Cement Masons

Health & Welfare

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.

Starting January 1, 2018 the Trustees have replaced the Moda Medical benefits with a new self-insured Plan called the Trust Plan. Members can choose between the Trust Plan and Kaiser for their medical benefits. For Dental benefits members can still choose between Moda Dental and Kaiser Dental. The hours that you need to work in a month to have coverage will depend on the Medical and Dental plans that you have chosen.

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.

Trust Plan Medical

For a Summary of Benefits for the Trust Plan, Click Here to Download Forms & Benefit Summaries.

The Trust Plan has a $500 Individual / $1,500 Family In-Network deductible and $25 copay or 20% coinsurance on most In-Network benefits. For Office Visits and some other services, only the copay applies and the deductible is waived for In-Network benefits. The Preferred Provider Network (PPO) is First Health. In-Network providers can be found at www.myfirsthealth.com. Using Out-of-Network providers will increase your costs. See the Summary of Benefits for the Trust Plan for more information.

Please note that the Prescription Drug benefits for the Trust Plan are still administered by Moda Health. You will receive a separate ID card that says Moda Health to give to your Prescription providers. You should call 503.243.3960 or 888.361.1610 with questions about your prescriptions.

Moda Dental

For a Summary of Benefits for the Moda Dental Plan, Click Here to Download Forms & Benefit Summaries.

For Members enrolled in the Delta Dental (Moda Health) Plan, they will select a PPO or Premier dentist from the directory online at www.modahealth.com. Each family member may choose a different dentist. Out-of-network coverage levels will apply if you receive care from a dental provider not in the network.

When a Member visits a PPO or Premier dentist, benefits are paid at the in-network benefit level and members are held harmless from balance billing.

When a member visits a Non-Participating dentist, benefits are paid at the out-of-network level. Members may be held liable for the difference between the dentist’s billed charge and the non-participating allowable.

Orthodontic Benefits

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 E Burnside Street
Portland OR 97216

Vision Benefits

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 Street
Portland OR 97216

Summary of Vision Benefits: The Plan pays $90 toward exam every 12 months. Lenses: The Plan pays $90 single, $140 bifocal, $170 trifocal, $235 lenticular, every 12 months. Frames: The Plan pays $150 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 Medical

To see a summary of benefits for your medical plan, Click Here to Download Forms & Benefit Summaries.

Kaiser is an alternative to the Trust Medical Plan and the Moda Dental Plan. You must live in the Kaiser service area and use Kaiser facilities and providers. 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), $25 Primary Care copay, 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. Primary Care copays are $35 and Inpatient hospitalization requires a $500 per admission copay. Please see the benefits summary for this Plan for more information.

For Active members enrolled with Kaiser for their medical benefits, the Trust self-insures a Chiropractic benefit. The Chiropractic benefits are: No Deductible. Chiropractic benefits are paid at 50% of reasonable and customary charges to a calendar year maximum of $500 per individual and $1,500 family. Please contact the Trust Office at 50-254-4022 or 800-591-8326 for more information on this benefit.

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 Dental
For a Summary of your Kaiser Dental Plan Benefits, Click Here to Download Forms & Benefit Summaries.

Kaiser Dental is an alternative to the Moda Health Dental Plan. You must live in the Kaiser Service area to enroll with Kaiser. You must use Kaiser Facilities and providers.

If you enroll with the Kaiser Dental Plan, you will also have an Orthodontic benefit through Kaiser.

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 at the time of the illness or injury to be eligible for this benefit., and a physician needs to certify your disability. This benefit is for Active members only, not for dependents or Retired members.

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

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.

Life and AD&D Benefit

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 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.