Article 5: Choosing Between the HMO Plans and the PPO Plan >>

5.2 Enrollment Procedures

When you first become eligible for benefits (as explained in Article 4.1 Eligibility: When Coverage Begins) you will be allowed to choose the medical and dental plans by completing forms provided by the Trust Fund and filing them with the Administrative Office. You and your dependents must be enrolled in the same medical and dental plans; your spouse cannot enroll in an HMO plan if you are enrolled in the PPO plan.

If you do not select a medical and/or dental plan, you will not have coverage until you have selected a medical and/or dental plan. The only benefit a Participant will have until he or she completes an enrollment form for one of the medical options and one of the dental options will be Life and AD&D insurance. If you fail to enroll in a plan, the Administrative Office will provide you with written notification of the plans in which you failed to enroll. If you supply the proper enrollment materials for a medical plan option, but do not supply the proper enrollment materials for the dental plan, you will be promptly enrolled in the medical plan by the Administrative Office.

You may enroll in an HMO Plan only if you live within the HMO’s service area which is a geographical jurisdiction defined by the HMO you select. For UnitedHealthcare, you must live or work within a 30-mile radius of a UnitedHealthcare participating provider (physician/medical group). For Kaiser Permanente, you must live or have your principal place of work within the Kaiser Permanente service area, which is defined by Kaiser Permanente according to a listing of ZIP codes.