QUESTIONS |
ANSWERS |
What is my Insurance Classification?
Plan A |
. If you work for Albertsons, Ralphs, Staters or Vons (Plan A) and were hired prior to March 1, 2004 you are a Platinum +. If you were hired after that date you are a Silver, Gold or Platinum member |
Plan B |
If you work for Food-4-Less or Luckys (Plan B) and were hired prior to October 1, 2004 you are a B Platinum +. If you were hired after that date you are a Silver, Gold or Platinum member
|
How many hours
a month do I have to work for benefits? |
Courtesy
and Utility Clerks need 64 hours a month, meat
Cutters and Grandfathered Meat Wrappers need
76 hours a month, and all other classifications
need 92 hours a month. What
is a month? The hours you work in any
one week are credited to you as of each Sunday,
based on the standard Industry workweek, which
is Monday through Sunday. Your monthly
hours are credited to you as of the last Sunday
of each month.
64 hours: Plan A & B: Clerks Helpers
76 hours: Plan A: Meat Cutters and Grandfathered
Meat Wrappers hired prior to 11/4/85; Plan
B: Food & Meat & GM Clerks
92 hours: Plan A: Food, Meat & GM
Clerks |
When can I
switch coverage? |
During
open enrollment once a yea, usually in January. You can change once
in a five (5) year period outside open enrollment,
or if you move out of area. (Except Plans
A-110, B-110) |
What pre-paid
plans are available? |
Kaiser, PacifiCare (Not available
to A-110 and B-110 members) |
When will
I qualify for pre-paid? |
Plan
A-1: After 24 months
of earned eligibility.
Plan B Utility Clerks hired prior to 10/01/04: After
working through two open enrollments. OR
if promoted, after two (2) months of hours
in your new position.
Plan B: All Other Job Classifications hired
prior to 10/01/04: Have choice of pre-paid
from beginning of eligibility.
Plan G: Beginning of eligibility.
Plan A-110 & Plan B-110: not available. |
If a claim
is denied, how do I appeal the claim? |
Request an appeal form from the
Insurance Department and follow the directions
on the form. |
Clarify student
coverage. |
Students are covered from age 19
through their 24th birthday month as long as
they are unmarried and attending an accredited
school full-time. A completed "Student
Certification", signed by the member and
School Registrar, must be on file each
quarter or semester. To cover
the summer months the member must complete and
sign a "Student Certification of Intent
to Return to School After Summer Recess" each
year. |
I have to
have surgery, what should I do? |
Under
Indemnity: Use a contracting
hospital and have doctor call the Review at 1-800-274-7767 before
you go in. Under Pre-paid Plan: See Plan Provider. |
What
are the non-qualifying months? |
There
are none. Eligibility
is based on a skip-month basis, with January's
hours providing eligibility for March, February
for April, etc. |
I have not
received a medical card yet, why?
|
Indemnity
Plan members receive a Medical Plan 2000+ card
and use providers from a list. It takes the plans almost a month
after you become eligible to send out cards. If
you need help you may call their 800#.
Blue Cross Group 57D72A 1-800-825-1030
PacifiCare Group 737 1-800-624-8822
Kaiser Group 1500 1-800-464-4000 |
Explanation
of billings received when members are short
hours for medical coverage
|
Members
will receive a Cobra notice if they are short
hours or no longer working. If a member wishes
to obtain Cobra they must complete the application
and return it before the deadline given. If
a member was short hours due to a paid vacation
or disability they should request an Application
for Reinstatement of Eligibility and return
it with either the vacation information or
the disability or worker's comp. stubs.
Special notes to Ralphs employees: If they
were on vacation they need to see that their
store manager reports their vacation in writing
(email) to Ralphs Payroll Dept. Vacations must
be a full week Monday through Sunday. Have
store manager ask payroll to contact the Trust
Fund. |
How long will
my benefits last after I quit? |
If
you terminate your employment through a voluntary
quit or are terminated, your coverage will
remain in effect for the remainder of the month
that you left work. You may
continue benefits through Cobra. |
This information has been
written as clearly and accurately as possible. You should be aware,
however, that benefits are governed by master policies,
contracts and Plan documents. In all cases
of benefit determination or differences of opinion,
the legal policies, contracts or Plan documents will
prevail.
You can examine the master
policies, contracts and Plan documents by contacting
the Fund Office. If
you prefer, you can request, in writing, copies of
these documents for a reasonable fee. The Fund
Office will send you the documents within 30 days
of receiving your request.
The Fund maintains the Health
Care Plan for the exclusive benefit of eligible
employees; however, eligibility for or participation
in the Health Care Plan is not an assurance or
guarantee of continued employment.
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