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Health Coverage Options

Your Options

For coverage starting January 1, 2027, participantsAn individual or that individual's spouse or dependent children who meet(s) the eligibility requirements established by the Fund. on Earned Coverage will choose between two different Health Plan benefit options for themselves and their covered dependents. Participants and their dependents must be enrolled in the same benefit option (either Anthem PPO or Centivo), which each have different participant and dependent premiums. The two options are as follows:

  • Anthem PPO Plan, which is the current Health Plan default for participants on Earned Coverage and retirees. This is a traditional participating provider network with a deductible, coinsurance, and coinsurance out-of-pocket maximums.
  • Centivo Plan, which has a narrower provider network with no in-network deductible, fixed in-network copayments, and an out-of-pocket maximum on copayments. You will need a referral from your Centivo primary care provider (PCP) for most services. If you see a provider outside the Centivo network, you will need to satisfy a deductible, coinsurance, and coinsurance out-of-pocket maximum (which match the out-of-network amounts under the Anthem PPO).

This benefit option is not available to Medicare-eligible retirees enrolled in Certified Retiree coverage or to Medicare-eligible totally disabled participants and dependents.

In the greater Los Angeles area, the Centivo option will include many providers from UCLA Health (including those in The Industry Health Network (TIHN) clinics). However, TIHN benefits will no longer be available as of 1/1/27 - instead, Centivo copayments will apply.

In the New York metro area, the Centivo option will include many providers at Mount Sinai, Montefiore, and other medical groups. Centivo has provider networks in many metropolitan areas, but you should confirm availability in your area before you select the Centivo option.

 

Disclaimer

NOTE: This is only a brief summary of your benefits. All benefit descriptions contained herein are governed by the limitations and other information contained in your SPD.