Your Choices
|
When you initially become eligible for coverage (and once every 12 months after any election) you are allowed to select between 3 plans for medical benefits and between 5 plans for dental benefits. Failure to complete the enrollment process in a timely manner will cause your Hours Bank Reserve to be charged as if you are enrolled, but you will have no actual coverage (see Amendment #47).
| |
Medical |
Dental |
| Your Choices |
•Anthem Blue Cross (PPO) |
•United Concordia PPO |
| •UnitedHealthcare (HMO) |
•DeltaCare USA (DMO) |
•Kaiser Permanente (HMO)
|
•United Concordia (DMO) |
| |
•Safeguard Dental (DMO) |
| |
•CIGNA Dental (DMO) |
|
|
|
|
Anthem Blue Cross PPO (Prudent Buyer)
|
The Board of Trustees have contracted with Anthem Blue Cross of California for the purpose of making the extensive Anthem Blue Cross PPO network available to you. The doctors and hospitals (providers) have agreed to substantial reductions from their regular fees when the preferred providers are used.
|
|
|
|
UnitedHealthcare
|
UnitedHealthcare is a network model Health Maintenance Organization (HMO). It contracts with doctors who are in private practice or are part of established Medical Groups.
You choose a participating Medical Group and from that Medical Group you must select a primary care physician (PCP). Your PCP will be responsible for all of your healthcare needs, and will refer you to a specialist when necessary.
Generally, covered benefits are provided to you at no cost or for a fixed copayment for most outpatient services.
|
|
|
|
Kaiser Permanente
|
Kaiser is a hospital model HMO that owns its own medical clinics and hospitals, and employs its own doctors. Under the Kaiser Plan, you can choose your own physician, and are encouraged to do so. You must live within the list of Kaiser ZIP codes to be eligible to enroll in the Kaiser Plan. You can use any Kaiser facility at any time. There are specialist doctors within Kaiser. Generally, covered benefits are provided to you for a fixed copayment or at no cost.
|
|
|
|
Dental Choices
|
Whether you select Kaiser, UnitedHealthcare, or Anthem Blue Cross as your medical Plan, you have the option to enroll in one of the Dental Plans as part of your covered benefits.
You get a choice of one of the following dental plans:
- Delta Dental PPO Plan
- CIGNA Dental Plan (DHMO)
- DeltaCare USA Dental Plan (DHMO)
- United Concordia Dental Plan (DHMO)
- MetLife/Safeguard Dental Plan (DHMO)
The Trust offers five dental plans from which to choose: a dental PPO plan and four Dental Health Maintenance Organizations (DHMO) plans. The dental PPO plan is provided by United Concordia/Concordia Advantage Plus. The four DHMO plans are CIGNA, DeltaCare USA, United Concordia and MetLife/Safeguard.
|
|
|
|
Vision
|
Participants in the Anthem Blue Cross (PPO) and UnitedHealthcare (HMO) have vision coverage through Vision Service Plan. Kaiser Permanente (HMO) participants have vision coverage through Kaiser. Safety prescription glasses are covered through Vision Service Plan for all three medical plans.
|
|
|
|
Prescription
|
All eligible participants have prescription drug coverage through the mandatory generic prescription drug plan managed by Prescription Solutions.
|
|
|
|
Member Assistance
|
- Member Assistance Program (MAP): covers all eligible participants and members of their household.
|
|
|
