We’ve put together these guidelines to help you determine eligibility
Two Options for Coverage
The Plan now offers Participants two options for medical coverage. Active Employees and Retirees who are not eligible for Medicare may select from the Self-Funded Preferred Provider Organization Plan (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.
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).
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 UA Local 467 Defined Benefit Plan, have ten years of Benefit Credit under that Plan, must have been continuously covered for benefits under the Healthcare Plan for 44 out of the 48 months immediately preceding retirement (not counting COBRA coverage), and must be a member in good standing of UA Local 467.
Military Service Rules
The rules for what occurs if you are in certain active military service are summarized on pages 12-14 of the booklet.
Privacy-Protected Health Information
The Board of Trustees has adopted rules to protect the privacy of your health care records.
Claims and Appeal Procedures
New claims and special procedures were adopted to comply with governmental regulations.
You or your provider may call the Trust Fund Office, United Administrative Services, at (408) 288-4400, to confirm your eligibility status or for information about the benefits payable under the Plan.
A Participant or Beneficiary may also request information to the Trust Fund Office
Our Funding and Plan Sponsorship
This Plan is funded by contributions made pursuant to Collective Bargaining Agreements between UA Local 467 and the following Employers or Employer associations: Plumbing-Heating-Cooling Contractors Association of the Greater Bay Area, Inc., Northern California Mechanical Contractors Association and the Industrial Contractors, Inc., UMIC, as well as a number of individual Employers who are not affiliated with those associations.
A complete list of Employers, Employer associations, and labor organizations sponsoring the Plan may be obtained by Participants and beneficiaries upon written request to the Trust Fund Office, subject to payment of a reasonable copying charge, and is available for examination by Participants and beneficiaries, upon reasonable notice.