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Healthcare Plan Designs and Costs

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Guaranteed Issue: Amalgamated Local 426 Health and Welfare Fund

Local 426 Health Benefit Fund Base Plan

Primary Only

Your Monthly Premium

$706.00

Individual Deductible
$3,000
Individual Out-of-Pocket Max
$5,350
Family Deductible
$6,000
Family Out-of-Pocket Max
$10,700
Office Visit
Deductible and 50% coinsurance
Specialist Visit
Deductible and 50% coinsurance

Plan Summary Details

View Rx Formulary

Find a Provider

How-To Guide for Finding a Provider

Local 426 Health Benefit Fund Blue Liberty 1500 Plan

Primary Only

Your Monthly Premium

$950.00

Individual Deductible
$1,500
Individual Out-of-Pocket Max
$5,350
Family Deductible
$3,000
Family Out-of-Pocket Max
$10,700
Office Visit
Deductible then $30 copay
Specialist Visit
Deductible then $50 copay

Plan Summary Details

View Rx Formulary

Find a Provider

How-To Guide for Finding a Provider

Local 426 Health Benefit Fund Liberty Plan

Primary Only

Your Monthly Premium

$1,049.00

Individual Deductible
$0
Individual Out-of-Pocket Max
$5,350
Family Deductible
$0
Family Out-of-Pocket Max
$10,700
Office Visit
$30 copay
Specialist Visit
$50 copay

Plan Summary Details

View Rx Formulary

Find a Provider

How-To Guide for Finding a Provider

Local 426 Health Benefit Fund ASO Plan

Primary Only

Your Monthly Premium

$1,201.00

Individual Deductible
$0
Individual Out-of-Pocket Max
N/A
Family Deductible
$0
Family Out-of-Pocket Max
N/A
Office Visit
$25 copay
Specialist Visit
$25 copay

Plan Summary Details

View Rx Formulary

Find a Provider

How-To Guide for Finding a Provider

Who is the carrier for the medical plans? What kind of network of coverage?

The plan sponsor is the Amalgamated Local 426 Health and Welfare fund, and the plan utilizes the nationwide Anthem BlueCard PPO network. The plan is governed by Federal ERISA law and not subject to state insurance law.

Can members over the age of 65 enroll in the Medical plans?

Yes, but these medical plans must be primary and not enrolled in Medicare.

Who can enroll in this Medical plan? Group/Individuals?

These medical plans can be written down to the sole proprietor level but also offered in a traditional group/employer sponsored setup.

When offering these medical plans on a true group setting who is eligible to enroll?

W-2 and 1099 contractors can enroll in the medical plans that are offered at a group level.

Would just need the sponsoring employers FEIN for setup.

Are there any Employer Contribution Rules for premiums or any minimum employee participation rules?

NO

When do these plans renew?

medical plans operate on a calendar year deductible and OOPM framework. Meaning Deductibles and Out of Pocket max will reset every January 1.

When can I enroll?

We allow monthly enrollments throughout the year at the first of every month, however you must enroll by the 15th of the month prior to your desired effective date.

Ex: 6/1/24 enrollments must be completed by 5/15/24