Salud y Bienestar
Medical
Opciones de planes de salud
Opciones de planes de salud
Consulte Cómo elegir su plan de salud o descargue Resumen de beneficios de los planes de salud para obtener información sobre los planes médicos y dentales disponibles en su área
Cobertura del plan Activo
El Plan Activo se ofrece en todas las jurisdicciones mediante un Acuerdo Laboral o para participantes del plan que no están sujetos a negociación colectiva.
Cobertura del plan Activo incluye:
Medico
Dental
Visión
Medicamentos recetados
Seguro de vida y Fallecimiento Accidental y Desmembramiento (AD&D)
La cobertura para dependientes elegibles está incluida con el Plan Activo
Cobertura del plan Bronce
El Plan Bronce se ofrece de la siguiente manera:
Aprendices de 1.º y 2.º período en California
Aprendices de 1.º, 2.º y 3.º período en Nevada
Clasificaciones específicas de acuerdos de taller
Acuerdos de tablaroca (drywall) en Arizona, Colorado, Nuevo México y Utah
Su salario base puede ser más alto al elegir el Plan Bronce, de acuerdo con el Acuerdo Laboral.
Cobertura del plan Bronce incluye:
Medico
Dental
Visión
Medicamentos recetados
Seguro de vida y Fallecimiento Accidental y Desmembramiento (AD&D)
La cobertura para dependientes se ofrece como una opción y requiere el pago de una tarifa mensual.
Cobertura individual – $0
Cobertura individual + 1 dependiente – $150
Cobertura familiar – $250
Cómo elegir su plan de salud
Al elegir su plan de salud y agregar dependientes, debe considerar lo siguiente:
Las Organizaciones para el Mantenimiento de la Salud (HMO) de Kaiser y las Organizaciones de Proveedores Preferidos (PPO) de Independence ofrecen cobertura médica integral, pero bajo estructuras diferentes.
Independence PPO:
Independence maintains a nationwide network of providers and your dependents will likely be able to get care in other areas and stay in the network.
Kaiser HMO (CA and CO only):
The HMO will only cover services within a defined service area. If your dependent resides outside the service area the HMO may only cover verified emergency services.
Independence PPO:
Yes, you have that freedom and flexibility to go out of network but you will be responsible for higher out of pocket costs including a $500 deductible for the Active Plan and a $10,000 deductible for the Bronze Plan and 50% of the allowable charge.
Kaiser HMO (CA and CO only):
No. HMOs maintain a closed network, unless you have an emergency out of the service area.
Independence PPO:
Independence maintains a nationwide network of providers and your dependents will likely be able to get care in other areas and stay in the network.
Kaiser HMO (CA and CO only)
The HMO will only cover services within a defined service area. If your dependent resides outside the service area the HMO may only cover verified emergency services.
Independence PPO:
No.
Kaiser HMO (CA and CO only):
Yes.
Independence PPO:
For the Active Plan, you will pay a specific co-pay amount per service with no annual deductible.
For the Bronze Plan, once your deductible is met, you will pay your coinsurance amount which is a percentage of the amount negotiated between the provider and Independence.
Your annual deductible and co-insurance amount will depend on your PPO Plan.
Kaiser HMO (CA and CO only):
You will owe the specified co-pay amount per service.
Independence PPO:
The PPO plans are paired with prescription benefits through Express Scripts.
Kaiser HMO (CA and CO only):
Medications are covered through the Kaiser network for those on the HMO.
Independence PPO:
The PPO plan will coordinate benefits according to which plan is "primary." See the SPD for details on the "Birthday Rule" for dependent coverage.
Kaiser HMO (CA and CO only):
The HMO is usually considered to be the primary plan, regardless of which participant is the primary member. An HMO plan will not coordinate benefits with other plans.
You can change your medical or dental plan at any time as long as you have been enrolled on your current plan for 1 year unless you are in the first year of Apprenticeship.