Welcome to the Cement Masons – Employers Health, Welfare & Vacation Trust!
The Board of Trustees welcomes you to this negotiated Plan. The Plan and its funding are a result of both Labor and Management bargaining for contributions to the Trust to support this Plan of benefits and its eligibility requirements. The Trustees have designed the Plan to cover eligible Employees and their eligible Dependents, not for every expense, but rather for the major expenses associated with health care.
Members can choose between Moda and Kaiser for the medical and dental benefits. A member can choose the same carrier for both the medical and dental benefits, or they can choose one carrier for their medical benefits and choose the other carrier for their dental benefits. Within Moda and Kaiser there is a choice between a “Low” and a “High” plan for both medical and dental benefits.
Members can change their medical and dental plan once a year during Open Enrollment. Open Enrollment is held in December with Plan changes taking effect January 1.
Moda Plan Summary of Benefits: To see a summary of benefits for your medical plan, please go to the “Download Forms & Benefit Summaries” tab.
The Trust offers a “Low” and a “High” plan through Moda. The “Low” Plan requires less hours worked for eligibility than the “High” Plan.
The majority of the Trust’s members are enrolled on the “Low” Moda Medical Plan. The “Low” Moda Medical Plan has a $1,000 Deductible ($3,000 Family), $25 copay or 20% coinsurance on most In-Network benefits. The deductible does not apply to all services. Using Out-of-Network providers will greatly increase your costs. See the Summary of Benefits for this plan for more information.
The “High” Moda Medical Plan requires more hours worked for eligibility. The “High” Moda Medical Plan has a $500 Deductible ($1,500 Family), $20 copay or 10% coinsurance on most In-Network benefits. The deductible does not apply to all services. Using Out-of-Network providers will greatly increase your costs. See the Summary of Benefits for this plan for more information.
There are two dental plans offered by Moda – the PPO or Base Plan (Low) and the Premier or Buy-up Plan (High). The “Low” Plan requires less hours worked for eligibility than the “High” Plan.
What is the difference between the Moda PPO Plan and the Moda Premier Plan? Getting the best benefit out of the Moda PPO Network Plan requires that you use an Moda PPO Provider. Not using a PPO Provider increased your costs. If you currently use a PPO Network dentists, and you are happy with that dentist, then you shouldn’t change to the Premier Network. The Premier Network is an option if you do not use a PPO Network dentist.
PPO Network dentists agree to charge a pre-negotiated fee to Moda that is lower than what the Premier Network dentists agree to charge. This helps keep your costs down as well, as the portion you are left to pay is less due to the negotiated savings. Your $1,500 per person dental maximum will generally go further when on the PPO Dental Plan than it would on the Premier Dental Plan.
Orthodontic Benefits for members with Moda Dental are self-insured through the Trust Office. This benefit is for eligible employees and their covered dependents. Benefits are paid at 60% to a lifetime maximum of $1,000. Please have your orthodontic provider contact the Trust Office at 503-254-4022 or toll free at 1-800-591-8326. Claims should be submitted to the Trust Office:
Cement Masons – Employers H&W Trust
Attn: Orthodontic Claims
9848 East Burnside
Portland OR 97216
Active Members (and Early Retirees who have elected Vision Benefits) have a vision benefit that is self-insured through and paid through the Trust Office.
Vision Claims need to be submitted to the Trust Office:
Cement Masons – Employers H&W Trust
Attn: Vision Claims
9848 E Burnside
Portland OR 97216
Summary of Vision Benefits: The Plan pays: $60 towards exam every 12 months. Lenses: The Plan pays $60 single, $110 bifocal, $140 trifocal, $205 lenticular, every 12 months. Frames: Plan pays $50 towards frames every 24 months. Contact Lenses: Plan pays at eyeglass rate in lieu of lenses and frames.
Special Note to Members who have selected Kaiser as their Medical Carrier: Members with Kaiser as their Medical Carrier have a separate “Routine Eye Exam” benefit through Kaiser for the office visit co-pay of the Kaiser Plan you have chosen. This is separate from the self-insured Vision Benefit through the Trust. The Kaiser co-pay will not be reimbursed under the self-insured benefit.
Kaiser offers a choice between a “Low” and “High” Medical Plan. The “Low” Plan requires less hours worked for eligibility than the “High” Plan.
The Low Kaiser Medical Plan has a $500 deductible ($1,500 family) $15 co-pays or 20% coinsurance on most benefits. Please see the benefits summary for this Plan for more information.
The High Kaiser Medical Plan does not have a deductible. Office visit co-pays are $30 and hospitilization requires a $200 per admission copay. Please see the benefits summary for this Plan for more information.
Click here to be directed to the Kaiser Website to create an account or to log on to an existing account. You can use this website to find Kaiser locations, learn about getting care, transferring records, and more.
Kaiser offers a choice between a “Low” and “High” Dental Plan. The “Low” Plan requires less hours worked for eligibility than the “High” Plan.
The benefits on the two Kaiser dental plans are almost identical. The only difference is a $50 deductible ($150 Family) on the “Low” Plan. The “High” Plan doesn’t have a deductible. Otherewise the benefits are the same.
Time-Loss (Weekly Disability) Benefits
The Trust offers a short-term disability benefit for a non-occupational injury or illness. The benefit is $250 per week, for a maximum of 26 weeks per disability. You must have coverage under the health plan to be eligible for this benefit. This benefit is for members only, not for dependents.
If you have a non-occupational illness or injury and you wish to apply for this benefit, complete the upper portion of the “Statement of Short Term Disability Claim” and then have your physician complete the middle portion. Your employer will need to complete the bottom portion. This form can be found on this website under the Forms Section. Once completed, return to the Trust Office at 9848 E. Burnside, Portland, Oregon 97216. If you have any questions on this benefit, please contact the Trust Office at 503-254-4022 or toll free at 1-800-591-8326. This benefit is taxable income. We are required to withhold for Social Security and Medicare. If you would like Federal and Oregon state (Oregon residents only) taxes wittheld, then please complete the Form W-4 that can be found with the Short Term Disability Claim form.
Disability Waivers are provided by the Trust to extend coverage to disabled employees without using their Reserve Account and without using contributions from a contributing employer. Up to six Disability Waivers are provided per disability. The number of Disability Waivers applied is determined by the length of your doctor certified disability. In no case will more than six be applied per disability.
To be eligible for a Disability Waiver, a physician needs to certify your disability and the disability must have occurred while your coverage was in effect under the Plan.
If you wish to apply for the Disability Waivers, please complete the upper portion of the Disability Waiver application (See the forms section on this website). You will then need to have your physician complete the lower portion of the form. Once completed, return to our office at 9848 E . Burnside, Portland, Oregon 97216. If you have any questions on this benefit, please contact the Trust Office at 503-254-4022 or toll free at 1-800-591-8326.
The Trust offers a $10,000 Life and a $10,000 AD&D benefit to Active Members who are eligible for beneifts under the Plan at the time of their death. The benefit is not eligible to dependents.
The Trust contracts with LifeMap Assurance Company (formerly known as Regence Life and Health Insurance Company) to provide this benefit. For more information and to see if you have a beneficiary on file for this benefit, please contact the Trust Office at 503-254-4022 or 1-800-591-8326.