Find out what's covered under the Fund's extensive Benefit Plan.
Independence Administrators (IA) are the Fund's major medical insurance provider for doctors, hospitals, and specialists. When Participants visit providers who are in-network with Independence Administrators, the Fund pays the coinsurance percentage (Gold Level 90%, Silver Level 70%) of the total IA allowance, leaving the Participant responsible for the their coinsurance portion (Gold Level 10%, Silver Level 30%). Participants are responsible for the coinsurance until they have met their out-of-pocket maximum (OOP). Once an individual or family has reached their OOP Max, the Plan will pay 100% for all further In-Network claims for the duration of the Plan Year (April 1 through March 31).
Personal Choice Coinsurance Coverage Levels
- Active Eligibility - 600 or 1200 hoursApril 1st Eligibility - 600 hours from 7/1-12/31 or 1,200 hours from 1/1-12/31 October 1st Eligibility - 600 hours from 1/1-6/30 or 1,200 hours from 7/1-6/30
- Out-of-Pocket Maximums $1,000 / $2,000$1,000 Individual / $2,000 Family
- Cigna Dental90/10 Coinsurance Plan (separate from the IA and MHC coinsurance) $2,500 Annual Family Allowance $3,200 Lifetime Orthodontia
- Davis VisionAnnual eye exams covered 100% $100 Allowance for eyewear (additional $50 at Visionworks)
- Active Eligibility 450 or 900 HoursApril 1st Eligibility - 450 hours from 7/1-12/31 or 900 hours from 1/1-12/31 October 1st Eligibility - 450 hours from 1/1-6/30 or 900 hours from 7/1-6/30
- Out of Pocket Maximums $2,000 / $4,000$2,000 Individual / $4,000 Family
- No Dental CoverageSilver Level does not include dental coverage
- No Vision CoverageSilver Level does not include vision coverage
- Retire with Gold Level based on Credit SystemGold Level is the only coverage option for Retiree Health. You are eligible to retire with health coverage if you reach 25 or 30 credits. However, if you retire with 25 to 29 credits, your monthly copayment will be higher than if you retire with 30+ credits.
- 1 Gold Eligibility Period = 0.50 CreditYou will receive a 0.5 credit for every Gold Level eligibility period you qualify for.
- 1 Silver Eligibility Period = 0.25You will receive a 0.25 credit for every Silver Level eligibility period you qualify for.
- Maximum of 1 Credit in a Plan YearThere are two eligibility period in a Plan Year, so the maximum credit you can earn is 1. There is no credit for a missed eligibility period.
Prescription Coverage is the same for both Gold and Silver Levels
Major Medical Insurance Card
Use this card when visiting any in-network doctor, hospital, specialist. If you need a replacement card please call 1-800-242-3330.
Addtional Benefits Covered Through Independence Administrators
Lab Work is covered 100% if processed through LabCorp. If processed through an in-network lab, doctor or hospital, it would be covered under your respective coinsurance coverage level (Gold Level 90/10, Silver Level 70/30).