Tuesday, January 20, 2026

Frequently Asked Health Care Questions


Q. Who is eligible to become a Participant in the Plan?
A. You are eligible to participate in the Plan if you work for an Employer that is required to make contributions to the Health and Welfare Plan for the work you perform.  For most Participants, this means working in a position covered by a Collective Bargaining Agreement between the Employer and the Union.
Q. What if I don’t work enough hours to gain eligibility for the month?
A. If you fail to have the required employer contributions to continue Health Care coverage, you may be eligible to continue with COBRA Continuation Coverage. Please contact the Trust Fund Office at (626) 646-1079 or Toll Free at (800) 320-0106
Q. How do I maintain my monthly Health Care coverage?
A. You must have employer contributions of a specified amount set by the Plan each month, or elect COBRA Continuation Coverage to continue Health Care Coverage.
Q. How do I make a payment towards the continuation of my Health Care coverage?
A. You make a self-payment to remain eligible for Health Coverage through the Retiree or COBRA Continuation programs.
Make Check Payable & Remit to: Operating Engineers Local 501 Security Fund
P.O. Box 515057
Los Angeles, CA 90051-5057
Q. Whom should I call if I have questions about my Health Care eligibility?
A. Please contact the Trust Fund Office at (800) 320-0106
Q. Who are my eligible dependents?
A.Dependent means an individual who is:

  • The eligible legal Spouse or Registered Domestic Partner of the Employee.
  • Any child of the Employee (which includes natural children, step-children, or legally adopted children or children placed with the Employee for the purpose of adoption as certified by the public or private agency making the placement) who is under age 26.
  • Any minor for whom a court has appointed the Employee or the Employee’s eligible legal Spouse as guardian, so long as the guardianship is in effect.
  • Any never-married child of the Employee who is twenty-six (26) years of age or older, who is incapable of self-support because of mental or physical incapacity or condition, that commenced while eligible and that existed prior to the date he/she would have otherwise ceased to be eligible due to age, and who is substantially Dependent upon the Employee for support and maintenance, and is claimed as a Dependent on the Employee’s most recent federal tax return, or resides in the Employee’s household. The Employee must submit within thirty-one (31) days after the date he or she would normally cease to be eligible because of age, satisfactory proof of his/her incapacity. The Trust Fund may subsequently require periodic proof of his/her incapacity. This extension will continue until the earliest of (1) the date the child ceases to be eligible for reasons other than age, (2) the child ceases to be incapacitated, or (3) the end of the month in which the Employee fails to provide requested additional proof of incapacity.
  • Any unmarried child under age 19, whom the Employee is required to cover by a Qualified Medical Child Support Order (QMCSO). The term Dependent shall not include foster children (unless otherwise eligible); or any person in the military, naval, or air service. Employees are not entitled to Dependent coverage for any Dependents who are entitled to benefits as an Employee of a participating Employer.
Q. Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?
A. Yes. Due to the new Healthcare Reform Act, dependent children are now eligible to remain on the coverage until the age of 26, regardless of student status. 
Q. How do I add my new baby or spouse to my insurance plan?
A. You must submit legal documentation to the Trust Fund Office, along with a completed Enrollment Form. You can download the Enrollment Form off of this website located under "Forms" and mail it into the Trust Fund Office.

Forms Required Are:

  • Spouse - Copy of your marriage certificate
  • Child - Copy of your child's birth certificate
  • Step-Child - Copy of child's original birth certificate along with proof of residency (Tax Returns & Divorce Decree/Court Documents)
  • Domestic Partner - Copy or declaration of domestic partnership filed with the State
Q. Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A. Please call the Benefit Office and advise the Eligibility Department that you are getting a divorce or have already gotten a divorce. You will also need to submit a FULL copy of your Dissolution of Marriage Judement and court-filed QDRO (Qualified Domestic Relations Order) to this office.
Q. How do I obtain a replacement Medical and Prescription Card?
A. Please contact the Trust Fund Office at (800) 320-0106
Q. How do I inquire about the status of my medical claim?
A. If you have Kaiser Permanente and have a question regarding your claim, please call (800) 464-4000. If you have Anthem Blue Cross and have a question regarding your claim, please call (800) 320-0106.
Q. Who is the Prescription Drug Benefit Manager?
A.

OptumRx

Q. How can I contact the Prescription Drug Benefit Manager?
A. You can contact OptumRx at (888) 445-8745 or www.optum.com.
Q. If a service I need requires Prior Authorization, who do I (or my provider) contact?
A. For preauthorization of inpatient medical and Mental Health/Substance Use Disorder services, complex radiology, and durable medical equipment, contact the Medical (and Mental Health/Substance Use Disorder) Services Review Organization, California Participants can contact Anthem Blue Cross, at 800-274-7767 or visit their website at www.anthem.com/ca.

For preauthorization of inpatient medical and Mental Health/Substance Use Disorder services, complex radiology, and durable medical equipment, contact the Medical Services Review Organization, Nevada Participants can contact Anthem Blue Cross, at 800-274-7767 or visit their website at www.anthem.com/nv. For Mental Health/Substance Use disorder services preauthorization, please contact Behavioral Health-Care Options at (800) 873-2246.
Q. If I need to utilize Mental Health or Substance Abuse benefits, who do I contact?
A. California Employees contact Anthem Blue Cross at (800) 274-7767 (Note: Maintenance Attendants & Retirees not eligible for Mental Health/Substance Abuse coverage). Nevada Employees contact Mines & Associates at (800) 873-7138 (Note: Retirees are not eligible for Mental Health/Substance Abuse coverage).
Q. How do I find a dentist or find out if my dentist participates with United Concordia?
A. You may contact Delta Dental at (800) 422-4234 if you are enrolled in the HMO option. If you are enrolled in the PPO, call Delta Dental at (800) 765-6003. Alternatively, you may visit Delta Dental on the web at www.deltadentalins.com
Q. If I have Medicare, who does my provider submit the claim to?
A. Claims can cross over electronically from your provider through a HDM clearing house or if providers choose to submit hard copies they can be mailed to: Operating Engineers Local 501 Security Fund, PO Box 1618, San Ramon, CA, 94583.
Q.How do I find a vision service provider?
A.You may contact VSP at (800) 877-7195 or visit them on the web at www.vsp.com.