The ILWU-PMA Coastwise Indemnity Plan is a self-funded indemnity plan, which allows you to obtain services from any licensed doctor, or at any licensed hospital or Medicare approved skilled nursing facility. Benefits are paid according to a Schedule of Allowances under Basic Benefits and under Major Medical. By selecting a Doctor, Hospital or other provider that is a participant in the Preferred Provider Organization (PPO) you are guaranteed the maximum benefit, generally 100% of the PPO charge, for covered services.

If you are a Medicare eligible member, you will receive the same benefits as an active member. The Plan pays supplemental benefits to your Medicare coverage.

A detailed description of the Coastwise Indemnity Plan is available in the Supplemental Summary Plan Description booklet. Copies of the Supplemental Summary Plan Description booklet are supplied to ILWU Locals and are available without cost upon request at the Plan office.


Preferred Provider Organization (PPO)

                                 (Non-Medicare Eligibles Only)

The Welfare Plan has entered into agreements with Preferred Provider Organizations (PPOs) to provide medical care to plan members at special rates.  The PPO hospitals, doctors and facilities are among those already used most frequently by Welfare Plan participants.  You can use any hospital or doctor of your choice but the Major Medical plan will pay a higher benefit for Preferred Providers.

A PPO directory listing the names and addresses of Preferred Providers is available at Blue Shield's PPO Network Provider Directory.  If you have questions about whether a provider is a Preferred Provider, you may also call for information at the following numbers:

California

  • Coastwise Claims Office

1-800-955-7376
Blue Shield's PPO Network Provider Directory
Frequently Asked Questions (FAQ)
  • Magellan Behavioral Health (Mental Health)

1-800-424-5945

Oregon and Washington

  • First Choice Health Network 

1-800-231-6935
www.fchn.com
OR
1-206-292-8255

Prescription Drug Program (PPO)

Vision Service Plan (PPO)

Ophthalmology Benefit (PPO)

Chiropractic Benefit (PPO)

Important Notices
Date
April 19, 2012


Copyright 2005-2006 ILWU-PMA Benefit Plans. All rights reserved.