Sign, Pictorial & Display Industry Trust Funds

Medical Plan Options

Participants in the Sign Pictorial & Display Industry Welfare Fund may select from two medical plans: the Self-Funded PPO Plan and the Kaiser HMO.  

The Self-Funded PPO Plan allows you to see any doctor, whether or not they are part of a network. With this plan, you pay annual deductibles before the plan pays any benefits. You may visit any provider, but your out-of-pocket costs will be less if you utilize a PPO provider. The current PPO network is the Anthem Blue Cross Prudent Buyer network.

Under the Kaiser HMO plan, you must select a Primary Care Physician. This is the doctor you must always visit for all of your care. If you need to see a Specialist, your doctor will send you to another doctor for the necessary services. With an HMO, you do not pay an annual deductible and only pay a small fee for office visits.  Kaiser participants must visit Kaiser facilities. 

This chart will help you to compare many plan features side-by-side:

 
Self-Funded PPO Plan
Kaiser
Network Enrollees in the PPO Plan may visit any provider. Your benefits are higher if you use PPO providers who are contracted with the Anthem Blue Cross Prudent Buyer Network. Enrollees in Kaiser must receive all their care at Kaiser clinics and hospitals.
Deductible $300 PPO/$600 non-PPO
(two per family) 		None
Coinsurance/Co-Pays

Plan pays 90% PPO/70% non-PPO Non-PPO Hospital Deductible:  $200
Emergency Room deductible - Illness:  $100
Emergency Room deductible - Injury:  $50

 Office Visits: $25
Hospitalization: None
Emergency Room: $35
Out of Pocket Maximum per calendar year $1,300 PPO/$5,600 non-PPO $1,500 per person/$3,000 per family
Prescription Drug

Express Scripts Card: 20% coinsurance.  Maximum benefit - $20,000 per year.

Mail order:  $5 co-pay generic; $20 co-pay brand name drugs. 

If you obtain a brand name drug when a generic equivalent is available, you must also pay the difference between the cost of the brand name drug and the generic drug.

$10 generic/$25 brand name, for a up to a 100-day supply (both retail and mail order).

 
This group health plan believes it is a “grandfathered health plan” under the Patient Protection and Affordable Care Act. Because of this, certain provisions under the Affordable Care Act do not apply to this group health plan. See here for more information.