Kaiser

Traditional Plan (for Active Employees and Pre-Medicare Retirees)
Senior Advantage Plan (for Medicare-Eligible Retirees)

The Board of Trustees has made arrangements for members to elect hospital, medical and surgical coverage through a health maintenance organization (“HMO”), in place of the self-funded PPO Plan. The HMO option currently offered to active Employees and pre-Medicare retirees is the Kaiser Foundation Health Plan (“Kaiser”). For Medicare-eligible retirees, the option currently offered is the Kaiser Senior Advantage Plan.  A separate booklet describing this program is available at no charge from the Trust Fund Office.

To elect coverage through an HMO, you must complete a Plan election card and the enrollment packet of the HMO.  You may elect HMO coverage when first eligible under the Plan, or at the open enrollment period established by the Board of Trustees.  Currently there is an annual open enrollment election period in October of each year, to be effective on January 1 of the next year.  If you do not actively enroll in an HMO, you will automatically be enrolled in the PPO Plan or, if you are retired and eligible for Medicare, the Medicare Supplemental Plan.  Electing HMO coverage will have the following effects on the benefits you and your family receive:

  1. If you elect hospital, medical and surgical coverage through a Plan HMO, neither you nor your dependent is eligible for hospital, medical, or surgical benefits from the self-funded Plan.
  2. To have your eligible dependents receive benefits from your HMO, you must enroll them when you enroll; or for a new dependent, you must enroll him or her within 30 days of the marriage, birth, adoption or other event which qualifies the person as an eligible dependent under the Plan.  Failure to enroll a dependent in your HMO in a timely fashion may result in loss of coverage for that dependent until the next open enrollment date, unless late enrollment is accepted by the HMO.
  3.  All Participants who elect coverage through an HMO remain eligible for dental benefits, life insurance, and accidental death and dismemberment insurance.  All active Employees remain eligible for weekly disability benefits.
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