Medical coverage is an important part of your IBEW/Western Utilities Health & Welfare Trust Fund benefits. The Fund offers you five health plan options from which to choose:
- The Consumer Driven Health Plan
- The Comprehensive Health Plan
- The Kaiser Everyday Health Plan (Local 125 Members Only)
- The Kaiser Permanente HMO (Local 125 Members Only).
The information provided on this page is only a brief description of the Benefit Plans offered to participants under the IBEW/Western Utilities Health & Welfare Trust Fund. For detailed information on the medical plan options available to you, including copay, deductible, coinsurance and out-of-pocket maximums, please log-in and download the Plan’s Summary Plan Description or Open Enrollment Guide in the Documents/Forms section of this website.
The Consumer Driven Health Plan
The Consumer Driven Health Plan is a high-deductible health plan that provides coverage for emergencies, inpatient and outpatient hospital services and major medical care once you meet an annual deductible of $2,500 per person/$5,000 per family for in-network services and $5,000 per person/$10,000 per family for out-of-network services. While this plan option has a higher deductible than the other medical plan options, you are not required to pay a copay when you visit the doctor. Dental and vision coverage will be offered to CDHP participants at full cost. The Consumer Driven Health Plan includes a Health Savings Account (HSA) component, administered by HealthEquity. The HSA will help you save money and manage your out-of-pocket costs by allowing you to pay for qualified medical expenses with pre-tax dollars, including expenses for dental and vision care. You may also open up a Limited Health Care Flexible Spending Account (LHCFSA) that may be used only for dental and vision expenses.
The Comprehensive Health Plan
The Comprehensive Health Plan also provides coverage for emergencies, inpatient and outpatient hospital services and major medical care, as well as chiropractic benefits. However, you are required to meet an annual deductible of $300 per person or $900 per family when you use in-network providers, and an annual deductible of $600 per person or $1,800 per family when you go out-of-network for care. In addition, you will have to pay a higher copay when you receive care from a specialist or at an emergency room and when you purchase prescribed medications. The out-of-pocket limit for prescriptions drugs does not accumulate towards the $2,000/$4,000 annual out-of-pocket maximum under the Comprehensive Plan. However, it does accumulate toward the TOTAL out-of-pocket limit on in-network cost sharing of $6,600/$13,200.
The Premium Health Plan
The Premium Health Plan provides coverage for emergencies, inpatient and outpatient hospital services and major medical care, as well as chiropractic benefits. You are required to meet an annual deductible of $250 per person or $750 per family when you use network providers, and an annual deductible of $500 per person or $1,500 per family when you go out-of-network for care.
The Kaiser Everyday Health Plan (Local 125 Only)
The Kaiser Everyday Health Plan is only available to Local 125 participants living in certain portions of Washington and Oregon. There is an annual deductible to meet of $4,000 per person or $8,000 per family after the deductible $0 copay and $500 waived if admitted.
The Kaiser Permanente HMO (Local 125 Only)
The Kaiser Permanente HMO plan is only available to Local 125 participants living in certain portions of Washington and Oregon. There is no annual deductible to meet and, for most services, you will only have to pay a copay before the Fund begins to pay 100% of any eligible expenses. There is no out-of-network coverage.
Note: To maintain this plan offering, Kaiser Permanente requires that a minimum of ten (10) Fund employees enroll in the HMO.