySoundHealth?

Once you log in with your User Name and Password, you will be able to access:

• Personal health information, eligibility, work history, claim history and pension information (if applicable)
• Personal Health Assessment
• Online resources and tools
• Quit Tobacco Coaching Program
• Health Reimbursement information
• Behavioral Health Online

How do I get a User Name and Password?

Click the “Register” button on the home page. Fill in the requested information and choose your user name and password.

Should I complete the personal health assessment if I’m already healthy?

Definitely. Although genetics and environment play important roles in your health, your habits and behaviors cannot only affect the way you feel today, they can also contribute to a longer, healthier life. So even if you feel great, taking the PHA may uncover valuable information that can help you enjoy even better health.

How often can I submit a Personal Health Assessment?

The PHA is offered every year for a limited time. You and your covered spouse must each complete and submit a PHA each year during this time period to receive a portion of your HRA funding. If you and your spouse do not complete the PHA your deductible will be higher. You can also go back to StayWell Online throughout the year to the “What If” section to see the effects of your healthy changes and see how your health risks have changed.

What’s my incentive if I take my PHA?

When you, as the employee participant, complete the PHA and update your contact information, during the available time period, up to $300 will be credited to your HRA account. If you have an enrolled spouse, when they take the PHA during the available time period, the same amount will also be credited to your HRA account. If you and your eligible spouse do not take the PHA, your deductible will be higher.

What happens if I do not complete the PHA? What happens if my enrolled spouse does not complete the PHA?

If you, as the employee participant, do not complete your PHA, you will not receive part of your HRA funding. As a result, your deductible will be up to $300 higher. If you have family coverage, and neither you nor your spouse completes the PHA, your deductible will be up to $700 higher.

Why is it important to take the PHA?

The Trust is continuing to encourage and reward healthy behaviors among our plan participants. We want to get as much participation as possible in our wellness programs. These programs are designed to give employees and their families direct access to the medical expertise, information and personalized support they need to make better health decisions and enjoy healthier, happier lives. With healthier employees and families come lower medical costs, which allows us to continue offering excellent medical coverage.

What if I don’t know the answers to all of the questions?

If you don’t know some of the answers to the questions (blood pressure, cholesterol, etc.), you may leave them blank. The only required screening measurements on the PHA are height and weight. However, the more questions you answer, the more tailored and useful your results will be.

How soon after I take my PHA will the additional credit show up in my HRA account?

When you or your covered spouse complete the PHA and any other necessary steps, the additional credits will be put into your HRA account at the beginning of the following calendar year.

Is my privacy protected?

Yes. Any information you supply is completely confidential, protected by federal law, and cannot be shared with the Sound Health & Wellness Trust, the union or your employer without your permission.

Based on your answers to the questions in the PHA, you may be contacted by phone or mail to participate in a number of other voluntary programs that are relevant to your situation and health status. For example, you may be contacted about a quit smoking program, a health coaching program to work on a particular area of concern such as exercise or nutrition, or a program to help manage a chronic condition such as diabetes.

Please be aware that information on your health status and health conditions is shared only with the independent service providers that manage the programs and is not shared with the Trust, the union or your employer. By law, this information cannot be used to determine or deny health care coverage.

How do I take the Personal Health Assessment?

During the available time period, the fastest way is online. If you are not already logged in, you will be asked to log in to MySoundHealth. If you do not yet have a user name and password, or if you’ve forgotten your password, see the bullets at the bottom of the log in box and click on “Forgot your password?” or “Haven’t registered?”. Once you’ve logged on, simply follow the instructions to complete your assessment. When you’ve finished, click “Submit,” and your personal plan will be displayed online in just a few moments.

If you don’t have web access, call (877) 362-9969, option 6, to request a paper PHA.

Will I receive a debit card to use for my Health Reimbursement Arrangement (HRA)?

Though many HRA programs use a debit card, your Trust HRA does not require one. Please see “How is the HRA administered?” below for more details.

Who do I contact with questions about my HRA?

The Trust office at Zenith American Solutions manages the administration of your HRA account. You can call the Trust office directly at (800) 225-7620, select option 2 then option 1, with any questions about your HRA.

What is the purpose of the HRA and how does it benefit me?

The HRA gives participants extra funds to provide first dollar coverage for the majority of their eligible medical care expenses. Not until you have exhausted your HRA funds will you have to pay your deductible. Having an HRA can help you become more aware of the true cost of health care and empower you with greater control over your own health care spending, as well as helping you avoid a higher deductible each year. Also, any unused funds roll over to the next year as long as you remain eligible in the Plan.

How does my HRA work?

Participants hired after December 3, 2010, who are covered under the Sound Plan and have worked for 12 months are eligible to receive HRA funding. SoundPlus participants are eligible to receive HRA funding on their first month of eligibility under the Trust.

HRA funding is received after you and your eligible spouse (if married) complete several steps, including taking your Personal Health Assessment (PHA) when it is offered – including updating your contact information, notifying the Trust of your selected primary care physician and completing other health related actions. The maximum annual HRA funding is $500 for employee only coverage and $1,000 for family coverage.

Your HRA funds are used to offset part of your medical plan deductible and potentially the cost of other eligible medical expenses throughout the year. When you receive medical services, the bill will be submitted to the Trust, then any HRA eligible expenses will go directly to your HRA for automatic payment—with no claim forms, bills or hassles for you. Your online HRA account will show your activity as well as your balance.

What is covered under the HRA?

HRA funds are used to cover eligible medical expenses for such things as your doctor office visits, lab tests, x-rays, emergency room co-pays, in-network co-insurance or other eligible, covered medical expenses. For SoundPlus participants, out-of-network benefits are also covered.

What is not covered under the HRA?

The HRA will not be used for prescription, dental or vision benefits. For Sound Plan participants, the HRA will not be used for out-of-network benefits. The HRA will not be used for in-network provider preventive care like wellness visits and mammograms that are already covered in full through Prevention @ 100%. The deductible is not covered by the HRA either. However, you will only have to pay the deductible once your HRA is exhausted.

How is the HRA administered?

When you go to a medical care provider, the provider sends a claim to your health plan. The Trust will first determine if the claim is payable from your HRA. If it is, the claim will automatically be sent to the HRA for payment. At this point, if you have adequate money in your fund, your HRA will pay your doctor for your claim. If the HRA is used up, then the plan will pay its portion of the bill after the deductible is met.

What should I do if I think a mistake was made and something was paid or denied on my HRA account?

Contact the Trust office directly at (800) 225-7620, select option 2 then option 1, with any questions about your HRA.

Are non-covered benefits eligible to be paid by the HRA?

No, only covered medical benefits can be paid by the HRA.

If I don’t use my HRA this year, does it carry over into next year?

Yes. Unused funds in a calendar year are rolled over into the next year as long as you maintain your benefit eligibility status. (The amounts rolled over may be lower if you are a participant for less than the full year). The better you manage your health and cost of health services this year, the more money you’ll have left in your HRA to roll over to next year.

Who funds the HRA account?

Sound Health & Wellness Trust funds each participant’s HRA, if they qualify.

My EOB shows HRA/deductible. How can I tell if it’s deductible or was covered by my HRA?

On your Explanation of Benefits (EOB) statements from Sound Health & Wellness Trust, you will see an “HRA/deductible” amount that includes your deductible plus your HRA amount. If you completed all the steps necessary to receive your full HRA funding, your HRA automatically pays for the first $500 (for employee only) or $1,000 (for family coverage) before any covered expenses are applied to your deductible. If you, and your eligible spouse did not take the Personal Health Assessment (PHA), including updating your contact information and selecting a Primary Care Physician, you did not receive full HRA funding and your deductible will be higher.

How does the Quit Tobacco Coaching Program work?

Once you are enrolled, your coach will help you develop a personalized quit plan. The coach will also determine whether nicotine patches, gum, or lozenges will be helpful for you during the quit process.

Who is eligible for the program?

The Quit Tobacco Coaching Program is available to all Sound Health & Wellness Trust participants and covered spouses 18 years of age or older.

How much does it cost to participate in theQuit Tobacco Coaching Program?

We are committed to helping our participants become free of tobacco, so we are fully subsidizing the cost of the Quit Tobacco Coaching Program. Participants pay nothing for the program. Even the cost of nicotine patches, lozenges or gum is fully covered. If you and yourcoach or doctor decide you should use a prescription medication instead of patches or gum, contact the Trust Office to find out what’s covered under your prescription drug benefit and what your co-payment would be.

What about other forms of tobacco besides cigarettes?

The Quit Tobacco Coaching Program is tailored to the needs of the participants. Whatever the tobacco type—cigarettes, cigars, pipes, vaping or even smokeless tobacco—coaches will work with participants to design an effective plan toquit.

Is participation in the Quit Tobacco Coaching Program confidential?

Yes. Participation is completely confidential. We will not share personal health information with the Trustees, your union or your employer.

How does someone enroll in the Quit Tobacco Coaching Program?

Enrollment is easy—call 877.362.9969, option 4 to get started. A registration specialist will verify your eligibility to enroll and transfer you to acoach for an initial intervention.

Can I enroll again if I start using tobacco again?

Yes. We recognize that it often takes several attempts to quit tobacco for good, and that participants may start using tobacco again during the program. Participants are able to repeat the program a second time if necessary.

What are the hours for the Help Line?

You can call the toll-free Help Line anytime you need additional information or support. The line is staffed by expert coaches Monday through Saturday:

Monday – Thursday: 6:00am – 8:00pm
Friday: 6:00am – 6:00pm
Saturday: 6:00am – 10:00pm

How long does the program last?

The calls we make to you are typically completed within two to six months, depending on how quickly you move through the process of quitting. However, the coaches will help you establish your new tobacco-free lifestyle and provide you with ongoing support for as long as you like.

What if I miss my phone call from the Coach?

Please call us back at a convenient time for you. Studies have shown that the more calls you complete with a coach, the more success you will have in quitting tobacco. Call 877.362.9969, option 4.

Do I have to attend classes?

No. All of your counseling sessions take place over the telephone. This means you don’t have to try to find time for classes or trips to someone’s office. And, you can talk to a coach most days of the week – even Saturday.

What is Condition Management?

Condition Management is a Sound Health & Wellness Trust program provided by the Guardian Nurses Mobile Care Coordinator (MCC) Program that can help you manage specific chronic conditions. This confidential, and voluntary program is fully paid for by the Trust, and strikes a good balance between self-care and professional help by offering an innovative, comprehensive approach to chronic condition management. Participants work one-on-one over the phone or through in-person visits with a specially trained Mobile Care Coordinator nurse, who will work as your personal nurse advocate. You will gain greater confidence in managing your disease or condition, and as a result, improve your health. You are eligible if you are covered by the PPO Plan, have been diagnosed with certain conditions and are invited into the program.

How does the Condition Management program work?

1. If you have been diagnosed with a certain medical condition—diabetes, asthma, congestive heart failure, chronic obstructive pulmonary disease or coronary artery disease—you maybe invited to participate in the Condition Management program.
2. If you qualify, you will receive a call inviting you to participate in this program. You will be evaluated by the an MCC nurse over the phone. The MCC nurse will perform this initial assessment to determine how you are currently caring for yourself and your condition, your readiness to change your health and lifestyle behaviors, other medical concerns, medications and general health status.
3. If you are accepted into the program, the MCC nurse will then work with you to develop a personal plan. That plan identifies critical behaviors and lifestyle changes to help you better control your medical condition and improve your health.
4. You will receive ongoing telephone or in-person coaching to support behavior changes and increase your understanding of your condition. Your MCC nurse can also go to your healthcare provider visits with you. Your progress with your personal plan is periodically reevaluated and revised by your MCC nurse.

Do I have to participate in the program if I don’t want to?
No, the Condition Management program is voluntary.

What chronic conditions does the Condition Management program cover?
The Condition Management program can help you manage asthma, chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), congestive heart failure and diabetes.

How can the condition Management program benefit me if I’m already working with my healthcare provider?
Managing a chronic condition requires ongoing education and support. If your healthcare provider has diagnosed you with a chronic condition, your MCC nurse can answer your questions, educate you about self-care techniques and help you make lifestyle changes for maximum health and quality of life. The support provided by your MCC nurse is meant to supplement, but does not replace, your provider’s advice.

What are some reasonable outcomes I can expect from participating in the Condition Management program?
Condition Management program participants understand their conditions better, increase their ability to follow their healthcare provider’s directed treatment plans, and reduce the amount of unnecessary care they receive. They also take a more active role in their health care, become better at using self-care techniques and improve their quality of life.

How do I participate?
If you meet requirements, you will receive a phone call inviting you to participate. The invitation is based on your medical claims and your medication history.

Who is eligible for the program?
The program is available for employees and their covered spouses age 18 and over who have been diagnosed with one of the listed chronic conditions. Dependent children are not eligible.

How long does the Condition Management program last?
This will vary person to person. Our goal is make sure you understand your condition, treatment plan, options and how to avoid complications. Your understanding and how your condition is presently managed will determine the length of time you will be in the program.

If I participate in the Condition Management program is there any incentive?
If eligible for a Health Reimbursement Arrangement (HRA), the Sound Health & Wellness Trust will deposit $30 per month into your HRA for up to $270 per calendar year. In addition, eligible participants who are enrolled in Condition Management and actively engaged in the program, can earn $300 in annual HRA funding.

Is there a maximum period of time that I can receive the incentive?
If you are actively participating in the program, you can continue to receive the incentive until you have reached the maximum of $270 per year. You may continue to participate in the program, without receiving the incentive, after you have reached the $270 maximum based on your program goals with your nurse advocate.

Is my medical information kept private?
Yes. You can be sure that any information you share with your MCC nurse is protected by federal law and cannot be revealed to the Trustees, your union, or your employer without your permission.

Who is providing the program?
The program is provided by Guardian Nurses Mobile Care Coordinator (MCC) program and fully paid for by the Sound Health & Wellness Trust. Guardian Nurses has been a pioneer in patient advocacy since 2003 and are committed to improving patients’ experiences with today’s healthcare system by providing high-touch, uniquely personal advocacy services.

What will I receive for participating in a LiveWell Fit event?

Covered participants who have 1.) Pre-registered with the event organizer, 2.) Notified the Trust at least one week before the event, and 3.) Signed a reimbursement form at the event will receive a fee reimbursement check in the mail for up to four events per calendar year. Be sure to keep your registration receipt after registering with the event organizer. Fees are different for different events, so your reimbursement will vary.

If eligible for a Health Reimbursement Arrangement (HRA) you may also earn HRA funding from $50 – $150, depending upon the event. Learn more about HRA funding.

In addition, we offer several mile marker rewards for participating. You can receive mile marker rewards as you participate in events.  After completing your first event, you will be at your first mile marker, and you will receive a LiveWell branded sunshield buff. Completing your second event will put you at your second mile marker and earns you a technical fabric t-shirt. Once you have completed your third event and reached your third mile marker, you’ll receive reimbursement for a fifth bonus LiveWell Fit event. Finally, when you participate in your fourth event and meet your fourth mile marker you will have the choice of receiving either a Polar M200 GPS Running Watch/GPS/Activity Tracker, a Fitbit, or reimbursement for a pair of new running/biking shoes (some limitations apply and see your Wellness Coordinators if you have any questions). Each calendar year, you are eligible to be reimbursed for up to four LiveWell Fit events, however, each mile marker reward is earned only once and does not start over each calendar year.

What is the Bring a Buddy program and how does it work?

If a covered Trust employee or covered spouse who has not participated in a LiveWell Fit event before registers for the same LiveWell Fit event as you as your “buddy,” you both will be entered in the Bring a Buddy raffle for the chance to win a $300 VISA gift card. You can be entered to win up to four times for bringing first time LiveWell Fit Trust participants to up to four LiveWell Fit events (you are eligible for one entry per event even if you bring multiple buddies). To be eligible you must both be registered, you must both notify the Trust a week before the event and you must both participate in the event. Please note that to be entered to win, participants must be 18 years or older.

Will my family’s fees be reimbursed for a LiveWell Fit event?

Yes, if your family member is covered under your Sound Health & Wellness Trust medical plan. Please note that a few races have age requirements. If you are unsure if your child or spouse is covered on your plan, please call the Trust’s eligibility department at (800) 225-7620 option 2 then option 2.

How can I be sure I will be reimbursed for my event registration fees?

Once you have registered for an event, and at least one week before your event, you must call the Trust office at 800-225-7620 option 2 then option 5. You must also attend and participate in the event. After filling out the reimbursement form and turning your registration fee receipt in to your Wellness Coordinator at the event, you can expect your reimbursement check in the mail in about three to four weeks. Please note that fees for Virtual Races are not eligible for reimbursement.

I purchased an event T-shirt or have other expenses associated with the event, will the Trust reimburse this amount as well?

No, only event registration fees will be reimbursed by the Trust.

I forgot my receipt at home; can I still turn it in for reimbursement?

Yes, you can mail in the completed reimbursement form you received at the event from the Trust’s Wellness Coordinator with your receipt after the event.

What if I can’t make it to the event that I registered for, will I still be reimbursed?

No, you must participate in the event to be eligible for reimbursement.

I registered for an event but forgot to call the Trust office to confirm my spot. Will I be reimbursed?

No, if you do not call the Trust one week prior to the event you will not be reimbursed.

This is my first event! How should I prepare?

Getting from the couch to your first 5K (PDF) is easier than you think! The Sound Health & Wellness Trust has personal and confidential health coaches available to you at no cost, to help you create a plan and meet your exercise goals. Call to begin working with a coach today: (877) 362-9969 option 3.

How will I find the Trust Wellness Coordinator at the event?

You will receive a confirmation email 1–2 days prior to your event notifying you of the meeting location and time. Look for the Sound Health & Wellness Trust signs. The Wellness Coordinator will be the person in the lime green hat.

What if an event I’m interested in is not on the list?

Gather a group of six Plan participants from your workplace and call the Trust office at (800) 225-7620 option 2 then option 5 (at least three weeks before the event) to become a team leader and request reimbursement for your group in your chosen event.

I would like to register for more than one event, is there a limit?

We love your enthusiasm! You can be reimbursed for to up to four events per calendar year. Though once you reach three events, we’ll reimburse you for a fifth event.

I would like to put together a LiveWell Fit event team at my workplace. Can you help?

Yes, absolutely! Call the Trust at (800) 225-7620 option 2 then option 5 to be put in touch with your regional Wellness Coordinator who can help you get a team started for the LiveWell Fit. Way to lead!

What is the Guardian Nurses Mobile Care Coordinator® Program?

The Mobile Care Coordinator (MCC) Program is a unique, high-touch personal care management model whereby dedicated Registered Nurses support members in order to help them safely and effectively through the healthcare system.

How does the program work?

The MCC nurses will be notified when your doctor or hospital pre-certifies your hospital stay with the Trustor when you have claims for a serious health care condition. The nurse then mobilizes to visit the patient while they are still in the hospital, at their home or by phone to offer help, explain what’s going on with their health care, and make sure care is appropriate.

Who is eligible for the program?

All eligible members in the PPO plan, including spouses and dependent children, of the Sound Health & Wellness Trust

How do I participate?

There are two ways:

1. If you are experiencing a serious healthcare issue or will be admitted to the hospital, and you think you could use some help, you can call (877) 362-9969 option 2 from 8:00am to 5:00pm Pacific Time Monday through Friday to reach a local MCC nurse from Guardian Nurses.If you are struggling with depression, anxiety or addition, you can speak directly with the MCC nurse in charge of Behavioral Health regarding treatment for drug or alcohol dependency, anxiety, depression or any other mental health issue by calling Conni Fonseca, BSN, RN at (206) 446-8402.

   Remember that for healthcare issues that are not serious, the Trust offers a 24/7 telephone nurse line as well as Doctor on Demand video doctor visits

2. If you are admitted to the hospital, our MCC nurses will come and see you in the hospital in person. When they get to your room, they’ll offer their help.

What kind of things will the Guardian Nurses help me with?

• Explaining a new diagnosis so you understand
• Expediting an appointment with a physician or to get a test
• Going WITH you to an appointment with a physician, including specialists to ask questions and advocate for you
• Visiting you while you’re in the hospital to make sure you’re getting good care and that you have a safe discharge plan. They will also check back with you after you get home.
• Speaking with your healthcare provider on your behalf.

Do I have to participate in the program if I don’t want to?

Absolutely not. The MCC services are entirely voluntary.

What are some of the benefits of participating in the program?

Our nurses are working for you, not the hospital or doctors. For you. Their goals are to improve your experience in the healthcare system and to make sure you’re getting appropriate care so that you have a better outcome and improved health. That means less anxiety, less headaches and peace of mind for you and your family and hopefully a shorter, smoother recovery.

How is Guardian Nurses Mobile Care Coordinator® program different than the Trust’s telephone Nurse Line?

The nurses for the Trust’s MCC Program are mobile and local. That means that they are nurses who live in the Puget Sound area, who know the Seattle healthcare system, they know the ‘ins and the outs,’ and when you need them to be by your side for a hospitalization or serious health issue, they will be there.

The Nurse Line is a 24/7 telephone line to answer your immediate questions about less serious health care questions or concerns.

How many times / for how long can I participate in the program?

There is no time or number of visits limit. As long as you need help and are actively receiving services in the healthcare system for serious or complex conditions, the MCC nurses will help you.

Is my medical information kept confidential?

Absolutely! Any interaction with the MCC nurses is confidential and is kept between you and your nurse. If your nurse needs to talk with your healthcare provider/s, you give them authorization by signing a HIPAA form.

Are there any charges or fees for the MCC nurses?

No way. The MCC Nurses are a benefit of your participation in the Sound Trust’s PPO program and is completely paid for by the Trust.

Will the MCC Nurse help everyone in my household?

All covered participants in the PPO plan and their family are able to receive support from the MCC Nurses.