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Non-Union Medical Plan Choices
Non-union sites offer both the Blue Shield of California PPO and High Deductible Health Plan (HDHP) + Health Savings Account (HSA) options, as well as the Kaiser Permanente HMO plan option.
Blue Shield PPO
All locations
| Description | You Pay |
|---|---|
| Deductible | $500 Ind, / $1,000 Fam. |
| Coinsurance | 20% |
| Max. Out-of-pocket | $2,500 Ind. $5,000 Fam. |
| Dr. Visit | $40 |
| Specialist | 20% After Deductible |
| ER | 20% After Deductible |
| Hospital | $350 Copay + 20% |
| Outpatient | $350 Copay + 20% |
| Rx Generix | $10 |
| Rx Brand | $40 |
| Rx Non-Formulary | $75 |
| Rx Specialty | $75 |
Blue Shield HDHP/HSA
All Locations
| Description | You Pay |
|---|---|
| Deductible | $2,000 Ind. / $4,000 Fam. |
| Coinsurance | 20% |
| Max. Out-of-pocket | $4.,000 Ind. / $8,000 Fam. |
| Dr. Visit | 20% After Deductilble |
| Specialist | 20% After Deductilble |
| ER | 20% After Deductilble |
| Hospital | 20% After Deductilble |
| Outpatient | 20% After Deductilble |
| Rx Generix | $0 After Deductible |
| Rx Brand | 20% After Deductilble |
| Rx Non-Formulary | 20% After Deductilble |
| Rx Specialty | 20% After Deductilble |
Kaiser Permanente HMO
Where available in California and Pacific Northwest
| Description | You Pay |
|---|---|
| Deductible | $500 Ind. / $1,000 Fam. |
| Coinsurance | Varies |
| Max. Out-of-pocket | $2,000 Ind. / $4,000 Fam. |
| Dr. Visit | $15 |
| Specialist | $25 |
| ER | 20% After Deductilble |
| Hospital | 20% After Deductilble |
| Outpatient | 20% After Deductilble |
| Rx Generix | $10 |
| Rx Brand | $40 |
| Rx Non-Formulary | $40 |
| Rx Specialty | $40 |
Medical Plan Document Library
Eligibility
Eligible Employees:
You may enroll in the Employee Benefits Program if you are a full-time employee who is actively working a minimum of 30 hours per week.
Eligible Dependents:
If you are eligible for our benefits, then your dependents are too. In general, eligible dependents include:
- Your Legal Spouse
- Civil Union - Colorado
- Common Law Spouse in Colorado, Idaho
- Registered Domestic Partner in California, Nevada, Oregon and Washington and children up to age 26
- If your child is mentally or physically disabled, coverage may continue beyond age 26 once proof of the ongoing disability is provided
- Children may include natural, adopted, stepchildren and children obtained through court-appointed legal guardianship, as well as children of state-registered domestic partners
When Coverage Begins:
Newly hired employees and dependents will be eligible on the first day of the month following 30 days of employment. All elections are in effect for the entire plan year and can only be changed during Open Enrollment unless you experience a family status event.
Family Status Change:
- A qualifying life event is a change in your personal life that may impact your eligibility or dependent’s eligibility for benefits. Examples of some family status changes include:
- Change of Legal Marital Status (i.e. marriage, divorce, death of spouse, legal separation)
- Change in Number of Dependents (i.e. birth, adoption, death of dependent, ineligibility due to age)
- Change in Employment or Job Status (spouse loses job, etc.)
- If such a change occurs, you must make the changes to your benefits within 30 days of the event date; 60 days for loss of Medicaid or state child health plan. Documentation may be required to verify your change of status. Failure to request a change of status within 30 days of the event or 60 days for loss of Medicaid or state child health plan coverage, may result in your having to wait until the next open enrollment period to make your change. Please contact HR to make these changes.