who runs it
organizations running this strategy · 1
what it looks like in practice
activities of orgs running this strategy
A sample of programmatic activities from the orgs above. These are what the strategy looks like on the ground.
- Administration of health and welfare trust funds OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAdministers health and welfare benefits through a main office in Pasadena, California, and a satellite office in Las Vegas, Nevada, providing ongoing management of trust fund operations for eligible members and providers.
- Administration of health and welfare trust funds OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAdministers health and welfare benefits through a main office in Pasadena, California, and a satellite office in Las Vegas, Nevada, providing services to members and providers across multiple states.
- Administration of health and welfare trust funds OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAdministers health and welfare benefits through a main office in Pasadena, California, and a satellite office in Las Vegas, Nevada, providing benefits based on hours reported by signatory employers.
- Automatic enrollment and eligibility management OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProvides automatic enrollment in health and welfare benefits upon meeting eligibility criteria—200 or more hours reported by a signatory employer in a qualifying quarter or monthly period—with no medical underwriting required.
- Automatic enrollment in health and welfare benefits OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProvides automatic enrollment in health and welfare benefits upon meeting eligibility criteria based on 200 or more hours worked in a qualifying quarter, with no medical underwriting required.
- Behavioral health and mental health benefits administration OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProvides behavioral health services, including mental health and substance abuse treatment, through Carelon Behavioral Health, with enhanced benefits effective January 1, 2022; also administers MAP (Member Assistance Program) benefits via the same vendor.
- Behavioral health and mental health benefits administration OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceOffers a behavioral health program through Carelon Behavioral Health, including mental health, substance abuse treatment, and MAP (Member Assistance Program) benefits, with enhanced coverage effective January 1, 2022.
- Behavioral health program administration OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProvides behavioral health services, including mental health and substance abuse benefits, through Carelon Behavioral Health, with enhanced benefits effective January 1, 2022.
- Dental benefits administration OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProcesses dental claims through the Operating Engineers Health & Welfare Fund (Local 12) and provides members with a dental PPO network as the default plan.
- Dental benefits administration OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProcesses dental claims through the Operating Engineers Health & Welfare Fund (Local 12) and provides members with a dental PPO network as the default plan option.
- Dependent coverage enrollment OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceExtends health and welfare benefits to dependents immediately upon participant eligibility, with spouse and child coverage effective from the date of marriage or birth/adoption.
- Disability benefits programs OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceOperates a Weekly Disability program for eligible participants from Southern Nevada employers funded by employer contributions, and provides disability credit to extend full health and welfare benefits for 3 to 6 months when a member becomes disabled during a work quarter.
- Disability credit for continued benefits OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProvides disability credit to extend full health and welfare benefits for 3 to 6 months for members who become disabled during a work quarter.
- Eligibility determination and enrollment OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceDetermines eligibility for health and welfare benefits based on 200 or more hours reported by a signatory employer in a qualifying quarter or on a monthly basis; automatically enrolls eligible members without medical underwriting.
- Eligibility support through missing and reserve hours programs OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAllows eligible members to purchase missing hours (if short by 50 or fewer) to maintain eligibility and draw from a reserve hours account capped at 500 hours to meet the 200-hour quarterly requirement during periods of reduced work.
- Eligibility support through missing and reserve hours programs OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAllows members who are short by 50 or fewer hours to purchase missing hours to maintain eligibility and offers a reserve hours account (capped at 500 hours) that members can draw from to meet the 200-hour quarterly requirement during periods of reduced work.
- Hours purchase and reserve account system OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceAllows eligible members to purchase missing hours (if short by 50 or fewer) to maintain eligibility and maintain a reserve hours account (capped at 500 hours) that can be drawn upon to meet the 200-hour quarterly requirement during periods of reduced work.
- Medical and hospital claims processing OPERATING ENGINEERS HEALTH AND WELFARE FUNDdirect serviceProcesses medical and hospital claims for California providers through the Prudent Buyer Plan and routes non-California claims to local BlueCross BlueShield plans for adjudication.