This website provides an overview of your benefit coverage. However, in the event of a conflict between the information on this website and the official Plan documents, provisions of the official Plan documents will govern how the Plans work and how the Plans pay benefits.
If you are a Medicare-eligible Retiree who is enrolled in the Trust’s fully-insured Plan through Regence, please click here to learn more about your Plan benefits.
If you have any questions about your benefit coverage, please contact the Trust Administrative Office before you receive services.
Periodically the Trust may update Plan benefits. You’ll be notified of any updates through Summary Material Modifications (SMM), which legally modify the current benefits.
If you have any questions about your benefit coverage, please contact the Trust Administrative Office before you receive services.
Following is a summary of legal notices regarding your rights, along with links to detailed information. If you have any questions, please contact the Administrative Office for more information.
If you have a qualifying life event or change such as getting married, or having or adopting a baby, you may enroll your new dependents within a certain time period from the date of the event. If you or your dependents lose other qualifying coverage, you or your dependents may enroll within a certain time period from losing that other qualifying coverage.
See Eligibility Rules - Newly Acquired Dependents and Special Enrollment Rights in the Active Employee Summary Plan Description or Retiree Plans Summary Plan Description.
If a claim is denied in whole or in part, you may be able to appeal and request a review of the decision.
For information regarding how to file an appeal, and applicable timeframes see the appropriate section in the Active Employee Summary Plan Description or Retiree Plans Summary Plan Description.
You and your dependents may have the opportunity under federal law to temporarily extend health coverage (called continuation coverage) in certain instances where coverage under the Plan would otherwise end.
See When Plan Coverage Ends and Continuation of Coverage (COBRA) in the Active Employee Summary Plan Description or Retiree Plans Summary Plan Description.
CHIP provides low-cost comprehensive health coverage to children, and sometimes pregnant women, for families that earn too much money to qualify for Medicaid. Each state offers CHIP coverage:
The Trust is required to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which establishes national standards to protect individuals' medical records and other individually identifiable health information.
For more information, see the Trust’s HIPAA Privacy Notice.
The Women's Health and Cancer Rights Act of 1998 (WHCRA) is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy.
See Health Benefits - Women's Health And Cancer Rights in the Active Employee Summary Plan Description or Retiree Plans Summary Plan Description.
Information about your rights, and the administration and procedures of the Plan is available to you.
For more information, see the Creditable Prescription Drug Coverage and Medicare.
See Other Plan Information in the Active Employee Summary Plan Description or Retiree Plans Summary Plan Description.