Benefit Coordination

Provides temporary continuation of group health coverage under COBRA for eligible employees, retirees, and dependents following qualifying events, with coverage periods of 18 or 36 months depending on the event. Extends coverage by up to 11 months for disabled beneficiaries, with premium payments due within 45 days of election and by the 20th of the prior month thereafter.

Operates a Care Counseling program that provides preauthorization and provider cost comparison support for non-emergency medical services, with outpatient preauthorization reviews completed within one business day. Transitioning these services from MedExpert to Health Services Foundation (HSF) effective January 1, 2026.

Provides funds through HRA accounts to cover eligible medical expenses including hospitalization, physician visits, prescription drugs, and cost-sharing amounts such as deductibles, copays, and coinsurance.

Pays a $5,000 death benefit to beneficiaries of active bargaining employees and a $2,500 death benefit to beneficiaries of retired bargaining employees, with continued benefits at no cost for bargaining employees who become totally disabled before age 60.

Offers a choice of three dental plans to active employees and dependents, including a self-funded Dental PPO Plan and two fully insured prepaid plans. Covers diagnostic and preventive services without an annual deductible, including prophylaxis twice yearly, bitewing x-rays (twice annually for children under 18, once for adults), full mouth x-rays every five years, fluoride treatment twice yearly, and orthodontic benefits up to $2,500 for dependent children paid over 12 months.

Provides a Paid Maternity Leave Benefit of up to $800 per week or two-thirds of weekly pay for eligible participants, including pre-birth leave starting no earlier than the fourth month of pregnancy (up to six months intermittent) and post-birth leave of up to six weeks (eight weeks for cesarean section deliveries), implemented in collaboration with the Painters and Allied Trades Labor Management Cooperation Initiative.

Administers a comprehensive benefits program for active and retired bargaining employees and their dependents, including medical, dental, and death benefits. This includes self-funded plans, COBRA continuation coverage, and utilization review for medical services.

Conducts utilization review to assess the medical necessity, appropriateness, and cost-effectiveness of hospital stays and proposed medical or surgical services, using retrospective review, second and third opinions, concurrent review, and prior authorization.

Offers an online platform for employers to submit monthly contribution reports, calculate amounts due, and make electronic payments via ACH.

Issues formal notices of nondiscrimination based on protected characteristics such as race, color, national origin, age, disability, or sex.

Provides paid maternity leave benefits for eligible participants, including pre-birth leave starting in the fourth month of pregnancy and post-birth leave for up to six weeks, with an additional two weeks for cesarean sections, up to $800 per week.

Provides virtual one-on-one appointments with Trust Fund representatives via Zoom or telephone for member convenience.

Operates a nurse line staffed by registered nurses available seven days a week from 7am to 7pm Pacific Time.

Offers online employer reporting to process monthly contribution reports, calculate amounts due, and enable ACH electronic payments.

Offers virtual one-on-one appointments with Trust Fund representatives via Zoom or telephone and provides free language assistance services, including qualified interpreters and translated materials, for members with limited English proficiency.

Operates a Care Counseling program that offers preauthorization and cost comparison support for non-emergency medical services, including copay waivers for PPO providers. Additionally, provides a nurse line staffed by registered nurses available seven days a week.

Offers comprehensive dental coverage including diagnostic, preventive, and orthodontic services for dependent children up to a lifetime maximum of $2,500. This includes coverage for cleanings, bitewing x-rays, full mouth x-rays, and fluoride treatments.

Offers free language assistance services, including qualified interpreters and translated materials, to members with limited English proficiency.