Eligibility & Benefits
HOUR BANK ELIGIBILITY
Eligibility is determined on the basis of an hour bank system. An Employee has six months to accumulate 350 hours in their hour bank. If an Employee does not accumulate 350 hours in the first six months of Covered Employment, the Plan will look to subsequent six-month periods until the Employee meets the 350 hour requirement.
MEDICAL AND PRESCRIPTION DRUG BENEFITS
Initial coverage will be in effect the first day of the second month following the accrual of 350 hours. For example, if 180 hours are worked in June and 170 hours in July, eligibility will begin on September 1st. In this example, August is the lag month.
DENTAL, VISION, TIMELOSS AND DEATH BENEFITS
Eligibility for dental, vision, time loss and death benefits will become effective once a minimum of 1,000 hours has been accumulated in the hour bank.
Coverage for dental, vision, time loss and death benefits will become effective on the first day of the second month following accumulation of 1,000 hours.
FLAT RATE ELIGIBILITY
An Employee covered under a flat rate agreement becomes eligible for medical and Rx coverage on the first day of the second month following the month in which the Employee worked the required number of hours and for which the Employer made the required flat rate contribution to the Trust. Coverage for dental, vision, time loss and death benefits will become effective after 6 months.
The Summary Plan Description is a great place to find information on your Health Plan including eligibility and benefits. If you have any questions related to benefits and eligibility, please contact the Trust Office, Zenith American 206-282-3600 option 2
Click to learn more about your health plan.
Summary of Material Modifications
Any changes to the Plan Language, not found in the Plan booklet can be found here
Important Documents
Enrollment Form - Use this form to enroll in the health plan or update your personal information; address, marital status or add dependent information.
Other Insurance Coverage Form - Click here if you or your dependents have other insurance coverage. The Trust requires this form to be completed each year.
Accidental Injury Form- Fill out this form if you or your dependents have been injured on or off the job.
Capital Rx Pharmacy Claim Reimbusement Form - Complete a prescription claim reimbursment form if you have paid out of pocket for a covered prescription.
Benefit Highlights
Care at no cost
NWL Member Assistance Program
Offering participants confidential advice, support, and practical solutions to real-life issues. Ready to help anywhere, anytime. 5 free visits per family member, per issue, per year.
Call Uprise Health to connect with a Care Navigator 1-855-697-7940
Teladoc Health offers virtual visits for everyday, non-emergency conditions like the flu, sinus infections or pink eye. Board certified medical providers can diagnose, treat and prescribe medications to get you feeling better faster.
Teladoc Dermatology gives you access to board certified dermatologist anywhere you are. Whether you have a question about a recent skin change or need help managing a chronic skin condition like acne , rosacea, or psoriasis.
Teladoc Mental Health therapy is also available for participants and their covered dependents over the age of 18. You can schedule one visit or ongoing visits for life’s issues, big and small.
Register your account at www.teladochealth.com/benefits/premera
or call today 1-855-332-4059
Personal Health Support
Premera has Personal Health Support clinicians who can provide assistance tailored to your needs. Find out how to:
• Better manage a condition, such as asthma, diabetes, or heart disease
• Take care of yourself or a loved one to prevent readmission after a hospital stay
• Ask the right questions about an illness or procedure
For information, call 855-869-6775.
24 hour Nurseline
It’s after hours and you or a dependent have pain, an injury, or a fever you can’t shake—call the 24-Hour NurseLine at
1-800-755-0011. The number is also located on the back of your Premera ID card.
Premera Maternity Resource Program
Premera offers a comprehensive maternity program to help ease your concerns and make sure you get the pregnancy, delivery, postpartum care and newborn care you need. If you enroll in the program within the first 16 weeks of pregnancy, the Trust will waive the baby’s deductible in the first year of delivery. To contact a clinician today, call the Premera maternity support line at 855-756-0797 or send a secure message in the Wellframe App available in the Google Play or Apple store
Care for Type 2 Diabetes
A virtual clinic that helps you eat your way to better health with care plans made just for you. With support from clinicians and coaches, you can lose weight, reverse* type 2 diabetes, and reduce medications. No intense exercise plans and no calorie counting.
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