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Prescription Drug Coverage

http://roofersbenefits.com/medical/prescription-drug-coverage

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. Kaiser Prescription Drug Coverage. Prescriptions: can only be obtained from a Kaiser facility. This includes Dental prescriptions. Self-funded Medical Prescription Drug Coverage. Prescriptions are filled at your participant pharmacy through Caremark. Getting Started is Easy! Fill your prescriptions in three simple steps:. Present your benefit card to your pharmacist.

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Self-Funded (PPO)

http://roofersbenefits.com/medical/self-funded

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. Under the medical plan certain hospitals, doctors, and laboratories have agreed to accept negotiated rates for services provided to participants and dependents insured under this Plan. To receive the maximum available benefits, use an Anthem Blue Cross Prudent Buyer Hospital or Doctor for your covered services. Self-Funded Medical Plan Summary. Office Visit – $30&...

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Vision Benefits

http://roofersbenefits.com/other-benefits/vision-care

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. STANDARD EYE EXAMINATION AND GLASSES. Once each 12 months*. Once each 12 months*. Once each 24 months*. From your last date of service. Subject to a co-payment of $20.00. SPECTACLE LENSES AND FRAME:. Elective or medically necessary contact lenses may be provided instead of glasses. Medically necessary contact lenses:. 6800 Santa Teresa Blvd, Ste 100. San Jose, CA 95119.

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Kaiser – Traditional

http://roofersbenefits.com/medical/kaiser-traditional

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. Kaiser – Traditional. Principal Benefits for Kaiser Permanente Deductible HMO Plan. The Services described below are covered only if all the following conditions are satisfied:. The Services are Medically Necessary; and. Annual Out-of-Pocket Maximum for Certain Services. For self-only enrollment (a Family of one Member). 3,000 per calendar year. 3,000 per calendar year.

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Kaiser – Senior Advantage

http://roofersbenefits.com/medical/kaiser-senior-advantage

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. Kaiser – Senior Advantage. For any one Member in the same Family Unit. 3,000 per calendar year. For an entire Family Unit of two or more Members. 6,000 per calendar year. Copayments and Coinsurance for most Services and all Deductible payments count toward this maximum as described in the Evidence of Coverage. For any one Member in the same Family Unit. 10 per encounter...

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Life / AD&D Insurance

http://roofersbenefits.com/other-benefits/life-insurance

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. Life / AD&D Insurance. All Active Full-Time Employees. Retired Employees under age 65. Retired Employees age 65 and over. RETIREE LIFE INSURANCE BENEFIT. RETIREE AD&D INSURANCE BENEFIT. Matches Basic Life Benefit. From birth through 5 months. 6 months but under 19 years. Full-time students 19 years but under 24 years. A Hand and a Foot. A Hand and an Eye. You may expect...

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Forms

http://roofersbenefits.com/forms

Personal Self-Funded Plan Claims Look-Up. Kaiser – Traditional. Kaiser – Senior Advantage. Prescription Drug Discount Plan. Life / AD&D. DeltaCare Enrollment Form – English. Self-Funded Medical Plan Claim Form. Self-Funded Dental Plan Claim Form. Life Insurance Claim Form. Marriage Confirmation (requires notary) – English. Caremark Mail Order Form. Kaiser (Traditional) Enrollment Forms – English. Kaiser Senior Advantage Enrollment Form. SUMMARY PLAN DESCRIPTION (Health and Welfare Plan Booklet).