MEDICAL COVERAGE, PRESCRIPTION DRUGS, DENTAL, VISION CARE AND LIFE INSURANCE
Initial eligibility is met with the accumulation of a minimum of 500 hours worked. Coverage may be effective on the first day of the second month after the month in which the eligibility requirements are satisfied. Example: If 500 hours are reached in August, coverage begins October 1st. Thereafter, 125 hours per month are required to continue your monthly eligibility. If hours fall below 125 hours worked in one month, you can draw from your reserve hour bank to continue eligibility.
Coverage includes Medical, Prescription Drugs, Dental, Vision Care, Member Assistance Program and a Life Insurance policy of $5,000. Dental benefits are with the Delta Dental Plan, vision benefits are with Vision Service Plan and member assistance benefits are with PacifiCare. The two medical plans available are:
(1) The Blue Shield of California Medical Plan (PPO)
(2) The Kaiser Medical Plan (HMO)
Residence in the Humboldt and Del Norte counties or out of state, the Blue Shield of California Medical Plan may be the choice.
Please call the Trust Office to request the insurance packet of your choice. We need to receive, in the Trust Office, the proper paperwork to cover you under the plan you choose. Should you have any questions, please contact the Trust Fund office at (707) 526-1996.
NOTE: IF NO COMPLETED APPROPRIATE ENROLLMENT FORM IS RECEIVED BY THE ADMINISTRATIVE OFFICE AS OF THE FIRST DAY OF THE SECOND MONTH AFTER THE MINIMUM HOURS REQUIREMENT HAS BEEN MET, THE ELIGIBLE EMPLOYEE WILL BE DEFAULTED INTO EMPLOYEE-ONLY COVERAGE UNDER THE PPO MEDICAL PLAN.
DEPENDENT COVERAGE: For dependents, coverage is effective for the dependent on the date you meet the initial and continuing eligibility requirements, so long as a completed enrollment form is received by the Administrative Office with all of the required information within 60 days of you meeting the eligibility requirements. Otherwise, coverage is effective the first day of the month following the month in which a completed enrollment form is received and approved by the Trustees. However, for a newborn child or an adopted child, coverage is effective on the date of birth or the date of adoption or placement for adoption with the condition that an enrollment form is completed and received by the Administrative Office within 60 days of the date of birth or the date of adoption or placement for adoption. If the prescribed enrollment form is not received by the Administrative Office within the 60-day period, the effective date will be the first day of the month following the month in which the enrollment form is received. Coverage for a new spouse is effective the first day of the month following the month in which an enrollment form is completed and a copy of the marriage certificate is received by the Administrative Office. To obtain more information about these enrollment rights, please contact the Administrative Office at (707) 526-1996.