Welcome!

Welcome to your new benefits site! Information about your Plans is provided in the links above. As always, do not hesitate to contact us with any questions (408) 288-4400.

There is no longer a $10,000 limit on your prescription drugs.

Please take note of these changes that are now included in your SPD:
1.         Two Options for Coverage. The Plan now offers Participants three options for medical coverage.  Active Employees and retirees who are not eligible for Medicare may select from the self-funded Preferred Provider Organization Plan (also called the PPO Plan) and Kaiser Foundation Health Plan.  Retirees who are eligible for Medicare may select from the self-funded Medicare Supplemental Plan or the Kaiser Senior Advantage Plan. 
2.         Lifetime Maximum Benefit–$350,000.  Under the self-funded PPO Plan, the lifetime maximum benefit for claims is $350,000.  (Previously, the maximum was $250,000.)  On January 1 of each year, the maximum is restored by the lesser of $2,500 or the amount necessary to bring it up to $350,000.
3.         Medicare Supplemental Plan Maximum.  Under the Medicare Supplemental Plan, the maximum benefit for claims incurred  is $70,000 (up from $50,000).  On January 1 of each year the maximum is restored by the lesser of $2,500 or the amount necessary to bring it up to $70,000.
4.         Non-PPO Coverage is 60% of Usual Customary and Reasonable Charges (UCR).  The Plan pays 60% of UCR for non-PPO coverage.  UCR is defined on page 52 of the booklet.
5.         Reserve of Hours – 650 or More Hours.  Each Employee who is not eligible for benefits becomes eligible when his reserve of hours has been credited with 650 or more hours within any 12 consecutive month period.  (The prior booklet required 660 or more hours).
6.         130 Hours in Reserve Bank.  Once eligible for benefits, you and your dependents continue to be eligible so long as you have 130 hours in your reserve of hours.  (The prior booklet contained the old 110 hours rule.)
7.         Physical Examination.  Charges incurred for a physical examination are payable at the rate applicable to the provider performing the exam for one physical exam every two years up to $300 per examination.
8.         Residential Drug Treatment.  Benefits for covered treatment at a licensed  residential drug treatment program that has been approved in advance by the Board of Trustees is 100% for the person’s first stay, and 80% for the second stay for up to 90 days per stay, but in no event for more than the dollar limitation in effect under the provider’s contract.
9.         Kaiser Drug Benefits.  Prescription drug benefits for Kaiser members continue to be available only through Kaiser pharmacies.
10.       Retiree Eligibility Rules.  The rules of eligibility for Retiree Welfare benefits have been changed.  To qualify for welfare benefits as a new retiree, a member must be receiving benefits from the U.A. Local Union No. 467 Defined Benefit Plan, have ten years of Benefit Credit under that Plan, must have been continuously covered for benefits under the Health and Welfare Plan for 44 out of the 48 months immediately preceding retirement (not counting COBRA coverage), and must be a member in good standing of U.A. Local Union No. 467.
11.       Hearing Aid Benefit.  The Plan pays for an initial examination by a physician no more than once in a 24 month period, and a hearing aid examination also no more than once in a 24 month period, up to $85.00 each.  The Plan pays 80% of the cost of a hearing aid and provides a maximum benefit of $2,500 per ear over any five year period.
12.       Military Service Rules.  The rules for what occurs if you are in certain active military service were changed.  They are summarized on pages 12-14 of the booklet.
13.       Privacy-Protected Health Information.  The Board of Trustees has adopted rules to  protect the privacy of your health care records.
14.       Claims and appeal procedures.  New claims and special procedures were adopted to comply with governmental regulations.