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 is the Kaiser Foundation Health Plan (“Kaiser”).
For Medicare-eligible retirees, the option currently offered is the Kaiser Senior Advantage Plan.
Active Employees, Pre-Medicare Retirees, and Medicare-eligible Retirees
- Claim forms for these benefits are available from the Trust Fund Office or the Local Union. The Trust Fund Office may assist you in completing any of these forms, but you are ultimately responsible for submitting your own claims for these benefits. Submit insurance claims directly to the insurance company, at the address on the form.
- To elect coverage through Kaiser, 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.
- Enrollment/Change Form – English
- Enrollment/Change Form – Spanish
- Enrollment Form – Senior Advantage Plan
- UA Local 467 Health Insurance Enrollment / Change Form