2015 Benefits Books - Your Guide to Training and Health Benefits by SEIU 775 Benefits Group

YOUR BENEFITS YOUR GUIDE TO TRAINING AND HEALTH BENEFITS

2014-2015

2014-2015 BENEFITS BOOK

WELCOME Welcome to the fourth “Your Benefits” book from the SEIU Healthcare NW Training Partnership and Health Benefits Trust. This book is designed to serve as a complete guide to your training and health benefits. It features resources and information to make it easier to get the support you need. As a Home Care Aide, Care Begins With You. Your training and health benefits are a critical part of the compensation you receive and they provide the skills and personal stability needed to help you deliver excellent care to your consumers and create future career pathways. You are the key to quality care in Washington’s long-term care system. Thank you for all you do to promote excellence in home care. Charissa Raynor Executive Director Training Partnership and Health Benefits Trust

David Rolf Board Chair Training Partnership and Health Benefits Trust President, SEIU Healthcare 775NW

WWW.MYSEIUBENEFITS.ORG - Learning Management Portal Enter your Username and Password below for easy reference USERNAME

PASSWORD

PRIMARY CARE PROVIDER (DOCTOR) / URGENT CARE CENTER Write your Doctor and nearest Urgent Care Center here for reference PRIMARY CARE DOCTOR NAME

PHONE

URGENT CARE CENTER NAME, ADDRESS, HOURS, PHONE NUMBER

YOUR HEALTH PLAN PLAN NAME

MYSEIUBENEFITS.ORG

YOUR DENTAL PLAN PLAN NAME

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Benefits Summaries ........................................41

If You Need Assistance....................................4

WDS Delta Dental Pro Plan..............................58

Language Support ...........................................6

Willamette Dental ............................................61

Quick Start ......................................................7

Glossary ..........................................................90

Update Preferences ........................................10 2014-2015 Benefit Highlights .........................11 Get Online.......................................................12 Online Continuing Education ...........................13 Magazine ...............................................15

TRAINING BASICS .................................64 Quality Training, Quality Care ...........................65 How to Get the Most from Your Training ...........68 DOH Certification:

HEALTHY CHOICES

Access myseiubenefits.org ..............................8

HEALTH BENEFITS

CONTENTS

Follow These Steps for Success .......................70 Interpretation ..................................................72 Help Improve Future Classes...........................73

Care Begins With You ......................................17 2014-2015 Medical Plan Highlights ................18 Participating Employers ...................................19 Eligibility and Enrollment .................................19 Dental Partners ...............................................20 Your Benefits ..................................................21 Locate Closest Urgent Care Center ..................22 Prescription Medication Benefits .....................24 Vision Benefits ................................................25 3 DOORS OF COVERAGE .........................26

Training Standards ..........................................75 Training Standards Chart .................................76 Who to Contact for Training and Support..........78 Orientation and Safety .....................................79 Frequently Asked Questions ............................80 TRAINING POLICIES ...............................83 Frequently Asked Questions: Classroom Policies ....................................84 Student Code of Conduct and

TRAINING BASICS

Group Health Urgent Care Center ....................23

TRAINING STANDARDS ..........................74

BENEFITS POLICIES

HEALTH BENEFITS .................................16

Classroom Expectations ............................84 Reasonable Accommodation Policy .................86

Managing Your Health Care .............................29

Questions and Appeals....................................88

Complete a Preventive Care Visit .....................30

Glossary ..........................................................90

Notices ...........................................................113

Complete Your Health Profile ...........................31 Complete a Dental Cleaning ...........................32

GETTING STARTED.................................92 English............................................................92 Simplified Chinese ..........................................95

Frequently Asked Questions:

Korean ............................................................98

Eligibility and Enrollment .........................34

Spanish ..........................................................101

Group Health Options .............................38

Russian ..........................................................104

Kaiser Permanente .................................39

Vietnamese .....................................................107 Somali ............................................................110 2014-2015 BENEFITS BOOK

TRAINING POLICIES

HEALTH BENEFITS POLICIES FAQ ............34

TRAINING STANDARDS

HEALTHY CHOICES ................................28

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One-Stop Resource for Training, Health Benefits

To make it easier to understand your training and health benefits, the Training Partnership and Health Benefits Trust put together this “Your Benefits” book to help guide you. These benefits are effective Aug. 1, 2014 through July 31, 2015. This Benefits Book will be in effect until July 31, 2015. Inside, you will find important benefits information, including: Training Benefits • Training standards • Classroom policies • Glossary • Student resources Health Benefits For eligible Individual Providers or Agency Providers covered through their employers • Eligibility • Benefit summaries • Healthy choices YOUR GUID E

Our Online Benefits Book Is Always Available

TO TRAI NING

AND HEALTH

YOUR BENEFIT

BENE FITS

2014-2015

Did you know there is an online version of the Benefits Book? The online version of the Benefits Book is a useful tool if you misplace your book or want to view your benefits information from anywhere. You can view the online Benefits Book at www.myseiubenefits.org/benefits.

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Where to Find Updates

2014-2015

BENEFITS

BOOK

If there are changes to training standards or other information after the book is released, we will update this “Your Benefits” book the following ways: ONLINE Updates will be available online at www.myseiubenefits.org/benefits. HOME CARE INSIGHT Updates will also be in your magazine Home Care InSight, the magazine for Home Care Aides.

COLOR CODED Throughout the book, you will see information for both Individual Providers (IPs) and Agency Providers (APs). To help keep them straight, look for these colors:

Individual Providers Agency Providers

RENCE GUIDE SUPPORT

General Training and Health Benefits Support

Fill out a Contact Form at www.myseiubenefits.org/contact. Member Resource Center (MRC) 1-866-371-3200 Mon.-Fri., 8 a.m.-6 p.m. The MRC is closed the following holidays: • New Year’s Day • Martin Luther King, Jr. Day • Presidents’ Day • Memorial Day • Independence Day • Labor Day • Thanksgiving • Day after Thanksgiving • Christmas Eve Day • Christmas Day Check www.myseiubenefits.org/MRC for office closures and the most updated hours. ■ Individual Providers If you need information about your training or benefits eligibility, log in to www.myseiubenefits.org first. If you cannot find the answer to your question, contact the Member Resource Center at 1-866-371-3200.

■ Agency Providers Contact your employer for support.

Specific Training Support See chart on Page 78 for who to contact for specific training-related questions.

For answers to medical or dental plan questions, contact: Medical Plan Support Group Health 1-888-901-4636 Mon.-Fri., 8 a.m.-5 p.m. www.ghc.org Kaiser Permanente 1-800-813-2000 www.kp.org

Dental Plan Support Delta Dental (Dental) 1-800-554-1907 www.deltadentalwa.com Willamette Dental 1-855-433-6825 www.willamettedental.com

2014-2015 BENEFITS BOOK

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Specific Health Benefits Support

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For ForAssistance Assistance

សូ មទាក់ទងមកមជ្ឈមណ្ឌលធនធានសមាជិក តាមលលខ 1-866-371 3200 ល�ើលោកអ្ន កត្រូវកា រជំនួយការចុះល្មះសតមា�់ការ�ណ្តះ�ណ្ តា លរ� ស់លោកអ្ន ក ឬល�ើម្បីឱ្យ�ឹងថា លោកអ្ន កមាន សិទ្ិតស�ចបា�់ចំលោះអ្្ថ ត�លោជន៍ននការថែ ទា ំសុខភាពឬលទ។ 如需在安排培训日程或了解您是否有资格获取保健福利方面获取协助，请致电 1-866371-3200 联系会员资源中心。 Contact the Member Resource Center at 1-866-371-3200 if you need assistance registering for your training or to find out if you are eligible for healthcare benefits.

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훈련일정을 잡거나 건강혜택 자격 확인을 위해 도움이 필요하시면 회원지원센터 1-866-371-3200 로 전화주세요. ຕິດຕ່ໍ ຫາສູ ນຊ່ ວຍເຫື ຼ ອສະມາຊິກ (Member Resource Center) ທີ່ເບີ 1-866-371-3200 ຖ້ າທ່ າ ນຕ້ ອງການຄວາມຊ່ ວຍເຫື ຼ ອໃນການລົ ງທະບຽນ ສໍາລັ ບການຝຶກອົ ບຮົ ມຂອງທ່ ານ ຫື ຼ ເພ່ື ອຊອກ ຮູ້ ວ່ າທ່ ານມີສິດໄດ້ ຮັ ບເງິນຊ່ ວຍເຫື ຼ ອສໍາລັ ບການ ດູ ແລສຸ ຂະພາບຫື ຼ ບ່ໍ . Если у Вас есть вопросы, связанные с определением расписания занятий, или относительно получения Вами пособия по нетрудоспособности, обращайтесь в Учебно-методический центр по телефону 1-866-371-3200.

Paragraph Style: Body Text

Faafesootai le Member Resource Center ile 188-371-3200 pe afai ete manaomia le fesoasoani mole resitaraina mo lau toleniga pe fia iloa pe ete agavaa mo faamanuiaga mo togafitiga tau soifua maloloina. Comuníquese con el Centro de Recursos para Miembros al 1-866-371-3200 si necesita asistencia para registrarse en su entrenameinto o para saber cuál es su elegibilidad para los beneficios de salud. Kala xiriir Xarunta Macluumaadka Xubinka 1-866-371-3200 haddii aad u baahan tahay caawimaadda diiwaangelinta tababarkaaga ama si aad u oggaatid haddii aad u qalantid dheefaha daryeelka caafimaad. Makipag-ugnayan sa Member Resource Center sa 1-866-371-3200 kung kailangan ninyo ng tulong sa pagpaparehistro ng inyong pagsasanay o para malaman kung kayo ay karapat-dapat sa mga benepisyo sa pangangalaga ng kalusugan. Зверніться до Учбово-методичного центру за тел. 1-866-371-3200, якщо Вам буде потрібна допомога з реєстрацією для проходження навчання або якщо Вам буде необхідно з’ясувати, чи маєте Ви право на пільги з медичного забезпечення. Hãy gọi Trung Tâm Nguồn Lực Thành Viên theo số 1-866-371-3200 nếu quý vị cần được trợ giúp trong việc lên lịch đào tạo hoặc tìm hiểu về điều kiện để nhận phúc lợi y tế.

T n a w

RENCE GUIDE Training Quick Start

1. Find Your Training Standards ■ Individual Providers There are different training standards depending on what type of care you provide. ■ Agency Providers Your employer can help you understand your training standards. Contact your employer to get your training standard information.

2. Watch the Orientation and Safety DVDs - If Required Look at the training grid on Page 76 to see your requirement.

3. Schedule Training Early Schedule within first two weeks of hire to ensure the best choices. ■ Individual Providers Create your Username and Password to log in to the training portal at www.myseiubenefits.org. Go online to www.myseiubenefits.org to log in to register for training or call the Member Resource Center at 1-866-371-3200. ■ Agency Providers Check with your employer on the best way to register. Your employer has policies on scheduling for training.

Health Benefits Quick Start 1. Check your eligibility for health insurance benefits and enroll ■ Individual Providers Go online to www.myseiubenefits.org to enroll online, or call the Member Resource Center at 1-866-371-3200. Your eligibility for health insurance depends on the number of hours you work. ■ Agency Providers Contact your employer to see if you are eligible for health benefits through your employer. 2. Make an appointment with your primary care doctor Go to your health insurance provider’s website or contact them by phone (see contact info on Page 30) to find available doctors and other providers. See the Health Benefits section for more details.

2014-2015 BENEFITS BOOK

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Track page number and update when final.

QUICK START

QUICK REFER IF YOU NEED ASSISTANCE Benefits Easily Online IFManage YOU Training NEED and ASSISTANCE

The best way to manage your training is through the www.myseiubenefits.org website. Through the online portal, you can easily update your information and stay on top of your training.

How to Log In to the Website 1. Sign up to log in to the portal Enter your first name and last name.

If you know your Student ID enter it in the Student ID Field. If you donâ&#x20AC;&#x2122;t know your Student ID, enter the last four digits of your Social Security number along with your birthdate (mm/dd/yyyy). (Note: If you are an Individual Provider, you must use your Student ID instead of your birthdate and last four digits of your Social Security Number.)

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2. Fill out the basic student information

This screen is to verify your information. You will be asked to verify your information regularly. Make any necessary changes and click SAVE.

RENCE GUIDE QUICK START

3. View your student profile page

4. Email confirmation

Now Youâ&#x20AC;&#x2122;re Ready to Log in to the Website! Remember, your username is your Student ID and your password is what you set when you signed in. Please put your username and password on Page 2 of this book.

2014-2015 BENEFITS BOOK

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If you have provided your email address (recommended), you will receive an email notification.

QUICK REFER QUICK REFERENCE GUIDE | UPDATE PREFERENCES

UPDATE YOUR PREFERENCES ONLINE

Keeping your language and contact preferences updated is an important way to help the Training Partnership provide you with the best possible training experience. Make sure to update your preferences as soon as possible so we can reach you effectively.

2 Click the “View Your

Profile” link on the left side of the screen.

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Click the “Edit Profile” link on the middle of the screen:

4 Modify the settings and update other information and click

the SAVE button.

RENCE GUIDE 2014-2015 BENEFIT HIGHLIGHTS | QUICK REFERENCE GUIDE

TRAINING & BENEFITS HIGHLIGHTS

TRAINING Refresher Courses

As another way to help students achieve success with the DOH Certification Exam, the Training Partnership is offering a free, 2-hour, zero-credit Skills Refresher course. Any student who has completed the 70-hour Basic Training series is welcome to sign up and attend. Not available in all areas. Register through the Member Resource Center at 1-866-371-3200 or www.myseiubenefits.org/contact.

Thirteen Languages Training Partnership offers training in 13 languages including English: Arabic, Cambodian/Khmer, Cantonese, English, Korean, Laotian, Russian, Spanish, Samoan, Somali, Tagalog, Ukrainian, Vietnamese.

HEALTH BENEFITS 2014-2015 Plan Changes

Notes

Out-of-Pocket Maximum Group Health $1,200

Increased but now all deductibles, copays and coinsurance apply

Kaiser Permanente $1,250 Plan Highlights Preventive Care

In-network, paid in full with no annual limit

Female Contraception

Included in Preventive care, paid in full

Annual limits removed

Urgent Care Group Health $15 copay Kaiser Permanente $30 copay $200 copay

* Catholic Community Services does not pay for contraceptive and sterilization services.

Improve Your Health and Earn $100 Complete the following three activities to improve your health care.

★ ★ ★

FILL OUT YOUR HEALTH PROFILE Once you are registered, complete the online Health Profile. See Page 31 for details. COMPLETE A PREVENTIVE CARE APPOINTMENT Select a primary care provider and then complete an appointment. See Page 30 for details. COMPLETE DENTAL CLEANING/CHECKUP Complete a dental cleaning/ checkup with your dentist. See Page 32 for details. 2014-2015 BENEFITS BOOK

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Emergency Room

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MYSEIUBENEFITS.ORG

Your easy online source for Online CE, training standards and class registration Once you get your online username and password, you’re ready to go online to manage and take training! Over the past year, the Training Partnership has worked to increase the quantity and depth of the resources available on the website www.myseiubenefits.org

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In addition to the ability to register online, find training standards, and other resources, you can take a robust number of Online Continuing Education courses – right from your computer.

www.myseiubenefits.org

WHY GO ONLINE Manage and Register for Training If you are an Individual Provider, you can register for training online. You can view available courses and pick times that work for you.

Online Continuing Education You can take your Continuing Education conveniently online – anytime, anywhere! See the following page for details on Online Continuing Education.

RENCE GUIDE ONLINE CONTINUING EDUCATION

ONLINE CONTINUING EDUCATION

In addition to dozens of courses in English, there are online CE courses in Russian and Spanish available as well. New courses will be coming online throughout the year. With online classes you pick the times and topics that work for you. You can see the available courses, register for and access courses, receive credit, and navigate help information â&#x20AC;&#x201C; all online and 24 hours a day! Each online course takes about one hour to complete, which may vary depending on learning style, material covered and Internet connection speed.

Online Continuing Education Classes In English as of July 2014 Mental Illness

Dispelling Disability Myths

Supporting Consumers with Mental Illness, Part 1

The Faces of Down Syndrome

Supporting Consumers with Mental Illness, Part 2

Historical Perspectives on People with Developmental Disabilities

Supporting Behavior Changes in Consumers, Part 1

Positive Behavior Support for young consumers with Developmental Disabilities

Dementia An Introduction to Dementia

Supporting Behavior Changes in Consumers, Part 2

Health/Wellness Oral Health Basics Denture Care and Cleaning Gaining Consumer Cooperation for Oral Care

Physical Disabilities An Introduction to Physical Disabilities

Providing Consumer-Directed Care for Common Medical Conditions: Dehydration

Multiple Sclerosis

Providing Consumer-Directed Care for Common Medical Conditions: Urinary Tract Infections

Hearing and Vision Conditions Traumatic Brain Injury

Providing Consumer-Directed Care for Common Medical Conditions: Pneumonia

2014-2015 BENEFITS BOOK

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Developmental Disabilities

QUICK REFER IF YOU NEED ASSISTANCE Providing Consumer-Directed Care for Common Medical Conditions: CHF Providing Consumer-Directed Care for Common Medical Conditions: Seizure Providing Consumer-Directed Care for Common Medical Conditions: Stroke Providing Consumer-Directed Care for Common Medical Conditions: COPD Providing Consumer-Directed Care for Common Medical Conditions: PVD Providing Consumer-Directed Care for Common Medical Conditions: CAD

Safety Best Practices for the Professional HCA Infection Control and Workplace Safety Protecting Worker Safety Through Violence De-escalation, Part 1

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Protecting Worker Safety Through Violence De-escalation, Part 2

Supporting Consumer Independence The LGBTQ Community: Basics for a Better Working Relationship The LGBTQ Community: Unique Needs of Seniors and Older Adults

Online Continuing Education Classes In Spanish and Russian as of July 2014

Reducing the spread of infection through standard precautions

Best Practices for the Professional HCA

Using Household Cleaning Chemicals Safely

Traumatic Brain Injury

Green Cleaning

Body Mechanics

Infection Control and Workplace Safety

Falls Prevention: Helping Consumers Stay Safe and Independent in Their Homes

Better Health through Nutritious Cooking

Nutrition

An Introduction to Dementia

Better Health through Nutritious Cooking Cultural Competency - Nutrition

Other Arthritis & Acute Mental Status Changes Cultural Competency: Pain Management and Assumptions Providing End of Life Care, Part 1 Providing End of Life Care, Part 2 Recognizing and Reporting Consumer Abuse, Neglect and Financial Exploitation Home Care Aides Make a Difference Promoting Creativity Relationships between Consumers

Multiple Sclerosis

An Intro to Physical Disabilities

IMPORTANT NOTE The following courses were available in early 2011 for a short time, so if you took them at that time, you cannot take them again. If you did not take them then, they are available to take online. Relationships Between Consumers Home Care Aides Make a Difference Supporting Consumer Independence The Faces of Down Syndrome Dispelling Disability Myths Promoting Creativity

RENCE GUIDE INSIGHT MAGAZINE

Next Issue of InSight Magazine As a community of Home Care Aides, you do important work and you have an important story to tell. You can help raise understanding of common challenges and experiences for Home Care Aides to help improve the profession. To share knowledge and skills with the Home Care Aide community, a new magazine will be published to focus on you and your work.

Magazine Highlights Training and Health • Training standards updates • Best practices for Home Care Aides • Knowledge and skill builders • Student participation policies and news • Health benefits policies and news • Your safety at work Important Updates to the “Your Benefits” Book • Updates to the “Your Benefits” book will be printed in the magazine as well as posted online; be sure to check your magazine for updates.

As a Home Care Aide, you have amazing stories to tell. We want to hear from you! If you have a great story or tip to share, please send it to editor@myseiubenefits.org.

2014-2015 BENEFITS BOOK

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SEND US YOUR STORY IDEAS

HEALTH BENEFITS 16

MYSEIUBENEFITS.ORG

HEALTH BENEFITS

HEALTH BENEFITS TRUST AFFORDABLE HEALTH BENEFITS FOR YOU For eligible Individual Providers and Agency Providers, the Health Benefits Trust is a nonprofit organization providing affordable health coverage focused on keeping you healthy. The health care benefits offered by the Health Benefits Trust are part of a community of care that starts with you.

You are eligible if you work at least 86 hours every month! To start your health care coverage, ask yourself: •

Did I work at least 86 hours in the previous three months?

•

Did I fill out and send the enrollment form or enroll online?

•

Do I know about the monthly cost to me of $25 (automatically deducted from paycheck)?

There are a few more things to know about eligibility, but if you answered yes to these questions, you are on your way to great health care coverage!

How to Enroll  Individual Providers: You can enroll by logging in to the Portal with your Student ID and click on the IP Online Enrollment form. You can also enroll by printing a paper form (found on www.myseiubenefits.org) fill out and submit to the address or fax number on the form. Call the MRC at 1-866-371-3200 if you need help.

 Agency Providers: Talk with your employer about enrollment. 2014-2015 BENEFITS BOOK

2014-2015 PLAN CHANGES & HIGHLIGHTS Plan Changes

Notes

Out-of-Pocket Maximum Group Health $1,200

Increased but now all deductibles, copays and coinsurance apply

Kaiser Permanente $1,250 Plan Highlights Preventive Care

In-network, paid in full with no annual limit

Female Contraception*

Included in Preventive care, paid in full*

Annual limits removed

Urgent Care Group Health $15 copay Kaiser Permanente $30 copay Emergency Room

$200 copay

* Catholic Community Services does not pay for contraceptive and sterilization services

2014-2015 Benefits Plan* The Health Benefits Trust designed the 2014-2015 benefits with your health in mind. We strive to provide a health plan that better serves the needs of Individual Providers and Agency Providers by meeting the following goals: •

Providing great coverage while keeping your costs low. •

Emphasizing preventive care to encourage your overall health.

•

Encouraging participation in health assessments so you can better understand how daily decisions affect your health.

•

Encouraging regular dental cleanings because your oral health is linked to your overall health.

•

Improving your understanding of getting care when you need it by using Urgent Care instead of the emergency room care.

•

Encouraging convenient, lower-cost prescriptions through mail order.

•

Making mail prescriptions for some chronic conditions very affordable.

•

Encouraging use of in-network providers because it saves you money. * Effective Aug. 1, 2014

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HEALTH BENEFITS

ENROLLMENT Participating Employers STATE OF WASHINGTON n Individual Providers: If you are are contracted through the Department of Social and Health Services (DSHS), you are considered an Individual Provider (IP). You can be covered by the Health Benefits Trust if you meet the eligibility requirements. Want to know if you’re eligible? See page 26 for details

AGENCY EMPLOYERS n Agency Providers: If you are a Home Care Aide working for these Washington agency employers, you are considered an Agency Provider (AP). You may be covered by the Health Benefits Trust if you meet the eligibility requirements. This list may change. Check with your employer to verify participation. • • • • • • •

AAA Residential Services Addus Healthcare Amicable Healthcare Catholic Community Services CDM Chesterfield Concerned Citizens

• • • • • • •

Fidelis Home Care Services of Montana Korean Women’s Association Olympic Community Action Council Coastal Community Action Council ResCare Senior Life Resources Northwest

Want to know if you are eligible? Contact your employer for more details.

ELIGIBILITY: Am I eligible for the Health Benefits Trust coverage? If you work at least 86 hours per month for 3 months in a row you’ve met the initial eligibility requirements! You have to work at least 86 hours every month to remain covered with the Health Benefits Trust and cannot have other coverage. If you are an Individual Provider (IP) the monthly 86 hour requirement can include: • Hours worked • Training hours • Accrued vacation hours If you are an Agency Provider (AP) contact your employer for more information.

HOURS FELL BELOW 86? If you were covered by the Health Benefits Trust and then had a reduction in hours you can continue your benefits through COBRA. For more details see page 34 for Frequently Asked Questions - Eligibility. 2014-2015 BENEFITS BOOK

Health and Dental Plan Partners The Health Benefits Trust coverage includes medical, vision, prescription and dental benefits and we partner with these health plans: Group Health 1-888-901-4636 Mon.-Fri., 8 a.m.-5 p.m. www.ghc.org Kaiser Permanente 1-800-813-2000 www.kp.org

Delta Dental 1-800-554-1907 www.deltadentalwa.com Willamette Dental 1-855-433-6825 www.willamettedental.com

WE WANT YOU TO HAVE HEALTH CARE COVERAGE Even if you donâ&#x20AC;&#x2122;t meet the 86 hour eligibility rule to be eligible for coverage through the Health Benefits Trust, you may still qualify for free or low-cost health care benefits. See page 26 for more details or visit:

www.wahealthplanfinder.org

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HEALTH BENEFITS

YOUR BENEFITS Eligible IPs and APs enjoy many benefits through the Health Benefits Trust.

Medical Benefits Nobody ever plans to get sick, but the Health Benefits Trust has you covered. Depending on your ZIP code*, your medical, vision and prescription drug health care coverage will be provided by Group Health or Kaiser Permanente. Some of these services may be covered in full or you may have a copay (small out-of-pocket cost) for the following services: • Acupuncture • Allergy shots and other injections • Chiropractor visits • Doctor’s office visits • Hearing exams • In-patient hospitalization • Laboratory services • Mammograms • Maternity services • Mental health • Rehabilitative therapies • Routine immunizations • X-rays and diagnostic imaging Want more information on what’s covered? See pages 41-63 for Benefits Summaries *If you are currently enrolled in the Health Benefits Trust, you are enrolled in one of the following plans depending on your ZIP code: Group Health Cooperative HMO You live within 30 miles of a Group Health Medical Center or contracted facility and enrolled in the Trust after 8/1/2012.This plan only has coverage in-network. There are no out-of-network benefits. Group Health POS You live within 30 miles of a Group Health Medical Center or contracted facility. Group Health PPO You live more than 30 miles from Group Health Medical Center or contracted facility. Kaiser Permanente HMO You live within the Kaiser Permanente service area (southwest Washington/Portland, OR only). For more information, see page 54 for plan and network grid. 2014-2015 BENEFITS BOOK

Locate Closest Urgent Care Center Why Use Urgent Care Centers? Urgent care is a much more affordable option than emergency room care when you are enrolled with the Health Benefits Trust. Your cost for a visit to the emergency room is $200 (waived if you are admitted to the hospital) compared to just $15 for a trip to Urgent Care with Group Health and $30 with Kaiser.

URGENT CARE

Here are some examples of when to use Urgent Care or the emergency room. This is not intended to be a complete list.

URGENT CARE Copay GH $15

KP $30

EMERGENCY ROOM Copay $200 (waived if you are admitted)

Allergies

Chest Pain

Asthma Attack (Minor)

Compound Fractures (Bone Visible)

Cold, Flu, Fever

High Fever

Cough

Ingestion of Poison

Dizziness

Major Head Injury

Fractures

Seizures

Headache

Severe Asthma Attack

Nausea

Severe Burns

Low back pain

Shock

Migraine

Uncontrollable Bleeding

Minor Burns Minor Cuts/Lacerations Sore Throat Sprains Stitches Urinary tract infection

MYSEIUBENEFITS.ORG

Six Group Health medical centers have Urgent Care Centers, most with evening, weekend, and holiday hours. Group Health also contracts with many community Urgent Care Centers throughout the state of Washington. Use the Group Health Provider Directory at www.ghc.org to find urgent care providers in other areas. You can also find urgent care locations, hours and wait times from the Group Health iPhone and Android App.

WESTERN WASHINGTON BELLEVUE MEDICAL CENTER URGENT CARE | 425-502-4120 425-502-3000 11511 N.E. 10th St. Bellevue, WA 98004

SILVERDALE MEDICAL CENTER URGENT CARE | 360-307-7300 360-307-7300 10452 Silverdale Way N.W. Silverdale, WA 98383

CAPITOL HILL CAMPUS, SEATTLE URGENT CARE | 206-326-3175 206-326-3000 201 16th Ave. E. Seattle, WA 98112

TACOMA MEDICAL CENTER URGENT CARE | 253-596-3300 253-596-3300 209 Martin Luther King Jr. Way Tacoma, WA 98405

EVERETT MEDICAL CENTER URGENT CARE | 425-261-1660 425-261-1500 2930 Maple St. Everett, WA 98201

EASTERN WASHINGTON

OLYMPIA MEDICAL CENTER URGENT CARE | 360-923-7740 360-923-7000 700 Lilly Rd. N.E. Olympia, WA 98506

URGENT CARE | 509-324-6464 RIVERFRONT MEDICAL CENTER 509-324-6464 322 W. North River Dr. Spokane, WA 99201

DID YOU KNOW? Urgent care is a much more affordable option than emergency-room care when enrolled with the Health Benefits Trust. The out-of-pocket cost for a trip to the emergency room is $200 (waived if you are admitted to the hospital) vs. just $15 for a trip to Urgent Care with Group Health and $30 with Kaiser.

2014-2015 BENEFITS BOOK

HEALTH BENEFITS

Group Health Urgent Care Centers

PRESCRIPTIONS | HEALTH BENEFITS

Manage Your Prescriptions Prescription Drug Benefits Your prescriptions are a big part of your health benefits. Make the most of them by managing them wisely. The co-pay is lower for drugs that treat diabetes, high blood pressure, high cholesterol and heart failure. The co-pay is also lower for other generic drugs, and formulary brand-name drugs. Group Health Pharmacy Costs Less URGENT CARE You will have the lowest co-pay, or no co-pay, by using mail order prescription drugs through the Group Health pharmacy. Transfer Prescriptions If you have existing prescriptions, have them transferred to Group Health or Kaiser Permanente to receive the best benefit from your coverage. Mail-Order Prescriptions Getting your prescriptions by mail helps make your prescriptions more affordable. Group Health members get a co-pay discount of up to $5 vs. filling your prescription at the pharmacy. Kaiser members can obtain a three months supply for only two co-pays vs. three co-pays at the pharmacy. 1-month supply - up to a $5 discount on your Group Health copay 3-month supply - up to a $15 discount on your Group Health $45 copay Value-Based Prescriptions Free for You For some Value-Based prescriptions through Group Health, there is no co-pay when you have prescriptions mailed to you through convenient mail order services. See next page for a list of the prescriptions available for this benefit.

MYSEIUBENEFITS.ORG

Value-Based Drugs

Formulary Contraceptives*

Diabetes:

Group Health

Kaiser

Value Based Drugs* Group Health Generic drugs Group Health

Kaiser

$25

Kaiser

$25

$50

glyburide insulin NPH High Cholesterol: lovastatin pravastatin

Non-formulary brand name drugs Group Health

glipizide

simvastatin

Formulary brand name drugs Group Health

metformin

Kaiser (requires approval)

$50

* Catholic Community Services does not pay for contraceptive and sterilization services

Heart Failure: carvedilol metoprolol XL spironolactone

High Blood Pressure: hydrochlorothiazide chlorthalidone lisinopril enalapril captopril ramipril lisinopril/ HCTZ amlodipine verapamil diltiazem metoprololIR atenolol

How to Transfer Your Prescription Group Health Go online to www.ghc.org to transfer your prescription or call Customer Service at 1-888-901-4636. Kaiser Permanente Go online to www.kp.org or call 1-800-813-2000.

How to Set Up a Mail-Order Prescription Group Health After setting up an online account you can order refills online or by phone and have them mailed to you – free of charge. Kaiser Permanente After setting up an online account you can order refills online and have them mailed to you – free of charge.

Vision Benefits Keeping your eyes healthy and regularly updating optical prescriptions are important to your overall health. Vision benefits through the HBT are an affordable way to ensure your sight is protected.

DID YOU KNOW? Everyone should have regular eye exams, even if you’re not having problems with your vision.

• For a $15 co-pay per visit, you receive routine vision care. • Every two years you receive $200 worth of optical supplies, including contact lenses and frames. Want more information on what’s covered? See pages 41-63 for Benefits Summaries 2014-2015 BENEFITS BOOK

HEALTH BENEFITS

Rx Co-pay (In-network) for 30 day supply

WE’VE GOT YOU COVERED 3 DOORS OF COVERAGE Whether you’ve been covered by the Health Benefits Trust and are losing coverage due to a reduction in your hours or you’ve never been covered, we still want you and your family to get the coverage you need. With the Washington Health Benefits Exchange (Affordable Care Act or ACA) you have more options than ever to get the care you need.

HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA HEALTH BENEFITS EXCHANGE

• Must work at least 86 hours each month for 3 months in a row to be eligible

• Eligibility depends on family income

• Cost varies

• $25 per month • Full medical, dental, vision

MYSEIUBENEFITS.ORG

• No cost • Enroll anytime, when eligible

• Enroll during open enrollment Nov. 15, 2014Feb. 15, 2015 • Enroll anytime if you have a “qualifying” event (such as marriage, child)

COVERAGE OPTIONS HEALTH BENEFITS TRUST If are an Individual Provider and you work 86 hours per month for three months in a row, you have met the initial eligibility requirements for coverage through the Health Benefits Trust. If you are an Agency Provider, contact your employer for more information. Coverage costs $25 per month and covers medical, dental, vision and prescriptions.

MEDICAID / APPLE HEALTH Depending on your household income, you may qualify for free health care coverage through Medicaid / Apple Health. Visit Washington Healthplanfinder for more information at www.wahealthplanfinder.org.

WASHINGTON HEALTH BENEFITS EXCHANGE (AFFORDABLE CARE ACT (ACA) ALSO KNOWN AS HEALTHCARE REFORM OR OBAMACARE) Even if you don’t qualify for Medicaid there may be other affordable options. You can shop for health care coverage at any time if you’ve had a ‘qualifying event’ or during open enrollment (November 15, 2014 through February 15, 2015). Visit Washington Healthplanfinder for more information at www.wahealthplanfinder.org.

2014-2015 BENEFITS BOOK

HEALTHY CHOICES 28

MYSEIUBENEFITS.ORG

HEALTHY CHOICES Working Together to Keep You Healthy As a home care worker, you know how important it is to stay healthy. With the benefits you receive from the Health Benefits Trust, you have excellent health care, dental and vision benefits at a low cost. There are some key things you can do to keep costs low: Have a preventive care visit

•

Understand the importance of using urgent care vs. the emergency room

•

Use mail order pharmacy and generic drugs

HEALTHY CHOICES

•

Steps to Better Health There are several ways you can maximize your benefits for better health:

•

Complete your Preventive Care Office Visit

•

Complete a Health Profile (Group Health) or Total Health Assessment (Kaiser)

•

Complete a Dental Cleaning Visit

•

Use urgent care vs. the emergency room when appropriate

•

Manage prescriptions; use mail order

HEALTHY HOME CARE AIDE

URGENT CARE

URGENT CARE a Complete Preventive Visit

Find a doctor; complete your first visit

Complete a Dental Cleaning Complete your first dental cleaning

Find Your Closest Urgent Care Centers Locate the centers near you

Manage Your URGENT CARE Prescriptions Transfer prescriptions to your health plan, use mail order

Complete Three Activities Marked with a Star and Receive $100! If you have 1) completed your Health Assessment; and 2) completed a preventive office visit; and 3) completed a dental cleaning checkup, you will receive a check for $100. (Checks are sent 8-10 weeks after all three activities are complete.) 2014-2015 BENEFITS BOOK

Complete a Preventive Care Visit

One of the most important things for you to do is to select a Primary Care Provider and set up your first preventive care visit. A strong relationship with your Primary Care Provider is at the heart of your care, and helping you stay healthy.

How to Select Your Primary Care Provider (PCP) How to Select a Primary Care Provider

URGENT CARE

Health Plan

Online or Call Customer Service

Group Health

www.member.ghc.org Click on Provider and facility directory (under getting care)

1-888-901-4636

Kaiser Permanente

www.kp.org Click on Find a Doctor

1-800-813-2000

H Complete a Preventive Care Visit Establishing a relationship with your Primary Care Provider (PCP) is important to your health. Make a preventive care appointment so your PCP can best help you to be or stay healthy.

What’s a Primary Care Provider? A Primary Care Provider is a family practice, general practice, internal medicine, or pediatrics provider who provides most of a member’s primary care. A PCP helps coordinate a member’s specialty care.

MYSEIUBENEFITS.ORG

DID YOU KNOW? It costs much less when you use in-network providers. Assuming you have four office visits this year, your out-of-pocket cost using a Group Health provider would be $60 compared to $500 or more with an out-of-network provider.

H Registering at www.MyGroupHealth.org or www.KP.org will help get you connected to the most convenient care. At www.MyGroupHealth.org you can make appointments online, order prescriptions and email your Primary Care Provider (PCP). Once you register, you can complete your Health Risk Assessment (GH) or Total Health Assessment (KP).

URGENT CARE

You will see questions about your daily activities like: •

What are your daily eating habits?

•

How often do you exercise?

•

How often do you drink alcohol?

What you do affects your health. Take the Health Assessment and find resources that will help you become healthier!

How Healthy Are You? Find out! Register to take your Health Profile Health Plan

Online

Customer Service

Group Health

To get to the Health profile you need to have a MyGroupHealth account. To register, visit: www.MyGroupHealth.org

1-888-874-1620

Kaiser Permanente

www.kp.org

1-800-813-2000

2014-2015 BENEFITS BOOK

Complete a Dental Cleaning

★ Your oral health is part of your overall health. Regular dental care should be part of your healthcare schedule. Complete a dental cleaning as part of the incentives program to earn $100.

Full dental coverage with Willamette or Delta Dental Each HCA has to choose a plan with either Willamette or Delta Dental during enrollment. If you have chosen Delta Dental, dental cleanings are covered in full – two times every calendar year. Under Willamette Dental, you also have full coverage for cleanings two times a year after a $15 copay.

Dental Benefits Healthy teeth and gums are a critical part of your overall health. That’s why comprehensive dental benefits are included in the coverage you receive through the Health Benefits Trust. Coverage helps with routine dental care as well as dental emergencies.

MYSEIUBENEFITS.ORG

DID YOU KNOW? The American Dental Association says healthy gums are linked to a healthy heart. This is another reason to visit your dentist regularly.

TAKE CARE OF YOUR SMILE To take the best care of your teeth, gums and overall health, you should see your dentist every six months for a complete exam and cleaning.

HEALTHY CHOICES

To keep your teeth healthy, your dental benefits include, at no additional cost to you, the following in-network services: • Routine exams • Regular cleanings • X-rays • Gum care • Fillings Depending on your plan, some of the cost of the following procedures may also be covered: • Crowns, Inlays • Bridges, Dentures • Implants • Oral surgery • Periodontics (treatment for gum disease) • Endodontics (root canals)

Dental benefits are provided by Delta Dental and Willamette Dental. Have questions about which dental plan is right for you? See pages 58-63 for more details

COMPLETE THREE ACTIVITIES, EARN $100!

★

2014-2015 BENEFITS BOOK

FREQUENTLY ASKED QUESTIONS Eligibility and Enrollment 1. How many hours do I have to work for continuing coverage? After your coverage begins, you must work at least 86 hours each month to have continuous coverage. Training hours and accrued vacation hours can be used to satisfy the 86 hour requirement.

2. Can I use authorized, unclaimed hours from a previous month to satisfy my hour requirement in a subsequent month? No. For the purpose of health care insurance eligibility, hours are only applicable to the month in which they are authorized, not when they are claimed or paid. However, if you had training during the month you can count those hours. You can also use accrued vacation hours.

3. How do I enroll for coverage? ■ Individual Providers Log on to www.myseiubenefits.org to complete enrollment or call the Member Resource Center at 1-866-371-3200. ■ Agency Providers Contact your employer to coordinate your enrollment.

4. When can I submit my enrollment form for coverage? ■ Individual Providers You can enroll as soon as you have authorization to work as an Individual Provider. ■ Agency Providers Contact your employer to coordinate your enrollment.

5. I don’t have enough hours some months resulting in a lapse in coverage, do I have to meet the initial eligibility requirements again? No, you only need to meet the initial eligibility requirements if you are not covered by the plan for 12 months in a row. If you’ve been out of the plan for 12 months or more you will need to re-qualify by working three months of 86 hours and waiting the 2 month administrative period.

6. I work for a Home Care Agency and I’m also an Individual Provider. If I’m currently enrolled in my agency employer’s plan, can I terminate that coverage and enroll in the Health Benefits Trust as an Individual Provider instead of keeping my agency plan? Yes, but please keep in mind the initial eligibility requirements when determining your cancellation date with your agency employer’s plan. You should keep your current plan until your coverage as an Individual Provider begins. NOTE You cannot be covered under both the Health Benefits Trust as an Individual Provider and another employer’s plan.

MYSEIUBENEFITS.ORG

FREQUENTLY ASKED QUESTIONS Individual Providers

Agency Providers

Grandfathered Agency Providers: you were an Agency Provider in September 2011 and enrolled in the plan

Your coverage will terminate on the first day of the second month.

Your coverage will terminate the first day of the next month.

Individual Providers

Agency Providers

Grandfathered Agency Providers

Worked less than 86 hrs in:

Coverage ends last day of:

Worked less than 86 hrs in:

Coverage ends last day of:

Worked less than 86 hrs in:

Coverage ends last day of:

May

June

May

June

May

If you lose coverage, you may choose to pay the full monthly (COBRA) premium. In this case, the Health Benefits Trust will send you a COBRA notice and election form explaining your coverage option and the cost.

8. I am an Individual Provider. What if I report my hours to Social Service Payment System (SSPS) so late that they don’t make the $25 deduction from my check? You will need to notify the Health Benefits Trust and mail in a check or money order for $25 payable to SEIU Healthcare NW Benefits Trust, PO Box 6, Mukilteo, WA 98275. You will also need to send a copy of your paycheck stub (also known as your Remittance Advice) and invoice showing you claimed at least 86 hours for that month. It is very important to report your hours to SSPS in a timely manner to avoid having to make a payment by mail. Your health insurance provider may not be able to verify your eligibility and your coverage will be considered lapsed until we receive your check and supporting documentation.

9. Can I be covered by another plan at the same time that I’m enrolled in the Health Benefits Trust Plan and use it as secondary coverage? No, participants may not have health care benefits or insurance through other individual, family, employment-based, military or veterans coverage or insurance. The only exception is Medicare and Medicaid. If enrolled in Medicare or Medicaid, you may enroll in the Trust and your Medicare or Medicaid coverage becomes secondary to your Trust coverage.

10. Can I add dependents to my plan? ■ Individual Providers Dependents are not covered. The Individual Provider benefits do not allow coverage for dependents under this plan.

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

7.What happens if I work less than 86 hours in a month after I am enrolled in the plan? Your coverage will end:

FREQUENTLY ASKED QUESTIONS â&#x2013; Agency Providers If you are covered by the Health Benefits Trust through your employer, you can cover dependent children only by paying the full premium for them through payroll deduction. Dependent children can only be added when they are initially eligible or during the annual open enrollment period. Check with your employer for more information.

11. When will my coverage be effective? Individual Providers You must work at least 86 hours per month for 3 consecutive months. After youâ&#x20AC;&#x2122;ve met this requirement, it takes 2 months before your coverage starts. See the example below: February

March

April

May

You worked at least 86 hours

Administrative period You worked at least 86 hours

June

You worked at least 86 hours

July Coverage begins on July 1st

Submit an enrollment application anytime before May 20th

Agency Providers Contact your employer to coordinate your enrollment.

12. Is there a pre-existing condition waiting period? No.

13. What if I have coverage through Washington Health Plan Finder (the Washington Health Benefit Exchange or Affordable Care Act)? Can I enroll in this plan? Only if you cancel your coverage. You cannot have both.

14. If I have coverage through my spouse, can I cancel that coverage and sign up for the Health Benefits Trust plan? Yes, but please keep in mind the initial eligibility requirements when determining your cancellation date.

15. What if I am currently on COBRA through another plan? Can I cancel COBRA and enroll? Yes. Please contact the Health Benefits Trust with questions on the COBRA benefit at 1-866-771-7359.

16. How do I cancel my coverage and the corresponding paycheck deductions? The request must be made in writing and can be faxed or mailed. Requests received before the 15th of the month will stop further payroll deductions. Fax: (206) 859-2637 Mail: SEIU Healthcare NW Health Benefits Trust PO Box 6 Mukilteo, WA 98275

17. If I cancel my insurance, can I enroll again later? Yes, but if you have voluntarily cancelled your coverage, you will have to meet the 36

MYSEIUBENEFITS.ORG

FREQUENTLY ASKED QUESTIONS initial eligibility requirements again in order to regain coverage. If you are an Agency Provider, you must wait until the next annual open enrollment. If not, then this would be the same process as someone losing coverage less than/more than 12 months.)

Plan Specifics 1. If I haven’t received my medical ID card, who do I call? If you do not receive your card by the 15th of the month that your coverage starts contact: ■ Individual Providers Call the MRC 1-866-371-3200 ■ Agency Providers Talk with your employer

2. I want to change my dental insurance provider. How can I do this?

If you are an Individual Provider, please call the Member Resource Center toll-free at 1-866-371-3200 about options for changing dental insurance providers.

3. When I am outside Washington state or the United States am I covered by the plan? Yes, but you must contact the health insurance provider for specific benefits and claim submission procedures at: Group Health 1-888-901-4636 Kaiser 1-800-813-2000 Delta Dental 1-800-554-1907 Willamette (contact the clinic where the services were provided)

4. Who do I contact if I have specific questions about my coverage or a claim? Contact your insurance provider directly for an explanation of benefits and/or questions you have about claims. Group Health (POS, PPO, HMO) 1-888-901-4636 www.ghc.org Kaiser Permanente 1-800-813-2000 www.kp.org Delta Dental (Dental) 1-800-554-1907 www.deltadentalwa.com Willamette Dental 1-855-433-6825 www.willamettedental.com

5. My address has changed. Who do I notify? If you are an Individual Provider, request for an address change must be made to either your DSHS case worker or to Social Service Payment System (SSPS) directly. If you are an Agency Provider, contact your employer to make this change.

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

If you are an Agency Provider, please contact your employer about open enrollment or qualifying events. Typically, this is only allowed during the annual open enrollment period that takes place in July of each year and has an August 1 effective date.

BENEFIT POLICIES | FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS Group Health Specific Questions 1.What if I don’t want to see any doctors who practice with Group Health Medical Centers? If you are a new enrollee in the Health Benefits Trust effective 8/1/2012 or later, and you live within 30 miles of a Group Health Medical Center or contracted provider, your health care coverage is only for using Group Health Medical Centers or contracted providers. There is no out-of-network coverage. For all other enrollees, each time you seek health care services, you can choose to use your in-network providers, or not. Your highest level of benefits ($0 deductible) will be found using in-network providers: Group Health Physicians for the POS (Options) plan and First Choice Health Network of Providers for the PPO (Options PPO) plan. You will pay more out of pocket costs by using an out-of-network provider. For example, you will have a $500 deductible.

2.What does Group Health HMO vs. POS vs. PPO mean? If you live within 30 miles of a Group Health facility or contracted provider, and your coverage begins 8/1/2012 or later, you will automatically be enrolled in the HMO plan. If you enrolled in the HBT plan prior to 8/1/2012 your coverage is through the POS plan. If you live beyond 30 miles, you will automatically be enrolled in the PPO plan. In the POS and PPO plans, you have the choice of in-network or out-of-network providers each time you seek service.

3.How do I look for a provider available to me through Group Health? The easiest way to find a provider is through the Group Health website, www.ghc.org. On the right hand side of www.ghc.org, under “Find a Doctor or Medical Facility” click on “Provider & Facility Directory”; then click on “Doctors and Other Providers”; then under “*Health plan provider network:” either choose “Group Health” for the HMO plan or “Options PPO” for the PPO plan or “Options” for the POS plan. Or call Group Health Customer Service toll free: 1-888-901-4636 • • • •

Finding a provider Specific benefit questions Complex medical care case management Inpatient care case management

4.How do I pay my co-pay? Group Health no longer accepts cash payments at Group Health Medical Centers. Group Health expects payment at time of service, and will gladly accept: • Credit cards, debit cards, and personal checks. Visa, MasterCard®, American Express, and Discover® credit and debit cards are welcome. Personal checks will be scanned, converted to electronic transactions, and immediately deducted from your checking account. • Prepaid debit cards you can purchase at large stores, including Safeway, QFC, Target, 38

MYSEIUBENEFITS.ORG

FREQUENTLY ASKED QUESTIONS | BENEFIT POLICIES

FREQUENTLY ASKED QUESTIONS and Walmart. Look for them where gift cards are sold. • Prepaid debit cards from banks or credit unions. You can reload these cards at any time. For more info, go to ghc.org/payment, ask one of our cashiers, or call Customer Service toll-free at 1-888-901-4636.

Kaiser Permanente Specific Questions 1. What is Kaiser Permanente’s service area? If you live in any of the following counties/ZIP codes, your medical coverage will be provided by Kaiser Permanente’s HMO plan. Washington counties: Clark, Cowlitz, Lewis 98591 98593 98596, Skamania 98639 98648, Wahkiakum 98612 98647

2.Do I have out-of-network coverage under Kaiser Permanente? No (with the exception of emergency services). To access your comprehensive coverage, you must use a Kaiser Permanente provider/facility. www.kp.org Link to find Kaiser Permanente Providers http://myseiu.be/mTdBBa

3. How do I contact Kaiser Permanente Membership Services? Call Kaiser Permanente Membership Services toll free: 1-800-813-2000 • • • • •

Choose a primary care provider Specific benefit questions Complex medical care case management Inpatient care case management Speak to an advice nurse

• Ask about Kaiser Permanente facilities across the country

3.What can I do when I register for Kaiser Online Access?: • • • • • • • •

E-mail your doctor’s office View select test results Order prescription refills (and have them mailed to you, with free shipping) Request or cancel routine appointments Review recent past office visits See a list of your recent immunizations and allergies Act for a family member (e-mail your child’s doctor, and more) Receive a monthly e-newsletter Register at https://members.kaiserpermanente.org/redirects/register

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

Oregon counties: Multnomah, Polk, Washington, Yamhill

WHICH PLAN AND NETWORK APPLIES TO ME? Group Health Cooperative – HMO Plan for members who enroll 8/1/2012 or later

Group Health “Options Select” – POS Plan if you have been previously enrolled prior to 8/1/2012 and are re-enrolling:

Group Health “Options” – PPO Plan

Your network is called: “Group Health Cooperative” If you are enrolling effective 8/1/2012 or later, you will be automatically enrolled in this plan if you live within 30 miles of a Group Health Facility or Contracted Provider.

Your network is called: “Group Health Options Select” If you are enrolling effective 8/1/2012 or later, you will be automatically enrolled in this plan if you live within 30 miles of a Group Health Facility or Contracted Provider. Your in-network is called: “Options Select”

Your in-network is called: “Options” You will be automatically enrolled in this plan if you live farther than 30 miles from a Group Health Facility or Contracted Provider or live in Montana.

All care is provided at Group Health Medical Centers and from other Group Health contracted providers No out-of-network coverage is available.

In-Network care is provided at Group Health Medical Centers and from other Group Health contracted providers. Out-of-Network care is provided by First Choice Health Network Providers. The First Choice Health Network has an extensive panel of preferred providers in WA, OR, ID, AK and MT.

In-Network care is provided by Group Health Medical Centers; other Group Health contracted providers; First Choice Health Network Providers and First Health Network Providers The First Choice Health Network has an extensive panel of preferred providers in WA, OR, ID, AK and MT. Out-of-Network care is any other licensed provider

Link to look up Group Health Providers http://myseiu.be/imSCSp

Mark NOTE: WAITING FOR CONTENT FROM DIMARTINO AND HBT Naomi Note: What does this mean?

MYSEIUBENEFITS.ORG

BENEFIT SUMMARIES

MEDICAL PLAN HIGHLIGHTS | BENEFIT POLICIES

The following pages are benefit summaries, only, and are not intended to replace the specifics of the individual planâ&#x20AC;&#x2122;s Certificate of Coverage, Contract, or Evidence of Insurance. If there is a contradiction, the Certificate of Coverage, Contract, or Evidence of Insurance will take precedence.

BENEFITS POLICIES

WHO DO I CONTACT IF I HAVE QUESTIONS ABOUT MY BENEFITS? Contact your insurance provider directly for an explanation of benefits and/or questions you have about claims. Group Health 1-888-901-4636 www.ghc.org Kaiser Permanente 1-800-813-2000 www.kp.org Delta Dental (Dental) 1-800-554-1907 www.deltadentalwa.com

1-855-433-6825

Willamette Dental 1-855-433-6825 www.willamettedental.com

WHO DO I CALL TO ASK ELIGIBILITY QUESTIONS? n Individual Providers: Contact the Member Resource Center toll-free at 1-866-371-3200. n Agency Providers: Contact your employer. 2014-2015 BENEFITS BOOK

GROUP HEALTH OPTIONS - Benefit Summaries Questions? 1-888-901-4636 www.ghc.org NOTE: This is a benefit summary, only, and is not intended to replace the specifics of the planâ&#x20AC;&#x2122;s Certificate of Coverage, Contract, or Evidence of Insurance. If there is a contradiction, the Certificate of Coverage, Contract, or Evidence of Insurance will take precedence.

MYSEIUBENEFITS.ORG

Group Health HMO

Effective Date 8/1/2014

Health Plan Group Health

Ref RQ-84229

This is a brief summary of benefits. THIS IS NOT A CONTRACT OR CERTIFICATE OF COVERAGE. All benefit descriptions, including alternative care, are for medically necessary services. The Member will be charged the lesser of the cost share for the covered service or the actual charge for that service. For full coverage provisions, including limitations, please refer to your certificate of coverage. In accordance with the Patient Protection and Affordable Care Act of 2010, The lifetime maximum on the dollar value of covered essential health benefits no longer applies. Members whose coverage ended by reason of reaching a lifetime limit under this plan are eligible to enroll in this plan, and Dependent children who are under the age of twenty-six (26) are eligible to enroll in this plan.

BENEFITS POLICIES

Benefits

Inside Network

Plan deductible

No annual deductible

Individual deductible carryover

Not applicable

Plan coinsurance

No plan coinsurance Individual out-of-pocket limit: $1,200

Out-of-pocket limit

Out-of-pocket expenses for the following covered services are included in the out-of-pocket limit: All cost shares for covered services

Pre-existing condition (PEC) waiting period

No PEC

Lifetime maximum

Unlimited

Outpatient services (Office visits)

$15 copay

Hospital services

Inpatient services: $100 copay, per day for up to 5 days per admit Outpatient surgery: $50 copay

Prescription drugs (some injectable drugs may be covered under Outpatient services)

Value based/formulary generic/formulary brand $4/$8/$25 copay per 30 day supply*

Prescription mail order

$5 discount per 30 day supply

Acupuncture

Covered up to 8 visits per medical diagnosis per calendar year without prior authorization; additional visits when approved by the plan $15 copay

Ambulance services

Plan pays 80%, you pay 20%

Chemical dependency

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

* Catholic Community Services does not pay for contraceptive and sterilization services Ref RQ-84229

2014-2015 BENEFITS BOOK

Group Health HMO Devices, equipment and supplies • Durable medical equipment • Orthopedic appliances • Post-mastectomy bras limited to two (2) every six (6) months • Ostomy supplies • Prostheic devices

Covered at 50%

Diabetic supplies

Insulin, needles, syringes and lancets-see Prescription drugs. External insulin pumps, blood glucose monitors, testing reagents and suppliessee Devices, equipment and supplies. When Devices, equipment and supplies or Prescription drugs are covered and have benefit limits, diabetic supplies are not subject to these limits.

Diagnostic lab and X-ray services

Inpatient: Covered under Hospital services Outpatient: Covered in full, MRI/PET/CT $50 copay High end radiology imaging services such as CT, MR and PET must be determined Medically Necessary and require prior authorization except when associated with Emergency care or inpatient services.

Emergency services (copay waived if admitted)

$200 copay at a designated facility

Hearing exams (routine)

$15 copay

Hearing hardware

Not covered

Home health services

Covered in full. No visit limit.

Hospice services

Covered in full

Infertility services

Not covered

Manipulative therapy

Covered up to 10 visits per calendar year without prior authorization $15 copay

Massage services

See Rehabilitation services

$200 copay at a non designated facility

Inpatient: $100 copay, per day for up to 5 days per admit Maternity services

Mental Health

Outpatient: $15 copay. Routine care not subject to outpatient services copay Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Naturopathy

Covered up to 3 visits per medical diagnosis per calendar year without prior authorization; additional visits when approved by plan $15 copay

Newborn Services

Initial hospital stay: See Hospital Services; Office visits: See Outpatient Services; Routine well care: See Preventive care. Any applicable cost share for newborn services is separate from that of the mother.

Obesity-related surgery (bariatric)

Not covered

Organ transplants Donor search & harvest applies to lifetime max

Ref RQ-84229

MYSEIUBENEFITS.ORG

Unlimited, no waiting period Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Group Health HMO Preventive care Well-care physicals, immunizations, Pap smear exams, mammograms Rehabilitation services (Occupational, speech, physical including services for neurodevelopmentally disabled members) Rehabilitation visits are a total of combined therapy visits per calendar year Skilled nursing facility Sterilization (vasectomy, tubal ligation)

Womenâ&#x20AC;&#x2122;s preventive care services (including contraceptive drugs and devices and sterilization) are covered in full.*

Inpatient: 60 days per calendar year $100 copay, per day for up to 5 days per admit Outpatient: 60 visits per calendar year $15 copay Covered in full up to 60 days per calendar year Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay Womenâ&#x20AC;&#x2122;s sterilization procedures are covered in full.* $1,000 per calendar year; $5,000 lifetime max Inpatient: $100 copay, per day for up to 5 days per admit

BENEFITS POLICIES

Temporomandibular Joint (TMJ) services

Covered in full

Outpatient: $15 copay

Tobacco cessation counseling

Quit for Life Program - covered in full

Routine vision care (1 visit every 12 months)

$15 copay

Optical hardware Lenses, including contact lenses and frames

$200 per 24 months

* Catholic Community Services does not pay for contraceptive and sterilization services Ref RQ-84229

2014-2015 BENEFITS BOOK

Group Health POS Effective Date: 8/1/2014

Health Plan: Options

Ref: RQ-84234

Inside Network

Outside Network

Plan deductible

No annual deductible

Individual deductible; $500 per calendar year

Individual deductible carryover

Not applicable

4th quarter carryover applies

Plan coinsurance

No plan coinsurance

Plan pays 80%, you pay 20% of the Usual, Customary and Reasonable (UCR) charges.

Individual out-of-pocket limit: $1200

Out-of-pocket limit is shared with in-network

Out-of-pocket limit

Out-of-pocket expenses for the following covered services are included in the out-of-pocket limit: All cost shares for covered services

Pre-existing condition (PEC) waiting period

No PEC

Same as in-network

Lifetime maximum

Unlimited

Same as in-network maximum

$15 copay

$15 copay, deductible and coinsurance apply

Outpatient services (office visits)

Hospital services

Inpatient Services: $100 copay, per day for up to 5 days per admit Outpatient surgery: $50 copay

Inpatient Services: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient surgery: $50 copay

Prescription drugs (some injectible drugs may be covered under Outpatient services)

Value based/preferred generic/ preferred brand/non-preferred $4/$8/$25/$50 copay per 30 day supply*

Preferred generic/preferred brand/non-preferred $13/$30/$55 copay per 30 day supply*

Acupunture

Covered up to 8 visits per medical diagnosis per calendar year without prior authorization; additional visits when approved by the plan $15 copay

$15 copay, deductible and coinsurance apply

Ref: RQ-84234

MYSEIUBENEFITS.ORG

* Catholic Community Services does not pay for contraceptive and sterilization services

Group Health POS Ambulance services

Plan pays 80%, you pay 20%

Same as in-network

Chemical dependency

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay

Covered at 50%

Covered at 50%; deductible applies

Diabetic supplies

Inpatient: Covered under Hospital services Outpatient: Covered in full

Inpatient: Covered under Hospital services Outpatient: Deductible and coinsurance apply

Diagnostic lab and X-ray services

Emergency Servies

High end radiology imaging services such as CT, MR and PET must be determined Medically Necessary and require prior authorization except when associated with Emergency care or inpatient services

$200 copay

Hearing exams (routine)

$15 copay

$15 copay, deductible and coinsurance apply

Hearing hardware

Not covered

Hospital services

Covered in full

Deductible and coinsurance apply

Home health services

Covered in full. No visit limit.

No visit limit

Infertility services

Not covered

Manipulative therapy

Covered up to 10 visits per calendar year without prior authorization $15 copay

Visits limit shared with in-network $15 copay, deductible and coinsurance apply

Massage services

See Rehabilitation services

(copay waived if admitted)

Ref: RQ-84234

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

Devices, equipment and supplies • Durable medical equipment • Orthopedic appliances • Post-mastectomy bras limited to two (2) every six (6) months • Ostomy supplies • Prostheic devices

Group Health POS Inpatient: $100 copay, per day for up to 5 days per admit Maternity services

Mental health

Outpatient: $15 copay. Routine care not subject to outpatient services copay.

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply. Routine care not subject to outpatient services copay. Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Natropathy

Covered up to 3 visits per medical diagnosis per calendar year without prior authorization; additional visits when approved by the plan

$15 copay, deductible and coinsurance apply

Newborn services

Obesity-related surgery (bariatric)

Not covered

Unlimited, no waiting period Organ transplant

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Shared with in-network Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply Deductible and coinsurance apply

Covered in full

Preventive care Well-care physicals, immunizations, Pap smear exams, mammograms

Womenâ&#x20AC;&#x2122;s preventitive care services (including contraceptive drugs and devices and sterilization) are covered in full.*

Womenâ&#x20AC;&#x2122;s preventive care services (including contraceptive drugs and devices and sterilization) are subject to the applicable Preventative Care cost share and benefit maximums. Routine mammograms: Deductible and coinsurance apply*

Rehabilitation services (Occupational, speech, physical including services for neurodevelopmentally disabled members) Rehabilitation visits are a total of combined therapy visits per calendar year Ref: RQ-84234

MYSEIUBENEFITS.ORG

Inpatient: 60 days per calendar year $100 copay, per day for up to 5 days per admit Outpatient: 60 visits per calendar year $15 copay

Inpatient: Day limits shared with in-network $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: Visit limits shared with in-network $15 copay, deductible and coinsurance apply

* Catholic Community Services does not pay for contraceptive and sterilization services

Group Health POS Skilled nursing facility

Sterilization (vasectomy, tubular ligation)

Temporomandibular Joint (TMJ) services

Routine vision care (1 visit every 12 months)

Optical hardware Lenses, including contact lenses and frames

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Womenâ&#x20AC;&#x2122;s sterilization procedures are covered in full.*

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply Womenâ&#x20AC;&#x2122;s sterilization procedures are covered subject to the applicable Preventative Care cost share and benefit maximums* Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Quit for Life Program - covered in full

Applicable cost shares apply

$15 copay

$15 copay, deductible and coinsurance apply

Members under 19: 1 pair of frames and lenses per year Members age 19 and over: $200 per 24 months

Shared with in-network

* Catholic Community Services does not pay for contraceptive and sterilization services

Ref: RQ-84234

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

Tobacco cessation counseling

Day limits shared with innetwork benefit, deductible and coinsurance apply

Covered in full up to 60 days per calendar year

Group Health PPO Effective Date: 8/1/2014

Health Plan: PPO

Ref: RQ-84238

Benefits

Preferred Provider Network (PPN)

Non-Preferred Provider Network

Plan deductible

No annual deductible

Individual deductible; $500 per calendar year

Individual deductible carryover

Not applicable

4th quarter carryover applies

Plan coinsurance

No plan coinsurance

Plan pays 80%, you pay 20% of the Usual, Customary and Reasonable (UCR) charges.

Individual out-of-pocket limit: $1200

Out-of-pocket limit

Out-of-pocket expenses for the following covered services are included in the out-of-pocket limit:

Shared as in-network

All cost shares for covered services

Pre-existing condition (PEC) waiting period

No PEC

Same as preferred provider network

Lifetime maximum

Unlimited

Same as preferred provider maximum

$15 copay

$15 copay, deductible and coinsurance apply

Outpatient services (office visits)

Hospital services

Inpatient Services: $100 copay, per day for up to 5 days per admit Outpatient surgery: $50 copay

Inpatient Services: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient surgery: $50 copay

Prescription drugs (some injectible drugs may be covered under Outpatient services)

Preferred generic/preferred brand/non-preferred $4/$8/$25/$50 copay*

Preferred generic/preferred brand/non-preferred $13/$30/$55 copay*

Acupunture

12 visits per calendar year

Shared with preferred provider benefit

Ref: RQ-84238

MYSEIUBENEFITS.ORG

* Catholic Community Services does not pay for contraceptive and sterilization services

Group Health PPO Ambulance services

Chemical dependency

Same as preferred provider benefit

Plan pays 80%, you pay 20%

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Covered at 50%

Covered at 50%; deductible applies

Diabetic supplies

Diagnostic lab and X-ray services

Inpatient: Covered under Hospital services Outpatient: Covered in full

Inpatient: Covered under Hospital services Outpatient: Deductible and coinsurance apply

$200 copay

Hearing exams (routine)

$15 copay

$15 copay, deductible and coinsurance apply

Hearing hardware

Not covered

Hospital services

Covered in full

Deductible and coinsurance apply

Home health services

Covered in full up to 130 visits total per calendar year

Shared with preferred provider visit limit Deductible and coinsurance apply

Infertility services

Not covered

Manipulative therapy

Covered up to 10 visits per calendar year without prior authorization $15 copay

Visits limit shared with preferred provider network $15 copay, deductible and coinsurance apply

Massage services

See Rehabilitation services

Emergency Servies (copay waived if admitted)

Inpatient: $100 copay, per day for up to 5 days per admit Maternity services

Outpatient: $15 copay. Routine care not subject to outpatient services copay.

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

Devices, equipment and supplies • Durable medical equipment • Orthopedic appliances • Post-mastectomy bras limited to two (2) every six (6) months • Ostomy supplies • Prostheic devices

Group Health PPO

Mental health

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Natropathy

12 visits per calendar year $15 copay

Shared with preferred provider visit limit. $15 copay, deductible and coinsurance apply

Newborn services

Obesity-related surgery (bariatric)

Not covered

Unlimited, no waiting period Organ transplant

Inpatient: $100 copay, per day for up to 5 days per admit

Not covered

Outpatient: $15 copay Not covered Covered in full

Preventive care Well-care physicals, immunizations, Pap smear exams, mammograms

Rehabilitation services (Occupational, speech, physical including services for neurodevelopmentally disabled members) Rehabilitation visits are a total of combined therapy visits per calendar year

Skilled nursing facility

Sterilization (vasectomy, tubular ligation)

Women’s preventitive care services (including contraceptive drugs and devices and sterilization) are covered in full.*

Inpatient: 60 days per calendar year $100 copay, per day for up to 5 days per admit Outpatient: 60 visits per calendar year $15 copay

MYSEIUBENEFITS.ORG

Routine mammograms: Deductible and coinsurance apply* Inpatient: Day limits shared with preferred provider benefit $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: Visit limits shared with preferred provider benefit limit $15 copay, deductible and coinsurance apply

Covered in full up to 60 days per calendar year

Day limits shared with preferred provider benefit, deductible and coinsurance apply

Inpatient: $100 copay, per day for up to 5 days per admit

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Outpatient: $15 copay Women’s sterilization procedures are covered in full.*

Ref: RQ-84238

Women’s preventive care services (including contraceptive drugs and devices and sterilization) are subject to the applicable Preventative Care cost share and benefit maximums.

Women’s sterilization procedures are covered subject to the applicable Preventative Care cost share and benefit maximums*

* Catholic Community Services does not pay for contraceptive and sterilization services

Group Health PPO

Temporomandibular Joint (TMJ) services

Tobacco cessation counseling Routine vision care (1 visit every 12 months)

Optical hardware Lenses, including contact lenses and frames

Inpatient: $100 copay, per day for up to 5 days per admit Outpatient: $15 copay

Inpatient: $100 copay, per day for up to 5 days per admit Deductible and coinsurance apply Outpatient: $15 copay, deductible and coinsurance apply

Quit for Life Program - covered in full

Applicable cost shares apply

$15 copay

$15 copay, deductible and coinsurance apply

Members under 19: 1 pair of frames and lenses per year Members age 19 and over: $200 per 24 months

Shared with preferred provider network

BENEFITS POLICIES Ref: RQ-84238

2014-2015 BENEFITS BOOK

KAISER PERMANENTE HEALTH Benefit Summaries Questions? 1-800-813-2000 or (503) 813-2000 Member Services Weekday Hours 8am-6pm Member Services Weekend Hours Closed www.kp.org NOTE: This is a benefit summary, only, and is not intended to replace the specifics of the planâ&#x20AC;&#x2122;s Certificate of Coverage, Contract, or Evidence of Insurance. If there is a contradiction, the Certificate of Coverage, Contract, or Evidence of Insurance will take precedence.

MYSEIUBENEFITS.ORG

Plan B Traditional Copayment Plan C13B

SEIU Healthcare NW Health Benefits Trust 12420-011 (Plan B, IP) Washington Traditional Copayment Plan C14B August 1, 2014 through July 31, 2015

Out-of-Pocket Maximum (All Copayments and Coinsurance amounts count toward the maximum, unless otherwise noted) $1,250 per Calendar year

For an entire Family

$2,500 per Calendar Year â&#x20AC;&#x153;not applicableâ&#x20AC;?

Preventative Care Services

You Pay

Routine preventative physical exam (includes adult, well baby, and well child)*

Scheduled prenatal care and first postpartum visit

Immunization

Preventive tests*

BENEFITS POLICIES

For one Member

Outpatient Services Primary care visit

$15

Specialty care visit

$15

Urgent care visit

$30

Emergency department visit

$200 (waived if admitted)

Outpatient surgery visit

$50

Chemotherapy/radiation therapy visit

$15

Laboratory, X-ray, imaging, and special diagnostic procedures

CT, MRI, PET scans

$50

Routine eye exam

$10

Nurse treatment room visit to receive injections

Administered medications equipment, external prosthetic devices, and orthotic devices

20% Coinsurance

Physical, speech, and occupational therapies (up to 20 visits per therapy per Calendar Year)

$15

Spinal and extremity manipulation therapy visit (after 12 visits, prior authorization needed)

$15

Inpatient Hospital Services

$100 per admission

Ambulance Services (per transport)

$75

Skilled Nursing Facility Services (up to 100 days per Calendar Year)

Chemical Dependency Services Outpatient Services

$15

Inpatient hospital and residential services

$100 per admission

* Catholic Community Services does not pay for contraceptive and sterilization services

Continued on next page

2014-2015 BENEFITS BOOK

Plan B Traditional Copayment Plan C13B

Optional Benefits (Amounts do not count toward the maximum) Alternative Care (self-referred)

Not Covered

Hearing aids (for Members age 19 and older

Not Covered

Outpatient perscription drugs*

$5 generic/$25 brand/$50 approved nonformulary brand. $0 for formulary contraceptives. You get up to a 30-day supply. When you use mail delivery, you get up to a 90 day supply of maintenance drugs for two Copayments.

Vision hardware and optical Services

No charge for one pair standard frames and lenses every 24 months

Vision hardware and optical Services (ages 19 years and older)

Balance after $200 allowance every 24 months

Exclusions and Limitations The Services listed below are either completely excluded from coverage or partially limited. This applies to all Services that would otherwise be covered and is in addition to the exclusions and limitations that apply only to a particular Service as listed in the description of that Service in the Evidence of Coverage (EOC). Certain exams and Services; Cosmetic Services; Custodial Services; Dental Services. Except when Medically Necessary for Members who have a medical condition that would place undue risk if performed in a dental office. The procedure is subject to Utilization Review.; Designated blood donations; Detained or confined members; Employer responsibility; Experimental or investigational Services; Eye surgery. Radial keratotomy, photorefractive keratectomy, and refractive surgery, including evaluations for the procedures.; Family Services. Services provided by a member of your immediate family.; Genetic testing; Government agency responsibility; Hearing aids. Unless the Hearing Aid rider has been purchased.; Hypnotherapy; Non-Medically Necessary Services; Nonreusable medical supplies; Outpatient Prescription Drugs. Unless the Outpatient Prescription Drug rider has been purchased. Our drug formulary applies. We cover non-formulary drugs only when you meet exception criteria unless specifically covered by your prescription drug plan.; Professional Services for fitting and follow-up Services for contact lenses; Services performed by unlicensed people; Services that are not health care Services, supplies, or items; Services related to a non-covered Service; Sexual reassignment surgery; Supportive care and other Services; Travel and lodging. Limited to: (a) Medically Necessary ambulance Services, and (b) certain expenses that we preauthorize.; Travel Services. All travel-related Services including travel-only immunizations (such as yellow fever, typhoid, and Japanese encephalitis), unless the Travel Services rider has been purchased.; Vision hardware and optical Services (ages 18 and younger). Unless the Pediatric Vision Hardware and Optical Services rider has been purchased.; Vision hardware and optical Services (ages 19 and older). Unless the Adult Vision Hardware and Optical Services rider has been purchased.; Vision therapy and orthoptics or eye exercises. Questions? Call Membership Services (M-F, 8 am-6 pm) or visit kp.org Portland area..503-813-2000. All other areas..1-800-813-2000. TTY..1-800-735-2900. Language Interpretation Services, all areas..1-800-324-8010 This is not a contract. This benefit summary does not fully describe your benefit coverage with Kaiser Foundation Health Plan of the Northwest. For more details on benefit coverage, claims review, and adjudication procedures, please see your EOC or call Membership Services. In the case of conflict between this summary and the EOC, the EOC will prevail. * Catholic Community Services does not pay for contraceptive and sterilization services

MYSEIUBENEFITS.ORG

For Employees of Catholic Community Services Your employer has certified that your groupâ&#x20AC;&#x2122;s health plan qualifies for an accommodation with respect to the federal requirement to cover all Food and Drug Administration-approved contraceptive services for women, as prescribed by a health care provider, without cost sharing. This means that your group will not contract, arrange, pay, or refer for contraceptive coverage. Instead, Group Health will provide separate payments for contraceptive services that you use, without cost sharing and at no other cost, for so long as you are enrolled in your groupâ&#x20AC;&#x2122;s health plan. Your employer will not administer or fund these payments. If you have any questions please contact your employer.

BENEFITS POLICIES

2014-2015 BENEFITS BOOK

WDS Delta Dental Pro Plan Benefit Summaries Questions? Customer Service toll-free (800) 554-1907, Monday â&#x20AC;&#x201C; Friday 8 a.m. to 5 p.m., Pacific Time

Please Note: This is a brief summary of benefits only and does not constitute a contract. You will receive a benefits booklet that completely details your Delta Dental PPO dental benefits. Please feel free to call our customer service department if you have any questions.

MYSEIUBENEFITS.ORG

WDS Delta Dental Pro SEIU - Individual Providers - Plan A Plan #: 00018

Name: Delta Dental PPO

Plan Summary

Effective Date: January 1, 2014

Payment Levels Delta Dental PPO Dentist

Delta Dental Premier or Nonparticipating Dentist

Out-of-State Dentist

100%

80%

100%

60%

80%

40%

Annual Maximum Per Person Benefit Perios: (January 1 - December 31)

$1,000

Annual Plan Deductible Waived for Class I covered dental benefits

$50

Class I - Diagnostic & Preventive Exams, Prophys, X-rays, Flouride, Fissure sealants Class II - Restorative

BENEFITS POLICIES

Restorations, Endodontics, Periodontics, Oral Surgery Class III - Major Crowns, Dentures, Partials, Bridges, Implants

MySmile® personal benefits center, available on Delta Dental of Washington’s Web site at DeltaDentalWA.com, is customized to your individual needs and provides you with answers to your most pressing questions about your dental coverage. Please Note: This is a brief summary of benefits only and does not constitute a contract. You will receive a benefits booklet that completely details your Delta Dental PPO dental benefits. Please feel free to call our customer service department if you have any questions. Delta Dental of Washington PO Box 75983 Seattle, WA 98175-0983 Customer Service toll-free (800) 554-1907, Monday – Friday 8 a.m. to 5 p.m., Pacific Time

ACCESSING CARE

How to use your Delta Dental PPO plan

The dental plan offered to your group is Delta Dental PPO, a preferred provider plan. You can choose any dentist — in or out of the PPO network — at the time of treatment. However, if you select a dentist who is part of the Delta Dental PPO network, your benefits will likely be paid at a higher level and your out-of-pocket expenses may be lower. Delta Dental of Washington will handle all customer service and claims processing for your plan. Tell your dentist you are covered by Delta Dental of Washington and give him or her your member identification number, the plan name and plan number.

2014-2015 BENEFITS BOOK

WDS Delta Dental Pro

Delta Dental Premier® dentists — (non-PPO)

Delta Dental Premier dentists are members of our traditional fee-for-service plan, but they are not part of the PPO network; therefore, your out-of-pocket costs may be higher. Delta Dental Premier dentists will still submit claims for you and receive payment directly from Delta Dental of Washington. Their payment will be based upon their pre-approved fees with Delta Dental of Washington. They also cannot charge you more than these fees. You are responsible only for your stated deductibles, coinsurance and/or amounts in excess of the program maximums.

Finding a dentist

You can find a participating dentist in your area by visiting the Delta Dental of Washington Web site at DeltaDentalWA.com. Click on the Patients tab and then on the Find A Dentist tab to begin your search. Be sure to select the appropriate plan — Delta Dental PPO or Delta Dental Premier — and follow the prompts.

Nonparticipating dentists

NOTE: For information on out-of-state dentists, please refer to your benefits booklet.

Predetermination (estimate) of benefits

If your dental care will be extensive, you may ask your dentist to complete and submit a request for an estimate, sometimes called a “predetermination of benefits.” This will allow you to know in advance what procedures are covered, the amount Delta Dental of Washington will pay and your financial responsibility. A predetermination of benefits is not a guarantee of payment.

MYSEIUBENEFITS.ORG

BENEFITS POLICIES

You are not limited to visiting a Delta Dental of Washington dentist. If you choose a nonparticipating dentist, you will be responsible for having the dentist complete and sign claim forms. It will also be up to you to ensure that the claims are sent to Delta Dental of Washington. Claim payments will be based on actual charges or Delta Dental of Washington’s maximum allowable fees for nonparticipating dentists, whichever is less. You will be responsible for any balance remaining. Please be aware that Delta Dental of Washington has no control over nonparticipating dentists’ charges or billing procedures.

WILLAMETTE DENTAL - Benefit Summaries Questions? 1-855-433-6825 www.willamettedental.com

NOTE: This is a benefit summary only and is not intended to replace the specifics of the Self-funded Dental Plan Document. If there is a contradiction, the Plan Document will govern.

2014-2015 BENEFITS BOOK

Willamette Dental Group SEIU Healthcare NW/Health Benefits Trust - IP Plan

COPAYS Annual Maximum

No annual Maximum*

Deductible

No Deductible

General Office Visit

You pay $15 per Visit

DIAGNOSTIC AND PREVENTIVE SERVICES Covered with the Office Visit Copay

X-Rays

Covered with the Office Visit Copay

Teeth Cleaning

Covered with the Office Visit Copay

Flouride Treatment

Covered with the Office Visit Copay

Sealants (per tooth)

Covered with the Office Visit Copay

Head and Neck Cancer Screening

Covered with the Office Visit Copay

Oral Hygiene Instruction

Covered with the Office Visit Copay

Periodontal Charting

Covered with the Office Visit Copay

Periodontal Evaluation

Covered with the Office Visit Copay

RESTORATIVE DENTISTRY Fillings (Amalgam)

Covered with the Office Visit Copay

Porcelain-Metal Crown

You pay a $250 Copay

PROSTHODONTICS Complete Upper or Lower Denture

You pay a $400 Copay

Bridge (per Tooth)

You pay a $250 Copay

ENDODONTICS AND PERIODONTICS Root Canal Therapy - Anterior

You pay a $85 Copay

Root Canal Therapy - Bicuspid

You pay a $105 Copay

Root Canal Therapy - Molar

You pay a $130 Copay

Osseous Surgery (per Quandrant)

You pay a $150 Copay

Root Planning (per Quadrant)

You pay a $75 Copay

ORAL SURGERY Routine Extraction (Single Tooth)

Covered with the Office Visit Copay

Surgical Extraction

You pay a $100 Copay

ORTHODONTIA TREATMENT Pre-Orthodontia Treatment

Not Covered

Comprehensive Orthodontic Treatment

Not Covered

MYSEIUBENEFITS.ORG

BENEFITS POLICIES

Routine and Emergency Exams

Willamette Dental Group MISCELLANEOUS Local Anesthesia

Covered with the Office Visit Copay

Dental Lab Fees

Covered with the Office Visit Copay

Nitrous Oxide

You pay a $40 Copay

Specialty Office Visit

You Pay a $30 Copay per visit

Out of Area Emergency Care Reimbursement

You Pay charges in excess of $250

*TMJ has a $1000 annual maximum/ $5000 lifetime maximum **Copayment credited towards the Comprehensive Orthodontic Service copayment if patient accepts treatment plan. Underwritten by Willamette Dental of Washington, Inc. This plan provides extensive coverage of services and supplies to prevent, diagnose, and treat diseases or conditions of the teeth and supporting tissues. Presented are just some of the most common procedures covered in your plan. Please see the Certificate of Coverage for a complete plan description, limitations, and exclusions. program, unless required by law. Services or supplies not listed as covered in the contract. Services or supplies where there is no evidence of pathology, dysfunction, or disease other than covered preventive services. Limitations If alternative services can be used to treat a condition, the service recommended by the Willamette Dental Group dentist is covered. Services or supplies listed in the contract, which are provided to correct congenital or developmental malformations which impair functions of the teeth and supporting structures will be covered for dependent children if dental necessity has been established. Orthognathic surgery is covered as specified in the contract when the Willamette Dental Group dentist determines it is dentally necessary and authorizes the orthognathic surgery for treatment of an enrollee, under age 19, with congenital or developmental malformations. Crowns, casts, or other indirect fabricated restorations are covered only if dentally necessary and if recommended by the Willamette Dental Group dentist. When initial root canal therapy was performed by a Willamette Dental Group dentist, the retreatment of such root canal therapy will be covered as part of the initial treatment for the first 24 months. When the initial root canal therapy was performed by a non-participating provider, the retreatment of such root canal therapy by a Willamette Dental Group dentist will be subject to the applicable copayments. General anesthesia is covered with the copayments specified in the contract if it is performed in a dental office; provided in conjunction with a covered service; and dentally necessary because the enrollee is under the age of 7, developmentally disabled or physically handicapped. The services provided by a dentist in a hospital setting are covered if medically necessary; pre-authorized in writing by a Willamette Dental Group dentist; the services provided are the same services that would be provided in a dental office; and applicable copayments are paid. The replacement of an existing denture, crown, inlay, onlay, or other prosthetic appliance or restoration denture is covered if the appliance is more than 5 years old and replacement is dentally necessary.

2014-2015 BENEFITS BOOK

BENEFITS POLICIES

Exclusions Bridges, crowns, dentures or any prosthetic devices requiring multiple treatment dates or fittings if the prosthetic item is installed or delivered more than 60 days after termination of coverage. The completion or delivery of treatments, services, or supplies initiated prior to the effective date of coverage Dental implants, including attachment devices and their maintenance. Endodontic services, prosthetic services, and implants that were provided prior to the effective date of coverage. Endodontic therapy completed more than 60 days after termination of coverage. Exams or consultations needed solely in connection with a service or supply not listed as covered. Experimental or investigational services or supplies and related exams or consultations. Full mouth reconstruction, including the extensive restoration of the mouth with crowns, bridges, or implants; and occlusal rehabilitation, including crowns, bridges, or implants used for the purpose of splinting, altering vertical dimension, restoring occlusions or correcting attrition, abrasion, or erosion. Hospital care or other care outside of a dental office for dental procedures, physician services, or facility fees. Maxillofacial prosthetic services. Nightguards. Personalized restorations. Plastic, reconstructive, or cosmetic surgery and other services or supplies, which are primarily intended to improve, alter, or enhance appearance. Prescription and over-the-counter drugs and premedications. Provider charges for a missed appointment or appointment cancelled without 24 hours prior notice. Replacement of lost, missing, or stolen dental appliances; replacement of dental appliances that are not recommended and approved by a Willamette Dental Group dentist. Services or supplies and related exams or consultations to the extent they are not necessary for the diagnosis, care, or treatment of the condition involved. Services or supplies by any person other than a licensed dentist, denturist, hygienist, or dental assistant. Services or supplies for treatment of injuries sustained while practicing for or competing in a professional athletic contest. Services or supplies for the treatment of an occupational injury or disease, including an injury or disease arising out of self-employment or for which benefits are available under workersâ&#x20AC;&#x2122; compensation or similar law. Services or supplies for treatment of intentionally selfinflicted injuries. Services or supplies for which coverage is available under any federal, state, or other governmental

TRAINING BASICS 64

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QUALITY TRAINING, QUALITY CARE The Training Partnership understands that adult learners bring a broad set of life experiences, education levels, and English language proficiency to the classroom. To meet that diversity, learning experiences are designed for you, adult students who bring previous knowledge and a passion for their work to

VISION Our vision is that every long-term care worker is a professional who has been trained rigorously, whose work is well respected and well compensated, who has meaningful opportunities for professional development and career growth, and who provides high quality care.

class. The focus is on practical skill development that will help you to do your job.

What Can You Expect from Basic Training Courses? As a student, you can expect to have an instructor with direct care experience who is passionate about supporting workers in their professional growth. •

You can expect opportunities to learn using different methods like watching video clips, completing written activities, and presenting to others.

•

You can expect to learn specific skills, see them demonstrated and then have a chance to demonstrate the skill yourself.

•

You can expect to use a student guide during class, which you can keep as a future resource.

‘‘

•

You can expect to be asked what you think, to share what you know, to contribute to discussion, and to answer questions.

The classes were very helpful and they gave me new, healthier ways to deal with challenges at work.” – Jasmine, Training Partnership Student 2014-2015 BENEFITS BOOK

TRAINING BASICS

•

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What Can You Expect from Continuing Education Courses? •

You can expect options in course formats, including in-person and online learning choices.

•

In person instructor-led courses let you ask questions of the

MISSION Our mission is to train and develop professional long-term care workers to deliver high quality care.

instructor, learn from and interact with other workers, and have hands-on practice with any skills covered. •

Online courses let you learn at your own pace whenever it is convenient for you.

•

You can expect variety in subjects, from broad overviews to in-depth explorations on specific topics.

•

You can expect to have online courses in multiple languages available to take 24 hours a day, seven days a week.

•

You can expect online learning courses that present information and ask you to apply what you have learned through interactive activities.

TRAINING BASICS

What Characterizes the Work of the Training Partnership? There are several themes you will find in the courses, actions, and work of the Training Partnership. They are: •

Dignity of the work and the Home Care Aides who do the work;

•

Dignity of the Consumer whose preferences, rights, individuality, and needs must be respected;

•

Empowerment of the Home Care Aide to improve their lives and the lives of Consumers;

•

Professionalism of the workforce; and

•

Cultural competency and inclusiveness to honor differences.

2014-2015 BENEFITS BOOK

HOW TO GET THE MOST FROM YOUR TRAINING Understand DOH Certification Requirements If you are required to receive certification, do not delay â&#x20AC;&#x201C; begin the process as soon as possible. Follow the instructions on the following pages to ensure you successfully complete certification.

Register Early for Training If you need Basic Training, we encourage you to register for your classes within the first two weeks of hire to get the best choice of class options. If you want to take Instructor-Led Continuing Education (CE) classes, register as early as possible to get the best choice of class options before your deadline.

Take Online Learning for Continuing Education Credits Online Continuing Education courses are an easy and convenient way to get the CE hours you need as a worker. You can view available courses, take classes and view your credits all from your computer â&#x20AC;&#x201C; 24/7.

Go Online for Convenient Service and Support The www.myseiubenefits.org web portal is your comprehensive resource for available classes, your current training status, benefits eligibility and much more. Log in to the portal first to get the answers you need. Instructions for getting a username and password are on Page 8.

Update Your Contact Info Ensure you are receiving the most current information about your training by updating your contact information with your employer. If you are an Individual Provider, update your information in the portal at www.myseiubenefits.org

Sign Up for News and Alerts Help make sure you get all the latest news and information you need on training standards, deadlines and new online Continuation Course courses. Sign up to receive news and alerts through email.

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TRAINING BASICS

2014-2015 BENEFITS BOOK

ONLY FOR WORKERS WHO REQUIRE CERTIFICATION

DOH Certification: Follow These Steps for Success The Department of Health (DOH) is responsible for the certification process. • This is the WA State agency responsible to issue the Home Care Aide credential (HCA). • DOH contracts with a testing company called Prometric to implement the HCA written and skills test. In an effort to help workers be successful through the process, partner organizations such as the Department of Social and Health Services and the Training Partnership are working to help share information about the DOH exam with workers. If you are required to become certified, the Training Partnership is currently recommending the following timeline to allow ample time to work through the certification steps. The steps below outline the SUGGESTED timeline for the process. Prior to Providing Care: Take Orientation & Safety • Watch the Orientation & Safety DVD that was provided to you at time of hire. • Call to confirm completion 1-866483-1397. You will need your confirmation number and the last 4 digits of your Social Security number. • All workers are required to complete a name and date of birth background check before you can begin work. You will work with the contracting staff to complete this. • After the name and date of birth background check is complete you are required to schedule a fingerprint appointment. Talk with your employer for directions on how to complete this.

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STEP 1 Submit DOH Certification Application DOH requires that you submit your application to become a certified Home Care Aide within 14 days of hire. • You can submit your application before your training is scheduled. NOTE: If you are limited English proficient (LEP) you must indicate this on your initial application. This means if your ability to read, write or speak English is limited you may be issued a provisional certification allowing up to 60 additional days to become a certified HCA. STEP 2 Register for Training ■ Individual Providers • Create your username and password to log in to the portal at www.myseiubenefits.org • Go to the website www.myseiubenefits.org to register for training or call the Member Resource Center at 1-866-371-3200 ■ Agency Providers • Check with your employer on the best way to register STEP 3 Submit Candidate Exam Application Immediately upon registering for training, download and read the Candidate Information Booklet and the Sample Candidate Application Form. • Download the Candidate Application Form and submit the application form and fee to Prometric to be scheduled for a Home Care Aide Exam. • On the application form you will attest that you are in training and to the estimated date you will complete the required 75 hours. You should allow

four weeks for your application to be processed. Download the forms at www.prometric.com/WADOH STEP 4 Target Completion of Basic Training Take your training as soon as possible to ensure best access to classes in your area and your preferred language. STEP 5 Self Study and Prepare for the Exam To prepare for the exam, review the “Exam Preparation Materials” found on the Prometric website for the Home Care Aide Exam. • There you will find practice questions, skills checklists and instructions that will help you be successful in the exam. • In addition, review the Practice Exam. www.prometric.com/WADOH

mation Booklet and General Instructions. www.prometric.com/WADOH STEP 7 Get Certified Your results are reported to DOH and they will send you a letter confirming you are officially certified. • You can check the DOH website listed in Step 2 to see if your certification is Active. • If you are Pending it means that DOH does not have all the information they need to complete certification. • Make sure you have fully completed the application, completed the back ground check, fully explained any personal history that could effect your ability to get certified and you have successful passed your written and skills examination through Prometric.

STEP 6 Take Exam Report to test location prepared to follow testing guidelines in the Candidate Infor-

DAYS

120

200

PRIOR TO PROVIDING CARE TAKE ORIENTATION & SAFETY STEP 1. SUBMIT DOH CERTIFICATION APPLICATION STEP 2. REGISTER FOR TRAINING STEP 3. SUBMIT CANDIDATE EXAM APPLICATION DEADLINE FOR COMPLETION

STEP 4. TARGET COMPLETION OF BASIC TRAINING

STEP 5. SELF STUDY; PREPARE FOR EXAM STEP 6. TAKE EXAM STEP 7. GET CERTIFIED DAY 200 STANDARD HOME CARE AIDES ARE REQUIRED TO RECEIVE CERTIFICATION

2014-2015 BENEFITS BOOK

TRAINING BASICS

SUGGESTED TIMELINE FOR TRAINING AND CERTIFICATION

INTERPRETATION Individual Providers and Agency Providers who work with Coastal CAP, Concerned Citizens, Full Life Care, Lower Columbia CAP, Oly CAP, Senior Life Resources, and Visiting Nurses, the community interpretation option is available to you when you register for classes. Please see instructions below. Agency providers who work with AAA Residential, Addus, Amicable, Catholic Community Services (CCS), CDM, Chest erfield, KWA, ResCare, and SeaMar, the community interpreter option is available to you. Indicate to the person who registers you for class that you will be bringing a community interpreter.

Language and Interpretation The Training Partnership values the diversity of Home Care Aides. Basic Training and Instructor-Led CE courses are offered in English, Cantonese, Spanish, Russian, Korean, Vietnamese, Cambodian/Khmer, Laotian and Somali. In January 2014, four additional languages were added: Arabic, Tagalog, Ukrainian and Samoan. For those students who speak another primary language and are unable to take courses in English, we offer a Community Interpretation option. We also offer a professional interpreter service free of charge to students on a first-come, first-served basis. Steps to Register for Community Interpretation 1. Notify the Training Partnership: At the time of course registration, tell us either using the online portal or the Member Resource Center if you will be bringing someone with you to serve as your interpreter. If you are bringing someone to interpret, you are responsible for telling them when and where the class will be held and for reserving space for them. 2. Community Interpreter Tip Sheet: You should request a tip sheet before class so you and your interpreter have the information you need for a successful experience.

INTERPRETATION

TIP SHEET

If you have a friend or family member interpret for you, we offer a tip sheet and other ine formation that will help prepar your interpreter to assist you

in class. View orientation info and tip sheet here: ining/ www.myseiubenefits.org/tra ter rpre nte ty-i uni using-comm

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HELP IMPROVE FUTURE CLASSES Participate in strengthening future classes – a call to action

Course Survey All Home Care Aides are encouraged to complete a course survey online. The Training Partnership Customer Service Team would like your feedback to provide the best possible training for our students. These surveys are short and feedback is taken seriously. The surveys will help us do the following: • Help improve our classes • Make sure your opinions are heard • Help us better meet your needs as a student How do you submit a course survey? After you complete a course, you will see a “Take Survey” link on your student home page. Simply follow that link to review the course.

TRAINING BASICS

In-person Feedback and Focus Groups In addition to surveys, the Training Partnership collects input from students through in-person feedback and focus groups. These opportunities allow students to share their ideas and feedback to improve classes. If you are interested in participating, email feedback@myseiubenefits.org and provide your full name and date of birth in the email. We will contact you in the future for feedback opportunities.

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TRAINING STANDARDS 74

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TRAINING STANDARDS Training standards vary for different types of workers. Be sure to check your own training

MISSION

standards through online and see the training

Our mission is to train and develop professional long-term care workers to deliver high quality care.

standards chart on the next page.

Basic Training Curriculum Different types of workers have different Basic Training standards. Basic Training is the introductory training you take to understand the fundamentals of Home Care Aide work.

Continuing Education Different types of workers have different Continuing Education standards. The Training Partnership provides quality Instructor-Led and online Continuing Education (CE) classes across the state. Continuing Education covers a broad range of subjects. You choose the ones that are

TRAINING STANDARDS

best suited to your interests and the Consumers you serve.

‘‘

The class on mental health really helped me understand the issue better and gave me tools. I feel more prepared to help my client with mental health issues now.” – Marcos, Training Partnership Student

2014-2015 BENEFITS BOOK

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Completed prior to providing care

Not applicable

Completed prior to providing care

Standard HCA IP or AP hired before 1/7/2012

Parent Individual Provider (HCS/AAA)*

Parent DD Individual Provider (DDD)*

Limited Service Provider*

Adult Child Individual Provider*

Respite

Within 120 days of starting to provide care

Not required

Within 120 days of starting to provide care

Not applicable

Not required

Not applicable

Within 120 days of starting to provide care

Basic Training 70 Hours

BASIC TRAINING

Not required

Within 120 days of starting to provide care Not required

Yes

HCA Credential Required?

Not required

Not applicable

Not required

Parent Provider (DDD Only) Class 7 Hours

CREDENTIAL

INITIAL CONTINUING EDUCATION (CE)

Not required

By your birthday

By your birthday in next calendar year after completing Accelerated Basic Training Not required

Not required, unless you voluntarily obtain your HCA credential

Not required, unless you voluntarily obtain your HCA credential Not required, unless you voluntarily obtain your HCA credential

Not required, unless you voluntarily obtain your HCA credential

By your birthday

By your birthday in next calendar year after completing Basic Training

Not required, unless you voluntarily obtain your HCA credential

By your birthday

Continuing Education 12 Hours

ONGOING CE

By your birthday following your last HCA credential renewal date

If your first renewal period is less than a full year from the date of certification, no CE will be due for the fist renewal period.**

Continuing Education 12 Hours

*NOTE: If you work for multiple employers, have multiple roles or multiple consumers, you may have different training standards than the chart indicates below. ** If you are credentialed on your birthday then your CE is due on your first birthday following your Current NAC Credential issuance date.

Completed prior to providing care

Not applicable

Standard HCA IP or AP hired after 1/7/2012 renewed certification

Completed prior to providing care

Safety Training 3 Hours

Standard HCA Individual Provider (IP) & Agency Provider (AP) hired after 1/7/2012 in process or Newly Issued HCA credential

Orientation 2 Hours

Accelerated Basic Training 30 Hours

UPDATED JULY 2014

ORIENTATION AND SAFETY

TRAINING STANDARDS

Not required

Providers with an new NAC or Special Education Endorsements

Not required

By your birthday

If CE is required in table above, then your CE is due by your first birthday after you start working as an HCA IP or AP. If CE is required in the table above, then your CE is due by your second birthday following you NAC Credential issuance date.**

Provides care to a consumer living in his or her home. Employed by a private, Medicaid homecare agency or DSHS.

A worker who has successfully passed a test and been credentialed by Department of Health as a Home Care Aide.

Home Care Aide (HCA) employed by a private, Medicaid homecare agency.

Home Care Aide (HCA) whose employer of record is DSHS.

Home Care Aide who does not work with their own parent or child. Works more than 20 hours a month or has more than one consumer.

This is an IP who provides care to his/her own adult child and is contracted through Home and Community Services (HCS) and/or an Area Agency on Aging (AAA). This is often referred to as a non-DDD Parent Provider.

This is an IP who provides care to his/her own adult child with a developmental disability and is contracted through the Developmental Disability Administration.

This is any IP who provides care 20 hours a month or less for one consumer.

An adult child providing care for his/her biological, step or adoptive parent.

This is an IP that provides DDA Respite services at 300 hours or less in a calendar year.

This is an HCA with a current healthcare credential, such as a Registered Nurse (RN), Licensed Practical Nurse (LPN) or Nursing Assistant Certified (NAC).

Home Care Aide (HCA)

HCA Credentialed

Agency Provider (AP)

Individual Provider (IP)

Standard HCA

Parent Individual Provider (HCS/AAA)

Parent DD Individual Provider (DDA)

Limited Service Provider

Adult Child Individual Provider

Respite

Non-HCA Credentialed

HOME CARE AIDE DEFINITIONS

***If you are currently certified as an LPN or RN, CE is not required for your role as an Individual Provider (IP) or Agency Provider (AP). You must maintain your LPN or RN credential and be in good standing with the state of Washington. Note: A provider may fall into more than one of these definitions. They must meet the higher requirements for training and certification.

Not required

Providers with a renewed NAC or Special Education Endorsements

For Workers Who Have a Current NAC Credential, the Chart Below Applies (Not LPN or RN)***

TRAINING STANDARDS

2014-2015 BENEFITS BOOK

WHO TO CONTACT FOR TRAINING SUPPORT AGENCY PROVIDERS INDIVIDUAL PROVIDERS

Class registration and rescheduling

(Senior Life Resources, OlyCAP, CoastalCAP, Concerned Citizens, Full Life)

AGENCY PROVIDERS

(Addus, Chesterfield, KWA, ResCare, SeaMar, Amicable)

(Catholic Community Services , CDM, AAA Residential)

Website or MRC

Your Employer

How to complete your Website or MRC training

Website or MRC

Your Employer

Username and Website or MRC password assistance

Website or MRC

Website, MRC or Employer

Your Employer

Confirmation Code

Website or MRC

MRC

Your Employer

Confirming class schedule

Website or MRC

Website, MRC or Employer

Your Employer

Training requirement Primary DSHS Contact Your Employer and deadlines

Your Employer

Questions about payment

Primary DSHS Contact Your Employer

Your Employer

Change of address

Primary DSHS Contact Your Employer

Your Employer

Change in training standards due to change in employment status

Primary DSHS Contact Your Employer

Your Employer

MYSEIUBENEFITS.ORG

ORIENTATION AND SAFETY If you are in a category that requires either the Training Partnership’s Orientation and Safety training (or both) you should have received a kit at the time of hiring or contracting. The kit contains the following: 1

Instructions on “How to Complete and Receive Credit for Safety and/or Orientation.”

Three DVDs: Orientation, Safety Training Part 1, and Safety Training Part 2.

Supplemental information titled, “Orientation and Safety – A Reference Tool for Individual Providers.”

Agencies may supplement this training with an agency-specific orientation program. If you did not receive the Orientation and Safety Kit, please contact your employer. Orientation and Safety Verification Line: 1-866-483-1397

CERTIFICATES

That’s it, you’re done! It’s fast and easy and you can do it from home.

2014-2015 BENEFITS BOOK

TRAINING STANDARDS

Students (and Agency employers and DSHS staff) can print their own certificates. Once you have completed your training, log in to your account and go to Training History. From there, click the “Certificate” link and print from the browser.

FREQUENTLY ASKED QUESTIONS Student Policies and Procedures 1 What is www.myseiubenefits.org? At www.myseiubenefits.org you can read important announcements from the Training Partnership, learn about our different programs and ask questions. On the website, you can register for classes, see your training history and track your progress. You can also take Continuing Education classes by visiting the Online Continuing Education page on our website, here: http://www.myseiubenefits.org/online-continuing-education. 2 How do I log in to www.myseiubenefits.org? Logging in to your account is an easy process from the website. The best way to manage your training and find your eligibility for benefits is through the www.mybenefits.org website. Through the portal, you can more easily update your information and stay on top of your training. Learn how to sign up for our website and set up your user name and password by watching the short video here: http://screencast.com/t/ZUP0vQLkxLGB Remember, your user name is your Student ID and your password is the word you created when you signed in. Please save your user name and password in a safe place. 3 How do I check in for classes? You just need a state-issued picture ID to check in for your classes. That can be a driverâ&#x20AC;&#x2122;s license, an ID card or a passport. 4 How do I update my contact information with the Training Partnership? You can update your contact info and set your preferred contact and language preferences in your student record by logging in at www.myseiubenefits.org or you can call the Member Resource Center (MRC) at 1-866-371-3200. 5 How do I ensure the Training Partnership knows I need classes in another language? Make sure you update your language preferences in the portal or call the Member Resource Center (MRC) for help in multiple languages at 1-866-371-3200. 6 How do I use a Community Interpreter? Learn about the Community Interpreter option, view an orientation and download and print a tip sheet on our Community Interpreter page here: www.myseiubenefits.org/ training/using-community-interpreter. 7 I arrived at class and I am not on the roster. What do I do? If your name is not on the roster and you decide to stay in the class, you will need to fill out an attestation form. Please note that filling out an attestation form does not guarantee that credit will be granted. 80

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FREQUENTLY ASKED QUESTIONS

2014-2015 BENEFITS BOOK

8 How do I find out how to take an Online Continuing Education class in English? Visit our Student Registration Guide and follow the steps on page 12, “To Take Online Classes” here: http://www.myseiubenefits.org/sites/default/files/Registration_Worker_v3.pdf. 9 Where can I find a Russian Online Continuing Education User Guide? Russian speakers are invited to use our Russian Online Continuing Education User Guide here: http://www.myseiubenefits.org/sites/default/files/Registration_Worker_Russian_eLearning.pdf 10 Where can I find a Spanish Online Continuing Education User Guide? Spanish speakers are invited to use our Spanish Online Continuing Education User Guide here: http://www.myseiubenefits.org/sites/default/files/Registration_Worker_SpanishOnly.pdf 11 What if I cannot meet my Continuing Education deadline because of a technical issue with the learning management portal, a class cancellation, or another unforeseen issue? Students have 365 days a year to complete their Continuing Education requirements. It is the student’s responsibility, even if there are unforeseen events, to ensure that they have enough time to complete their training before their deadline. 12 How do I get my training certificate? As a student (and Agency employers and DSHS staff) you can print your own certificates at any time. Once you’ve completed all of your training requirements go to www.myseiubenefits.org, log in to your account and go to Training History. From there, click the “Certificate” link and print from the browser. You can also watch this video to learn how to print your certificate: http://screencast.com/t/yNysWtPyW 13 I have a question about wages for training. Contact your employer or your DSHS contact. The Training Partnership cannot answer questions regarding wages.

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TRAINING POLICIES

2014-2015 BENEFITS BOOK

CLASSROOM POLICIES

Student Code of Conduct and Classroom Expectations At the Training Partnership we know you have taken your valuable time to come to class. We created the following policies to ensure a successful learning environment in which everyone can support each other and get the most out of each class. Any inappropriate behavior will not be tolerated and a student may be asked to leave resulting in non-completion of the module. Class Registration • Students need to be registered for class and on the class roster in order to take a class. • If you have not previously registered for a class, you will not be able to take the class. • If your name is not on the roster you will need to fill out an attestation form if you decide to stay in the class. Please note that filling out an attestation form does not guarantee that credit will be granted. Bring Picture ID • Students are expected to show a state-issued picture ID to sign in for class. It can be a state ID, a driver’s license or a passport. Safety • Students and staff must work within a safe and secure environment. Any behavior, which compromises this, is not acceptable. • No firearms or other weapons may be brought into the classroom.

Student Participation During Class Time • You should arrive to class 15 minutes before the start time to avoid being late. • Students are expected to fully participate in the learning experience. • Students will be doing skills over and over again; practicing skills is for the student’s benefit to help equip students to pass the state exam. • Be respectful of others by listening when others are talking and waiting your turn. • Class time is the opportunity to hear from other perspectives; please respect other’s opinions. • Return promptly from breaks and lunches. • Be prepared for all classes by bringing relevant books, files, pens and supplies. • Treat instructors, support staff and fellow students with respect at all times. Phones • Personal phone calls or other personal matters should be taken care of during breaks/ lunch. • Silence your cell phone during class. • Refrain from texting during class. Attendance • Only registered students and registered interpreters are allowed in the class. • Students may not bring consumers, children, pets excluding service animals or any other visitors to the class. 84

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CLASSROOM EXPECTATIONS | TRAINING POLICIES

CLASSROOM POLICIES Late Policy • If you arrive to class after the start time, you will be considered late and you will need to reschedule your class. • Instructors will close class for attendance 10 minutes after the scheduled class start time, except for the first day of a Basic Training Course; Instructors will provide an additional 10-minute grace period before closing class attendance. • Students who arrive after this time will not be permitted to attend the class and will be directed to the Member Resource Center (or whoever registered them for class) to reschedule. Facilities • Respect the property/classroom/restrooms; pickup after yourself (coffee cups, food, paper, etc.). • If food is not allowed in this facility please leave your food and drinks outside the classroom. • Smoking including vapor cigarettes and chewing tobacco is not allowed in the facility or at any of the entrances, only in the designated area or 25 feet from doors. Class Cancellation • A student will need to cancel class registration at least 72 hours in advance of the class time. • If the Training Partnership has to cancel a class, a notification of the class cancellation will be sent to you based on the communication preference in your online profile. The Training Partnership will work with you to reschedule the class. Inclement Weather • If the Training Partnership has to cancel a class due to inclement weather, a notification of the class cancellation will be sent based on the communication preference in your profile. The Training Partnership will work with you to reschedule the class.

TRAINING POLICIES

2014-2015 BENEFITS BOOK

REASONABLE ACCOMMODATION POLICY Policy on Reasonable Accommodation of Students with Disabilities The SEIU Healthcare NW Training Partnership (“Training Partnership”) admits students regardless of race, color, national origin, ethnic origin, gender, age, disability and sexual orientation to all the rights, privileges, programs, and activities generally accorded or made available to students by the Training Partnership. It does not discriminate on the basis of race, color, national origin, ethnic origin, gender, age, disability and sexual orientation in administration of its training and educational policies, admissions policies, scholarship and loan programs, and other Training Partnership administered programs.

What is Reasonable Accommodation? Reasonable accommodation means modifying or adjusting practices, procedures, policies, educational services and delivery, or the training environment so that a student with a disability can enjoy equal educational opportunity, so long as (1) there is sufficient medical evidence establishing a relationship between the disability and the need addressed by the specific accommodation; and (2) it does not impose an undue hardship on the Training Partnership.

Students with disabilities have the right to request and receive reasonable accommodation so that students may have the opportunity to take full advantage of the Training Partnership’s programs and activities.

When is a person regarded as having a disability? For purposes of accommodation, a person is regarded as having a disability if he or she has a sensory, mental, or physical impairment that is medically cognizable or diagnosable or exists as a record or history or is perceived to exist.

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REASONABLE ACCOMMODATION POLICY What is Undue Hardship? Undue hardship means, among other things, an excessively costly, extensive, substantial or disruptive modification or one that would fundamentally alter the nature or operations of the Training Partnership or its programs.

Overview of Accommodation Process To request reasonable accommodation, a student with a disability should request accommodation from the Training Partnership by completing the â&#x20AC;&#x153;ADA Request Formâ&#x20AC;? found at www.myseiubenefits.org/ADA_policy or by calling the Member Resource Center. Once the request is received by the Training Partnership, the Accommodation Process will start, during which the student will be asked to provide current documentation of his or her disability, the functional limitations resulting from the disability, and recommendations for specific accommodations. As part of the Accommodation Process, the Training Partnership will confer with the student to identify appropriate and reasonable accommodations that may be warranted under the particular circumstances. The Training Partnership has the right to establish qualifications and other essential standards and requirements for its courses, programs, activities and services. All students are expected to meet these essential qualifications, standards, and requirements with or without reasonable accommodations. More detailed information on the Accommodation Process can be found at www.myseiubenefits.org/ADA_policy

TRAINING POLICIES

2014-2015 BENEFITS BOOK

QUESTIONS & APPEALS What if I Have a Health Insurance or Dental Coverage Question or an Appeal?

When you have questions or a complaint about health or dental coverage: Call the Customer Service Department of your insurer, or for the Trustâ&#x20AC;&#x2122;s self-funded dental plan, Delta Dental: Group Health 1-800-542-6312 www.ghc.org Kaiser Permanente 1-800-813-2000 www.kp.org Self-funded Dental Plan Claims Administered by Delta Dental 1-800-547-9515 www.deltadentalwa.com

MYSEIUBENEFITS.ORG

QUESTIONS & APPEALS When you have an appeal: An appeal is a request to reconsider a decision to deny, modify, reduce, or end payment, coverage or authorization of coverage (known as an “adverse decision”). The appeal process for each of the Trust’s health and dental plans is different. You should review the Summary Plan Description of appeals procedures in your Benefits Summary provided by your insurer or, in the case of the Trust’s self-funded dental coverage, by Delta Dental. The Summary Plan Description contains a full explanation of the appeals process. You may also call the Customer Service Department of your insurer or, in the case of the Trust’s self-funded dental coverage, Delta Dental, for specific information about the appeals process. Those numbers are listed on the previous page. Your rights in an appeal: •

You must submit your appeals within 180 calendar days of the date you received notice of an “adverse decision.” Keep track of these deadlines as appeals that are filed late may not be considered.

•

You may request an expedited 72-hour review of your appeal when the adverse determination could jeopardize your life or health.

•

You may request all of the documents relevant to your request and the decision by the insurer or administrator.

•

You may submit additional comments, documents or other information to support your appeal.

More information about how to file an appeal can be found at “How to Appeal a Health Care Insurance Decision, A Guide for Consumers in Washington State” on the Office of the Insurance Commissioner’s website, www.insurance.wa.gov/consumers/health/Appeal/Table-of-Contents.shtml

2014-2015 BENEFITS BOOK

GLOSSARY AAA – Area Agency on Aging. ABT – Accelerated Basic Training. ADSA – See “ALTSA.” ALTSA – Aging and Long-Term Support Administration. Formerly ADSA. annual deductible – The amount you have to pay each year before you’re able to use any of your health insurance benefits. AP – Agency Provider. A worker who works for an agency – agency provider. ARC – See “The Arc.” ARNP – Advanced Registered Nurse Practitioner. Can be a Primary Care Provider (PCP). AT – Advanced Training. BT – Basic Training. BHP – Basic Health Plan of Washington. CNA – Certified Nursing Assistant. CE – Continuing Education. Supplemental training required for skills development. CEU – Continuing Education Units. CNA – Certified Nursing Assistant. COBRA – A private-pay insurance that covers you if you have a lapse in coverage or you are between jobs. co-pay –The amount you will pay at the time of your visit. cultural competency – An awareness of the customs, beliefs and religious practices of others. DDA – Developmental Disabilities Administration. Formerly DDD. DDD – Acronym no longer used. See “DDA.” deductible – The amount that you pay for covered services before the plan begins paying in a given year. You need only to satisfy your deductible once in a calendar year. diagnostic imaging – MRI (Magnetic Resonance Imaging), X-rays, mammograms. DME – Durable Medical Equipment. Walkers, crutches, etc. DSHS – Department of Social and Health Services.

MYSEIUBENEFITS.ORG

GLOSSARY health insurance provider – The company that manages your health insurance. For example, Group Health, Kaiser Permanente. Health Risk Assessment or Health Profile – An online health assessment or questionnaire that assesses your general health and wellness through a series of questions. in-network – You don’t have to pay as much when you use this group of providers. HMO: You only have coverage in-network. IP – Individual Provider. A Home Care Aide that provides care to a consumer living in his or her home and whose employer of record is DSHS. LPN – Licensed Practical Nurse. MRC – Member Resource Center. NDC – Nurse Delegated Core. NDD – Nurse Delegation Diabetes. O&S – Orientation and Safety. orthopedic appliances – Braces, splints, etc. PCP – Primary Care Provider. The doctor or ARNP you choose to oversee your care. out-of-network – A bigger group of providers where you may access care but your out-ofpocket expenses will be higher than with in-network providers. POS – Point of Service Insurance pays percentage of doctor visit that is out-of-network. PPO – Preferred Provider Organization A provider who is in-network. premium – The amount of money that you and/or your employer pay monthly, quarterly or yearly for your health insurance. RN – Registered Nurse. RNA – Registered Nurse’s Assistant. The Arc – National organization serving consumers with intellectual and developmental disabilities. Formerly known as “ARC.” TBI – Traumatic Brain Injury. value-based – Value based drugs are generic brands that treat: diabetes, high blood pressure, high cholesterol, and heart failure.

2014-2015 BENEFITS BOOK

TRAINING: GETTING STARTED HOW TO GET THE MOST FROM YOUR TRAINING Understand DOH Certification Requirements If you are required to receive certification, do not delay â&#x20AC;&#x201C; begin the process as soon as possible. Call the Member Resource Center to speak with a representative about your requirements.

Take Online Learning for Continuing Education Credits Online Continuing Education courses are an easy and convenient way to get the CE hours you need as a Home Care Aide. You can view available courses, take classes and view your credits all from your computer â&#x20AC;&#x201C; 24 hours a day, seven days a week.

Update Your Contact Info Ensure you are receiving the most current information about your training by updating your contact information with your employer.

Need Support for Training or Health Benefits in Your Language? Call the Member Resource Center at 1-866-371-3200 or email http://www.myseiubenefits.org/contact-us and a representative will answer your question in your language. 12 Languages Plus English for Training, Certification Exam Laotian Arabic Samoan Cantonese Somali Cambodian Spanish Korean 92 MYSEIUBENEFITS.ORG

Russian Tagalog Ukrainian Vietnamese

In addition, students can call the MRC for an interpreter in other languages on a first-come basis.

HEALTH BENEFITS:

WHAT YOU NEED TO KNOW WE’VE GOT YOU COVERED: 3 DOORS OF COVERAGE HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA HEALTH BENEFITS EXCHANGE

• Must work at least 86 hours each month for 3 months in a row to be eligible

• Eligibility depends on income

• Cost varies • Enroll during open enrollment Nov. 15, 2014Feb. 15, 2015

• No cost

• $25 per month

• Enroll anytime if you have a “qualifying” event (such as marriage, child)

• Full medical, dental, vision

Whether you’ve been covered by the Health Benefits Trust and are losing coverage due to a reduction in your hours or you’ve never been covered, we still want you and your family to get the coverage you need. Depending on your household income, you may qualify for free health care coverage through Medicaid. Visit Washington Healthplanfinder for more information at www.wahealthplanfinder.org Even if you don’t qualify for Medicaid there may be other affordable options. You can shop for health care coverage at any time if you’ve had a ‘qualifying event’ or during open enrollment (November 15, 2014 through February 15, 2015). Visit Washington Healthplanfinder for more information at www.wahealthplanfinder.org

Eligibility for Coverage with Health Benefits Trust

You must work at least 86 hours per month for three consecutive months to be eligible for these benefits. You do not need to wait until you are eligible to apply, you can complete the enrollment process after you’re hired.

Enroll ■ Individual Providers You can enroll by logging in to the Portal with your Student ID and click on the IP Online Enrollment form. You can also enroll by printing a paper form (found on www.myseiubenefits.org) fill out and submit to the address or fax number on the form. Call the MRC at 1-866-371-3200 if you need help. ■ Agency Providers Talk with your employer about enrollment. 2014-2015 BENEFITS BOOK

HEALTH BENEFITS TRUST: GETTING STARTED Look for Your Health Insurance ID Card After you enroll and become eligible you should receive an ID card in the mail. If you do not receive the card by the 15th of the month that your coverage starts, call the MRC at 1-866-371-3200 if you are an Individual Provider or, if you are an Agency Provider, talk with your employer. If you need to see your doctor before you receive your ID card, call your Health Plan Provider (Group Health 1-888-901-4636 or Kaiser 1-800813-2000) to get your ID number. You will need this ID number for your office visit.

Locate Your Nearest Urgent Care Center URGENT CARE

As soon as possible, you should find and write down the closest Urgent Care Center to you in the front of this book for easy reference. You can find Urgent Care locations at www.ghc.org or www.kp.org

Manage Your Prescriptions If you have existing prescriptions, have them transferred to Group Health or Kaiser. Next, set up mail-order refills online or at customer service to save money and time.

COMPLETE THREE ACTIVITIES, EARN $100! Register Online and Fill Out Your Health Profile

★

One you have your ID card you can register online at www.MyGroupHealth. org or www.KP.org to get the best care from your health provider. Once you are registered, complete the online Health Profile. The Profile is a set of online questions and a report to help you manage your health.

Complete a Preventive Care Appointment

★

Use the online provider directory at www.ghc.org or www.kp.org to find a primary care provider who’s a good match for you. Then make a preventive care appointment. During your visit, ask your doctor where the nearest Urgent Care facility is so that you know where to go if you need medical help when your doctor is not available.

Complete a Dental Cleaning/Checkup Appointment

★

Your oral health is an important part of your overall health. Choose a dentist, complete a cleaning - smile! Dental Dental 1-800-554-1907 or Willamette Dental 1-855-433-6825.

★ 94

Complete Three Activities Marked with a Star and Receive $100!

If you have 1) completed your Health Assessment; and 2) completed a preventive office visit; and 3) completed a dental checkup, you will receive a check for $100. (Group Health members: Checks are sent 8-10 weeks after all three activities are complete. Kaiser members: Call 1-866-771-7359 after completing.) MYSEIUBENEFITS.ORG

培训：入门如何从培训中获益最多理解DOH认证要求如果您需要获得认证，请勿拖延，应尽快开始流程。敬请致电会员资源中心，与代表讨论您的要求。

尽早注册参加培训如果您需要基础培训，我们鼓励您在受雇后两周内注册课程，以便获得最佳课程选择方案。如果您希望参加讲师指导式继续教育课程，请在最后期限前尽早注册，以便获得最佳课程选择方案。

参加在线学习，获取持续教育学分通过参加在线持续教育课程，您可简单、方便地获取家庭护工继续教育学时。您可以随时在电脑上查看可用课程、参加课程、查阅学分。

在网上获取便利服务和支持 www.myseiubenefits.org门户网站为您提供可用课程、当前培训状态、福利资格等综合资源。首先请登录门户网站，以便获取您所需的答案。

更新您的联系信息与您的雇主更新您的联系信息，即可确保您能够收到有关培训的最新信息。

需要获得以您的语言提供的培训或健康福利支持？敬请致电1-866-371-3200，或发送电子邮件至http://www. myseiubenefits.org/contact-us，联系会员资源中心，我们的代表将以您的语言回答您的问题。

除英语之外，还提供12种语言的培训和认证考试阿拉伯语

韩语

索马里语

广东话

老挝语

西班牙语

柬埔寨语

萨摩亚语

俄语

此外，学员还可致电会员资源中心，获取其他语言的口译服务，席位有限，先到先得。 2014-2015 BENEFITS BOOK

健康福利：

您需要了解的信息我们为您的健康保驾护航：保险三重门健康福利信托基金

MEDICAID/ APPLE HEALTH

WA健康福利交换

• 必须连续3个月每个月工作至少 86小时，方可获得资格

• 资格视收入而定

• 费用各有不同

• 免费

• 每月25美元 • 医药、牙科、视力全面保险

• 在2014年11月15 日至2015年2月 15日的开放报名期间报名 • 如果您发生“合资格”事件（如结婚、生子），即可随时报名

无论您是已经享受健康福利信托基金保险，即将因为工时减少而失去保险，还是从未享受保险，我们都希望您和您的家人获得所需的保险。根据您的家庭收入，您可能符合通过Medicaid获取免费医疗健康保险的资格。敬请访问 www.wahealthplanfinder.org了解更多信息即使您不符合Medicaid的资格，也可能有其他易于负担的选择。如果您发生“合资格”事件，或者在开放报名期间（2014年11月15日至2015年2月15日），则您可以随时选择适当的医疗健康保险。敬请访问www.wahealthplanfinder.org了解更多信息

健康福利信托基金保险获取资格

必须连续三个月每个月工作至少86小时，方可获得享受这些福利的资格。您无需等到符合资格时再申请，您可以在受雇后就完成报名流程。

报名 ■ 个人提供者用您的学员ID登录网站，并单击IP在线报名表格，即可报名。您还可以打印纸质表格（见www.myseiubenefits.org），填妥后提交至表格上的地址或传真号码。如需帮助，请致电1-866-371-3200联系会员资源中心。 ■ 机构提供者请与您的雇主讨论报名事宜。

MYSEIUBENEFITS.ORG

健康福利信托基金：入门留意您的健康保险ID卡报名并符合资格后，您应该会收到邮寄的ID卡。如果您未在保险生效当月15号之前收到卡片：如果您是个人提供者，则请致电1-866-371-3200联系会员资源中心；如果您是机构提供者，请与您的雇主讨论。如果您在收到ID卡之前需要就医，请致电您的健康计划提供商获取您的ID号（Group Health请拨打1-888-901-4636，Kaiser 请拨打1-800-813-2000）。进行办公室拜访时，您需要提供此ID号。

寻找最近的紧急护理中心 URGENT CARE

您应该尽快找到离您最近的紧急护理中心，并写在本手册封面，以便随时查看。您可以在www.ghc.org或www.kp.org寻找紧急护理中心。

管理您的处方如果您有任何现有处方，请将其转交给Group Health或Kaiser。然后，请在网上或客户服务处设置邮购再配方，以便节省时间和资金。

完成三项活动，即可赚取100美元！在线注册并填写您的健康资料

★

收到ID卡后，您可以前往www.MyGroupHealth.org或www.KP.org注册，以便从您的健康提供商获得最佳护理。注册后，请填写在线健康资料。健康资料由一些在线问题和报告组成，可帮助您管理健康状况。

完成预防性护理预约

★

请使用www.ghc.org或www.kp.org的在线提供商名录寻找适合您情况的主要护理提供商，然后进行预防性护理预约。拜访前，请询问您的医生最近的紧急护理设施在哪里，以便您在需要医疗帮助或您的医生不在的情况下知道应该去哪里。

完成洁牙/牙科检查预约

★

口腔健康是整体健康的重要部分。选择牙医，完成清洁，尽情欢笑吧！Dental Dental的电话为1-800-554-1907，Willamette Dental的电话为1-800-359-6019。

★

完成标记星号的三项活动，即可赚取100美元！如果您（1）完成您的健康评估、（2）完成预防办公室拜访；并且（3）完成牙科检查，您就会收到100美元的支票。（Group Health会员：支票在完成所有三项活动后8至10周内发出。Kaiser会员：完成后请致电1-866-771-7359。） 2014-2015 BENEFITS BOOK 97

교육: 시작하기 교육 프로그램을 효과적으로 활용하는 방법 DOH 인증 요건 이해하기 의무적으로 인증을 취득해야 하는 경우라면 미루지 말고 가능한 빨리 과정을 시작하 십시오. 멤버 리소스 센터로 전화해서 담당 직원과 필요한 자격 요건에 대하여 상담하 십시오.

교육 프로그램 조기 등록하기 초급 교육 과정을 이수하는 경우라면 입사 후 처음 2주 안에 등록하여 가장 적합한 수 업 일정을 선택할 수 있도록 합니다. 강사 주도 CE(평생 교육) 수업을 수강하는 경우 원하는 수업을 수강하려면 귀하의 신청 마감일(출생일) 전에 최대한 빨리 등록하는 것이 좋습니다.

온라인 과정으로 평생 교육 학점 취득하기 온라인 평생 교육 과정을 이용하면 간병인 자격 취득에 필요한 CE 시간을 쉽고 편리 하게 이수할 수 있습니다. 1년 365일 언제든지 집에 있는 컴퓨터로 접속해 개설된 과 정을 열람하고 수업을 들을 수 있으며 학점을 조회할 수 있습니다.

온라인으로 편리하게 서비스 및 지원 받기 www.myseiubenefits.org 웹 포탈에는 참여 가능한 수업, 귀하의 현재 교육 상태, 지 원 혜택 신청 요건 등이 종합적으로 마련되어 있습니다. 궁금한 점이 있을 때는 먼저 홈페이지를 확인해 보십시오.

연락처 정보 갱신 고용주에게 귀하의 현재 연락처 정보를 알려 교육과 관련한 최신 정보가 정확하게 전 달될 수 있도록 합니다.

교육이나 의료 보험 혜택에 관해 귀하의 언어로 지원을 원하세요? 1-866-371-3200 멤버 리소스 센터로 전화하거나 http:// www.myseiubenefits.org/contact-us에서 이메일을 보내 주 시면 담당 직원이 귀하의 언어로 질문에 대한 답변을 드리겠 습니다. 영어와 12가지 언어로 교육 및 자격증 시험 지원 아랍어 중국어(광동어) 캄보디아어 한국어 98

라오스어 사모아어 소말리어 스페인어

MYSEIUBENEFITS.ORG

러시아어 따갈로그어 우크라니아어 베트남어

또한 MRC로 전화하면 이 외의 언어에 대한 통역 지 원을 선착순으로 제공받을 수 있습니다.

의료 보험 혜택:

공지 사항

의료 보험 적용을 받을 수 있는 3가지 방법

HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA 의료 혜택 교환

• 월 근무 시간이 최소 86시간 이 상이어야 하며 3개월 연속으로 근무한 경우에만 신청할 수 있음

• 가입 자격은 소득 수준에 따 라 결정됨

• 부담 비용은 상 이

• 비용 부담 없음

• 월 $25 • 일반 의료 보험, 치과 및 안과 보 험 전액

• 등록 기간: 2014 년 11월 15 일 ~ 2015년 2월 15일 • 결혼, 출산 등 " 자격 요건" 발 생 시 항상 등록 가능

Health Benefits Trust의 보장을 받고 있거나 혹은 근무 시간 미달로 인해 보장 자격 을 상실 중이더라도 혹은 보장 받은 전력이 전혀 없더라도 귀하와 귀하의 가족이 필 요로 하는 의료 보험을 적용받을 수 있어야 합니다. 신청 세대의 소득 수준에 따라 Medicaid를 통한 무상 의료 보험 혜택을 신청할 수 있는 자격이 될 수도 있습니다. 자세한 내용은 Washington Healthplanfinder 홈 페이지(www.wahealthplanfinder.org)를 참조하십시오. Medicaid의 신청 자격이 되지 않더라도 귀하의 재정 상태에 적합한 다른 의료 보 험 상품이 있을 수 있습니다. 지정된 등록 기간(2014년 11월 15일 ~ 2015년 2월 15일) 중에 또는 '자격 요건'에 부합하게 된 경우 언제든지 필요한 보장 상품에 가 입할 수 있습니다. 자세한 내용은 Washington Healthplanfinder 홈 페이지(www. wahealthplanfinder.org)를 참조하십시오.

Health Benefits Trust 가입 요건

월 근무 시간이 최소 86시간 이상이며 3개월 연속으로 근무한 경우에만 해당됩 니다. 자격 조건에 미달하더라도 신청이 가능하므로 채용된 후 가입 신청을 완료 할 수 있습니다.

등록 ■ 개인 공급자 학생 ID로 포탈에 로그인한 뒤 IP 온라인 등록 양식을 클릭하여 등록할 수 있습니다. 또 다른 방법은 www.myseiubenefits.org에 있는 양식을 출력하여 작성한 다음, 양식에 표기된 주소 또는 팩스 번호로 제출하실 수 있 습니다. 도움이 필요한 경우 1-866-371-3200 MRC로 연락해 주시기 바랍니 다. ■ 에이전시 공급자 등록에 대해서 근무하는 회사에 문의하십시오.

2014-2015 BENEFITS BOOK

HEALTH BENEFITS TRUST: 시작하기 의료 보험 카드 수령하기 등록을 하고 가입이 완료되면 우편으로 의료 보험 카드를 받게 됩니다. 개인 공 급자인 경우 보험 적용을 받기 시작하는 달의 15일이 되는 날까지 보험 카드를 받지 못한 경우 1-866-371-3200 MRC로 연락해 주십시오. 에이전시 공급자는 회사의 담당 부서에 문의하십시오. 보험 카드를 수령하기 전에 병원을 가야 할 경 우 보험사(Group Health 1-888-901-4636 또는 Kaiser 1-800-813-2000)에 전화해서 ID번호를 받으십시오. 내원 시 이 카드 번호를 알려 주어야 합니다.

가장 가까운 응급 의료 기관이 어디 있는지 확인합니다. URGENT CARE

가급적 빠른 시일 내에, 가장 가까운 응급 의료 기관을 찾아 본 책자의 표지에 적어 두어 필요할 때 쉽게 참고할 수 있도록 합니다. www.ghc.org 또는 www. kp.org에서 응급 의료 기관을 찾아 보실 수 있습니다.

처방전 관리하기 기존 처방전이 있는 경우 이를 Group Health 또는 Kaiser로 이전해야 합니다. 그 런 다음 온라인이나 고객 관리 부서를 통해 처방전에 있는 약을 우편으로 수령할 수 있도록 신청하면 돈과 시간을 절약하실 수 있습니다.

3가지 활동을 완료하고 $100을 받으세요! 온라인 등록 및 의료 프로필 작성하기

★

보험 카드를 수령하고 나서 www.MyGroupHealth.org 또는 www. KP.org에 카드를 등록하면 의료 기관에서 보다 양질의 진료 서비스를 받 을 수 있습니다. 온라인 등록을 완료했으면 의료 프로필을 작성합니다. 질문지와 보고서로 이루어진 이 프로필을 통해 귀하의 건강을 더 효과적 으로 관리할 수 있습니다.

예방 검진 예약하기

★

www.ghc.org 또는 www.kp.org에 나와 있는 진료 기관 온라인 명단에 서 귀하에게 적합한 1차 진료 기관을 찾습니다. 그런 다음 예방 검진을 예약합니다. 내원 시 의사에게 가장 가까운 응급실이 어디인지 확인하 여 주치의가 근무하지 않을 때에도 필요한 경우에 진료를 받을 수 있도 록 합니다.

구강 클리닝/검진 예약하기

★

구강 건강은 귀하의 전반적인 건강에서 매우 중요한 부분을 차지합니 다. 치과를 선택하고 클리닝을 완료하면 검진이 끝납니다. Dental 치과 1-800-554-1907 또는 Willamette 치과 1-800-359-6019 중 하나를 선택하실 수 있습니다.

★ 100

별표로 표시되어 있는 3가지 활동을 완료한 뒤 $100를 받으세요! 1) 건강 검진과 2) 예방 진료 및 3) 치과 검진을 모두 완료하게 되면 $100 수 표를 지급받게 됩니다. (Group Health 가입자: 수표는 3가지 활동을 모두 완 료한 다음 8~10주 후에 송부됩니다. Kaiser 가입자: 완료 후1-866-7717359로 전화를 주십시오.)

MYSEIUBENEFITS.ORG

CAPACITACIÓN: INTRODUCCIÓN COMO OBTENER EL MÁXIMO DE SU CAPACITACIÓN Entender los requisitos de certificación del Departamento de Salud

Si usted tiene la obligación de recibir la certificación, no se demore, inicie el proceso tan pronto como sea posible. Llame al Centro de Recursos para Miembros para hablar con un representante acerca de sus requisitos.

Regístrese Temprano para la Capacitación Si usted necesita Capacitación Básica, lo invitamos a inscribirse en sus clases dentro de las primeras dos semanas de contratación para obtener la mejor oferta de opciones de clases. Si usted quiere tomar clases de Educación Continua dirigida por Instructor (EC), inscríbase lo antes posible para obtener la mejor selección de las opciones de clase antes de la fecha límite (su cumpleaños).

Tome sesiones de aprendizaje en línea para obtener Créditos de Educación Continua Los cursos de Educación Continua en Línea son una manera fácil y conveniente de obtener las horas de CE que usted necesita como Ayudante de AtenciónDomiciliaria. Usted puede ver los cursos disponibles, tomar clases y ver los créditos, todo desde su computadora, 24 horas al día, siete días a la semana.

Vaya al sitio web para Servicio y Soporte Convenientes El portal web www.myseiubenefits.org es su recurso completo para las clases disponibles, su nivel de capacitación actual, los beneficios de elegibilidad y mucho más. Inicie sesión en el portal primero para obtener las respuestas que necesita.

Actualice su información de contacto Asegúrese de que está recibiendo la información más actualizada acerca de su formación mediante la actualización de la información de contacto con su empleador.

¿Necesita apoyo para Formación o Beneficios de Salud en su idioma? Llame al Centro de Recursos para Miembros al 1-866-371-3200 o contáctenos en http://www.myseiubenefits.org/contact-us y un representante contestará a su pregunta en su idioma. 12 Idiomas además de inglés para la Formación, el Examen de Certificación Árabe Cantonés Camboyano Coreano

Laosiano Samoano Somalí Español

Ruso Tagalog Ucranio Vietnamita

Además, los estudiantes pueden llamar a la MRC para un intérprete en otros idiomas en base al orden de llegada.

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BENEFICIOS PARA LA SALUD:

LO QUE USTED NECESITA SABER NOSOTROS LO TENEMOS CUBIERTO: 3 PUERTAS DE COBERTURA HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA HEALTH BENEFITS EXCHANGE

• Debe trabajar al menos 86 horas cada mes durante 3 meses continuos para ser elegible

• La elegibilidad depende de los ingresos

• El costo varía

• $25 por mes • Médico, dental, de visión completo

• Sin costo

• Matricúlesedurante la inscripción abierta del 15 de noviembre de 2014 al 14 de febrero de 2015 • Matricúleseen cualquier momento si usted tiene un evento “calificador” (como el matrimonio, hijos)

Si usted ha estado cubierto por el HealthBenefits Trust y está perdiendo la cobertura debido a una reducción en sus horas o si nunca ha estado cubierto, aun así queremos que usted y su familia obtengan la cobertura que necesitan. Dependiendo de su ingreso familiar, usted puede calificar para la cobertura de salud gratuita a través de Medicaid. Visite Washington Healthplanfinder para más información en www.wahealthplanfinder.org Incluso si usted no califica para Medicaidpuede haber otras opciones asequibles. Usted puede comprar cobertura de atención médica en cualquier momento si usted ha tenido un “evento calificador” o durante la inscripción abierta (del 15 de noviembre de 2014 al 15 de febrero de 2015). Visite Washington Healthplanfinder para más información en www.wahealthplanfinder. org

Elegibilidad para la Cobertura con HealthBenefits Trust Usted debe trabajar al menos 86 horas al mes durante tres meses consecutivos para tener derecho a estos beneficios. No es necesario esperar a que usted sea elegible para aplicar, se puede completar el proceso de inscripción después de que haya sido contratado.

Inscríbase ■ Proveedores Individuales Usted puede inscribirse ingresando al Portal con su Identificación de estudiante y hacer clic en el formulario de inscripción en línea IP. También puede inscribirse mediante la impresión de un formulario en papel (que se encuentra en www.myseiubenefits.org) llenarlo y enviarlo a la dirección o número de fax que aparece en el formulario. Llame a la MRC al 1-866-371-3200 si necesita ayuda. ■ Proveedores de Agencia Hable con su empleador acerca de la inscripción.

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HEALTH BENEFITS TRUST: INTRODUCCIÓN Busque su tarjeta de identificación del seguro de salud Después de inscribirse y ser elegible usted debe recibir una tarjeta de identificación en el correo. Si usted no recibe la tarjeta para el día 15 del mes en que comienza su cobertura, llame al MRC al 1-866-371-3200 si usted es un Proveedor Individual o, si usted es un Proveedor de Agencia, hable con su empleador. Si usted necesita ver a su médico antes de recibir su tarjeta de identificación, llame a su proveedor del plan de salud (HealthGroup 1-888-901-4636 o Kaiser 1-800-813-2000) para obtener su número de identificación. Necesitará este número de identificación para su visita al consultorio.

Ubique su Centro de Atención de Urgencias más cercano URGENT CARE

Tan pronto como sea posible, usted debe encontrar y anotar el Centro de Atención de Urgencias más cercano a usted en la portada de este manual para una fácil referencia. Usted puede encontrar lugares de atención de urgencias en www.ghc.org o www.kp.org

Administre sus recetas Si usted tiene recetas existentes, haga que sean transferidas a GroupHealth o Kaiser. A continuación, configure las recargas de pedidos por correo en línea o en el servicio al cliente para ahorrar dinero y tiempo.

¡COMPLETE TRES ACTIVIDADES, GANE $ 100!

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Inscríbase en línea y llene su Perfil de Salud

Una vez que ya tenga su tarjeta de identificación, puede registrarse en línea en www. MyGroupHealth.org o www.KP.org para obtener la mejor atención de su proveedor de salud. Una vez registrado, complete el Perfil de Salud en línea. El perfil es un conjunto de preguntas en línea y un informe para ayudarle a manejar su salud.

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Complete una cita de Atención Preventiva

Utilice el directorio de proveedores en línea en www.ghc.org o www.kp.org para encontrar un proveedor de atención primaria que sea conveniente para usted. A continuación, haga una cita de atención preventiva. Durante su visita, pregunte a su médico dónde está el centro de atención de urgenciasmás cercano para que usted sepa a dónde ir si necesita ayuda médica cuando su médico no está disponible.

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Completar una cita de Limpieza Dental/Revisión

Su salud oral es una parte importante de su salud en general. ¡Elija un dentista, complete una limpieza, sonría! Dental Dental 1-800-554-1907 o Willamette Dental 1-800-359-6019.

★

¡Complete tres actividades marcadas con una estrella y reciba $ 100! Si usted ha 1) completado su Evaluación de la Salud; y 2) completado una visita a la Oficina de Prevención; y 3) completado una revisión dental, recibirá un cheque por $100. (miembros del GroupHealth: Los cheques se envían 8-10 semanas después de que las tres actividades se hayan completado. Los miembros de Kaiser: Llame al 1-866-771-7359 después de completarlas).

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ОБУЧЕНИЕ: ПЕРВЫЕ ШАГИ КАК СДЕЛАТЬ ТАК, ЧТОБЫ ОБУЧЕНИЕ ДАЛО МАКСИМАЛЬНЫЕ РЕЗУЛЬТАТЫ Разберитесь с требованиями к сертификации, установленными Департаментом образования Если Вам необходимо пройти сертификацию, не откладывайте – начните этот процесс как можно скорее. Позвоните в Учебно-методический центр, чтобы поговорить о том, что Вам нужно.

Зарегистрируйтесь на участие в обучении заранее Если Вам необходимо пройти Базовое обучение, мы порекомендовали бы Вам зарегистрироваться на прохождение учебных курсов в течение первых двух недель с момента найма на работу, чтобы иметь возможность выбрать лучшие варианты. Если Вам нужны курсы повышения квалификации, проводимые преподавателем, зарегистрируйтесь как можно скорее, чтобы иметь возможность выбрать лучшие варианты до наступления конечного срока (Вашего дня рожденья).

Пройдите дистанционное обучение для получения кредитов в рамках системы повышения квалификации Курсы дистанционного повышения квалификации – это простой и удобный способ заработать часы в рамках системы повышения квалификации, которые необходимы Вам как специалисту по уходу на дому. Вы можете просматривать доступные курсы, выбирать предметы и видеть заработанные Вами кредиты непосредственно со своего компьютера – 24 часа в день, семь дней в неделю.

Зайдите в Интернет для получения услуг и помощи в удобной для Вас форме Веб-портал www.myseiubenefits.org – это ресурс с исчерпывающей информацией о доступных предметах, Вашем текущем статусе в рамках прохождения обучения, возможности получения Вами каких-либо льгот, а также о многом другом. Чтобы получить ответы на волнующие Вас вопросы, необходимо войти на портал.

Обновите свои контактные данные Убедитесь, что Вы получаете наиболее актуальную информацию о своем обучении, предоставив своему работодателю свои обновленные контактные данные.

Вам нужна помощь на Вашем языке в прохождении обучения или получении медицинской страховки? Обратитесь в Учебно-методический центр по тел. 1-866-371-3200 или электронному адресу http://www.myseiubenefits.org/contact-us, и представитель центра ответит на Ваши вопросы на Вашем языке.

Обучение и экзамен на получение сертификата на 12 языках в дополнение к английскому языку Арабский язык Кантонский диалект китайского языка Камбоджийский язык

104

Корейский язык Лаосский язык Самоанский язык Сомалийский язык

MYSEIUBENEFITS.ORG

Испанский язык Русский язык Тагальский язык Украинский язык

Кроме того, студенты могут обратиться в Учебно-методический центр для получения услуг устного перевода на другие языки, при этом заявки выполняются в порядке поступления.

МЕДИЦИНСКАЯ СТРАХОВКА:

ЧТО ВАМ НЕОБХОДИМО ЗНАТЬ МЫ ВАС ЗАСТРАХОВАЛИ: 3 ВАРИАНТА СТРАХОВАНИЯ ОРГАНИЗАЦИЯ «HEALTH BENEFITS TRUST»

ПРОГРАММА «MEDICAID/APPLE HEALTH»

•

Чтобы соответствовать критериям, кандидат должен работать как минимум 86 часов в месяц в течение 3 месяцев подряд

•

25 долларов США в месяц

•

Полное покрытие расходов на услуги по медицинскому обслуживанию, стоматологические услуги и услуги окулиста

•

Уровень дохода определяет соответствие критериям

БИРЖА УСЛУГ ПО МЕДИЦИНСКОМУ СТРАХОВАНИЮ ШТАТА АШИНГТОН (WA HEALTH BENEFITS EXCHANGE) •

Стоимость варьирует

•

Зарегистрируйтесь для участия в период открытого набора с 15 ноября 2014 года по 15 февраля 2015 года

•

Зарегистрируйтесь в любое время, если наступил случай, обеспечивающий Ваше соответствие какому-либо из критериев (например, брак, рождение ребенка)

Отсутствие платы

Мы хотим дать Вам и Вашей семье ту страховку, которая Вам нужна, даже если Вы никогда не были застрахованы или были застрахованы организацией «Health Benefits Trust» и теперь теряете эту страховку из-за сокращения количества отработанных Вами часов. В зависимости от уровня дохода Вашей семьи Вы можете соответствовать критериям, необходимым для получения бесплатной медицинской страховки по программе «Medicaid». Для получения дополнительной информации посетите веб-сайт торговой площадки «Washington Healthplanfinder» по адресу www. wahealthplanfinder.org Даже если Вы не соответствуете критериям «Medicaid», Вам могут быть доступны и другие приемлемые по цене варианты. Вы можете купить медицинскую страховку в любое время, если наступил случай, ■обеспечивающий Ваше соответствие какому-либо из критериев, или в период открытого набора (с 15 ноября 2014 года по 15 февраля 2015 года). Для получения дополнительной информации посетите вебсайт торговой площадки «Washington Healthplanfinder» по адресу www.wahealthplanfinder.org

Соответствие критериям получения страховки от организации «Health Benefits Trust»

Чтобы соответствовать критериям получения данной страховки, Вы должны работать как минимум 86 часов в месяц в течение трех месяцев подряд. Чтобы подать заявку, Вам не нужно ждать, пока Вы станете соответствовать критериям – Вы можете зарегистрироваться после того, как будете наняты на работу.

Зарегистрируйтесь для участия ■

Индивидуальные лица Вы можете зарегистрироваться, войдя на портал по своему студенческому билету или выбрав форму онлайн-регистрации индивидуальных лиц. Кроме того, Вы можете зарегистрироваться, распечатав, заполнив и отправив форму (доступна на веб-сайте www.myseiubenefits.org) по указанным на ней адресу или номеру факса. Если Вам нужна помощь, обратитесь в Учебно-методический центр, позвонив по тел. 1-866-371-3200.

■

Агентства Поговорите со своим работодателем относительно регистрации.

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ОРГАНИЗАЦИЯ «HEALTH BENEFITS TRUST»: ПЕРВЫЕ ШАГИ Найдите свою идентификационную карточку медицинского страхования После того, как Вы зарегистрируетесь и станете соответствовать критериям, Вы должны получить по почте идентификационную карточку. Если Вы не получите карточку до 15 числа месяца, с которого начинается Ваша страховка, обратитесь в Учебно-методический центр, позвонив по тел. 1-866-371-3200, если Вы индивидуальное лицо, или поговорив со своим работодателем, если Вы действуете через агентство. Если перед получением своей идентификационной карточки Вам необходимо посетить своего врача, позвоните своему медицинскому страховщику (Group Health 1-888-901-4636 или Kaiser 1-800-813-2000) для получения своего идентификационного номера. Вам понадобится данный идентификационный номер при посещении врача.

Установите местонахождение ближайшего к себе центра неотложной помощи URGENT CARE

Вам необходимо в кратчайшие сроки найти ближайший к себе центр неотложной помощи и записать его данные на титульной странице данного буклета, чтобы впоследствии их можно было легко отыскать. Установить местонахождение центра неотложной помощи можно с помощью веб-сайтов www.ghc.org или www.kp.org

Управляйте своими рецептами Если у Вас имеются какие-либо неиспользованные рецепты, перерегистрируйте их на Group Health или Kaiser. Затем создайте шаблоны заказов для доставки почтой в режиме онлайн или через службу поддержки клиентов, чтобы сэкономить свои деньги и время.

ВЫПОЛНИТЕ ТРИ ДЕЙСТВИЯ, ЧТОБЫ ПОЛУЧИТЬ 100 ДОЛЛАРОВ США! Зарегистрируйтесь онлайн и заполните анкету с информацией о своем состоянии здоровья

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После получения своей идентификационной карточки Вы можете зарегистрироваться онлайн на веб-сайтах www.MyGroupHealth.org или www.KP.org для получения от своего медицинского страховщика максимально возможных услуг. Зарегистрировавшись, заполните анкету с информацией о состоянии своего здоровья. Анкета содержит ряд онлайн-вопросов и отчет, которые направлены на то, чтобы помочь Вам держать свое здоровье под контролем.

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Используя электронную базу данных поставщиков медицинских услуг по адресу www. ghc.org или www.kp.org, найдите подходящего Вам терапевта. Затем осуществите профилактический визит к врачу. Будучи на приеме у врача. спросите его/ее, где находится ближайший центр неотложной помощи, чтобы Вы знали, куда обратиться, если Вам будет необходима медицинская помощь, а Вашего врача не будет на месте.

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Здоровая ротовая полость для нас также важна, как и общее состояние Вашего здоровья. Выберите стоматолога, пройдите чистку зубов и улыбнитесь! Dental Dental 1-800-5541907 или Willamette Dental 1-800-359-6019.

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MYSEIUBENEFITS.ORG

ĐÀO ĐÀO TẠO: TẠO: BẮT BẮT ĐẦU ĐẦU CÁCH NHẬN ĐƯỢC NHIỀU LỢI ÍCH NHẤT TỪ KHÓA CÁCHTẠO NHẬN NHIỀU LỢI ÍCH NHẤT TỪ KHÓA ĐÀO CỦAĐƯỢC QUÝ VỊ ĐÀO TẠO CỦA QUÝ VỊ

Hiểu Được các Yêu Cầu về Chứng Nhận DOH Hiểu Được các Yêu Cầu về Chứng Nhận DOH Nếu quý vị bắt buộc phải nhận được chứng nhận, đừng trì hoãn – bắt đầu quy trình càng sớm càng tốt.

Nếuđến quýTrung vị bắtTâm buộcNguồn phải nhận được chứng đừng hoãn bắtcác đầu quy trình sớm càng tốt. Gọi Lực Thành Viên đểnhận, trao đổi vớitrìđại diện– về yêu cầu củacàng quý vị. Gọi đến Trung Tâm Nguồn Lực Thành Viên để trao đổi với đại diện về các yêu cầu của quý vị.

Đăng Ký Sớm để Tham Gia Khóa Đào Tạo Đăng Ký Sớm để Tham Gia Khóa Đào Tạo Nếu quý vị cần Khóa Đào Tạo Cơ Bản, chúng tôi khuyến khích quý vị đăng ký tham gia lớp học của

Nếu quý vị cần Khóa Đào Tạo Bản, chúng tôi khuyến khích để quýchọn vị đăng ký tham gia tùy lớp chọn học của mình trong vòng hai tuần đầuCơ tiên kể từ khi được tuyển dụng lựa tốt nhất các lớp mìnhNếu trong hai tuần đầu khiGiáo đượcDục tuyển dụngXuyên để chọn lựacótốt nhấtViên các tùy chọnDẫn, lớp học. quývòng vị muốn tham giatiên các kể lớptừhọc Thường (CE) Giảng Hướng học.đăng Nếu quý vị muốn gia để cácchọn lớp học Giáo Dụccác Thường Xuyên Giảng Dẫn, hãy ký càng sớm tham càng tốt lựa tốt nhất tùy chọn của(CE) lớp có học trướcViên thờiHướng hạn của quý vị hãy đăng càng (ngày sinhký nhật củasớm quýcàng vị). tốt để chọn lựa tốt nhất các tùy chọn của lớp học trước thời hạn của quý vị (ngày sinh nhật của quý vị).

Tham Gia các Khóa Học Trực Tuyến để Nhận Tín Chỉ Giáo Dục Tham Gia các Khóa Học Trực Tuyến để Nhận Tín Chỉ Giáo Dục Thường Xuyên Thường Xuyên Các khóa học Giáo Dục Thường Xuyên trực tuyến là cách thức dễ dàng và thuận tiện để đạt được số

CácCE khóa Dục là Quý cáchvịthức dễ dàng và thuận tiệnsẵn để đạt được gia số giờ màhọc quýGiáo vị cần khiThường là Hộ LýXuyên Chămtrực Sóc tuyến Tại Nhà. có thể xem các khóa học có, tham giờ lớp CE mà vị cần khi Hộcủa Lý Chăm Quý vị có khóa họcngày, sẵn có, các họcquý và xem các tínlàchỉ quý vị,Sóc tấtTại cả Nhà. từ máy tính củathể quýxem vị –các 24 giờ một bảytham ngàygia một các lớp học và xem các tín chỉ của quý vị, tất cả từ máy tính của quý vị – 24 giờ một ngày, bảy ngày một tuần. tuần.

Truy Cập Trực Tuyến để nhận Dịch Vụ và Hỗ Trợ Thuận Tiện Truy Cập Trực Tuyến để nhận Dịch Vụ và Hỗ Trợ Thuận Tiện Cổng thông tin web www.myseiubenefits.org là nguồn lực toàn diện dành cho quý vị về các lớp học

Cổng là nguồn lựcđiều toànkiện diệnnhận dànhcác chophúc quý lợi vị về lớphơn học sẵn có,thông trạng tin tháiweb đàowww.myseiubenefits.org tạo hiện tại của quý vị, tình trạng đủ vàcác nhiều sẵn có, trạng tháicổng đào thông tạo hiện của tiên quý để vị, tình điều nhận phúc lợi và nhiều hơn nữa. Đăng nhập tintại trước nhậntrạng đượcđủ câu trả kiện lời mà quýcác vị cần. nữa. Đăng nhập cổng thông tin trước tiên để nhận được câu trả lời mà quý vị cần.

Cập Nhật Thông Tin Liên Lạc của Quý Vị Cập Nhật Thông Tin Liên Lạc của Quý Vị Đảm bảo quý vị đang nhận được thông tin mới nhất về khóa đào tạo của quý vị bằng cách cập nhật

Đảm bảo quý lạc vị đang nhận thông tindụng mới nhất về khóa thông tin liên của quý vị được với nhà tuyển của quý vị. đào tạo của quý vị bằng cách cập nhật thông tin liên lạc của quý vị với nhà tuyển dụng của quý vị.

Cần Được Hỗ Trợ về Đào Tạo hoặc Các Phúc Lợi Y Tế Cần Được Trợcủa về Đào bằng NgônHỗ Ngữ QuýTạo Vị? hoặc Các Phúc Lợi Y Tế bằng Ngôn Ngữ của Quý Vị? Gọi đến Trung Tâm Nguồn Lực Thành Viên theo số 1-866-371Gọi đến Trung Tâm Nguồn Lực Thành Viên theo số 1-866-371-và 3200 hoặc email http://www.myseiubenefits.org/contact-us 3200 hoặc email http://www.myseiubenefits.org/contact-us và đại diện sẽ trả lời câu hỏi của quý vị bằng ngôn ngữ của quý vị. đại diện sẽ trả lời câu hỏi của quý vị bằng ngôn ngữ của quý vị.

12 Ngôn Ngữ Ngoài Tiếng Anh cho Đào Tạo và Kiểm Tra Để Lấy Chứng 12 Ngôn Ngữ Ngoài Tiếng Anh cho Đào Tạo và Kiểm Tra Để Lấy Chứng Nhận Nhận Tiếng Ả Rập Tiếng Quảng Ả Rập Đông Tiếng Tiếng Quảng Đông Tiếng Campuchia Tiếng Hàn Campuchia Tiếng Quốc Tiếng Hàn Quốc

Tiếng Lào Tiếng Samoa Lào Tiếng Tiếng Samoa Tiếng Somali Tiếng Tây Somali Tiếng Ban Nha Tiếng Tây Ban Nha

Tiếng Nga Tiếng Tagalog Nga Tiếng Tiếng Tagalog Tiếng Ukraina Tiếng Việt Ukraina Tiếng Tiếng Việt

Ngoài ra, các học viên có thể gọi Ngoài ra, để cáccó học viênthông có thểdịch gọi đến MRC được đến MRC để có được thông dịch viên các ngôn ngữ khác, viên các ngôn ngữ khác, người nào gọi trước thì được ngườivụ nào gọi trước thì được phục trước. phục vụ trước.

2014-2015 BENEFITS BOOK 2014-2015 BENEFITS BOOK

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CÁC PHÚC LỢI Y TẾ: ĐIỀU QUÝ VỊ CẦN BIẾT CHÚNG TÔI GIÚP QUÝ VỊ CÓ ĐƯỢC BẢO HIỂM: 3 CỬA BẢO HIỂM HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA HEALTH BENEFITS EXCHANGE

• Phải làm việc ít nhất là 86 giờ mỗi tháng trong 3 tháng liên tiếp để đủ điều kiện

• Tình trạng đủ điều kiện tùy thuộc vào thu nhập

• Chi phí khác nhau

• $25 mỗi tháng • Đầy đủ phúc lợi y tế, nha khoa, thị lực

• Miễn phí

• Ghi danh trong giai đoạn ghi danh mở từ ngày 15 tháng 11 năm 2014 đến ngày 15 tháng 2 năm 2015 • Ghi danh bất kỳ lúc nào nếu quý vị có sự kiện “đủ tiêu chuẩn” (như kết hôn, có con)

Cho dù quý vị đã được Health Benefits Trust bảo hiểm và sẽ mất bảo hiểm do giảm số giờ của quý vị hoặc quý vị chưa bao giờ được bảo hiểm, chúng tôi vẫn muốn quý vị và gia đình của quý vị nhận được bảo hiểm mà quý vị cần. Tùy vào thu nhập hộ gia đình của quý vị, quý vị có thể đủ tiêu chuẩn nhận bảo hiểm chăm sóc sức khỏe miễn phí qua Medicaid. Truy cập Washington Healthplanfinder để biết thêm thông tin tại www.wahealthplanfinder.org Ngay cả khi quý vị không đủ tiêu chuẩn nhận Medicaid, có thể có các tùy chọn hợp túi tiền khác. Quý vị có thể mua bảo hiểm chăm sóc sức khỏe bất kỳ lúc nào nếu quý vị có ‘sự kiện đủ tiêu chuẩn’ hoặc trong giai đoạn ghi danh mở (Ngày 15 tháng 11 năm 2014 đến ngày 15 tháng 2 năm 2015). Truy cập Washington Healthplanfinder để biết thêm thông tin tại www.wahealthplanfinder.org

Tình Trạng Đủ Điều Kiện nhận Bảo Hiểm với Health Benefits Trust

Quý vị phải làm việc ít nhất 86 tiếng mỗi tháng trong ba tháng liên tiếp để đủ điều kiện nhận các phúc lợi này. Quý vị không cần đợi cho đến khi quý vị đủ điều kiện để đăng ký, quý vị có thể hoàn thành quy trình ghi danh sau khi quý vị đã được tuyển dụng.

Ghi danh ■ Nhà Cung Cấp Dịch Vụ Cá Nhân Quý vị có thể ghi danh bằng cách đăng nhập Cổng Thông Tin bằng ID Học Viên của quý vị và nhấp vào mẫu Ghi Danh Trực Tuyến dành cho Nhà Cung Cấp Dịch Vụ Cá Nhân (IP). Quý vị cũng có thể ghi danh bằng cách in ra mẫu đơn dạng giấy (có trên www.myseiubenefits.org), điền vào và gửi đến địa chỉ hoặc số fax trên mẫu đơn. Gọi đến MRC theo số 1-866-371-3200 nếu quý vị cần được trợ giúp. ■ Nhà Cung Cấp Dịch Vụ Cơ Quan Trao đổi với nhà tuyển dụng của quý vị về việc ghi danh.

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MYSEIUBENEFITS.ORG

HEALTH HEALTH BENEFITS BENEFITS TRUST: TRUST: BẮT BẮT ĐẦU ĐẦU Tìm Kiếm Thẻ ID Bảo Hiểm Y Tế của Quý Vị Tìm Kiếm Thẻ ID Bảo Hiểm Y Tế của Quý Vị

Sau khi quý vị ghi danh và đủ điều kiện, quý vị sẽ nhận được thẻ ID qua đường bưu điện. Nếu Sau khi quý vịnhận ghi danh đủchậm điều nhất kiện, vào quý ngày vị sẽ nhận thẻmà IDbảo qua hiểm đường bưu điện. Nếu quý vị không đượcvà thẻ 15 củađược tháng của quý vị bắt đầu, quýlòng vị không nhận được thẻsốchậm nhất vào ngày của bảoCấp hiểm củaVụquý bắt đầu, vui gọi đến MRC theo 1-866-371-3200 nếu15 quý vị tháng là Nhàmà Cung Dịch Cá vị Nhân hoặc vui lòng gọilàđến 1-866-371-3200 nếulòng quý trao vị là đổi Nhàvới Cung Dịch Vụ Cá hoặc nếu quý vị NhàMRC Cungtheo Cấpsố Dịch Vụ Cơ Quan, vui nhàCấp tuyển dụng củaNhân quý vị. nếu quý vị là Nhà Cung Cấp Dịch Vụ Cơ Quan, vui lòng trao đổi với nhà tuyển dụng của quý vị. Nếu quý vị cần gặp bác sĩ của quý vị trước khi quý vị nhận được thẻ ID của mình, vui lòng gọi cho Nếu Cung quý vịCấp cầnChương gặp bácTrình sĩ củaBảo quýHiểm vị trước được thẻ ID1-888-901-4636 của mình, vui lòng cho Nhà Y Tếkhi củaquý quývịvịnhận (Group Health hoặcgọi Kaiser Nhà Cung Cấp Chương Trình Bảo Hiểm Y Tế củavịquý vị (Group Health 1-888-901-4636 hoặc Kaiser 1-800-813-2000) để nhận số ID của mình. Quý sẽ cần số ID này để thăm khám tại văn phòng. 1-800-813-2000) để nhận số ID của mình. Quý vị sẽ cần số ID này để thăm khám tại văn phòng.

Tìm Địa Điểm của Trung Tâm Chăm Sóc Khẩn Cấp Gần Quý Vị Nhất Tìm Địa Điểm của Trung Tâm Chăm Sóc Khẩn Cấp Gần Quý Vị Nhất URGENT CARE

URGENT CARE

Ngay khi có thể, quý vị cần tìm kiếm và viết ra Trung Tâm Chăm Sóc Khẩn Cấp gần quý vị nhất ở Ngay khi thể,của quýsách vị cần và viết ra Quý Trung Chăm Sóc Khẩn Cấp gầnChăm quý vịSóc nhất ở trang bìa có trước nàytìm đểkiếm xem dễ dàng. vị Tâm có thể tìm thấy các địa điểm Khẩn trang bìa trước của sách này để xem dễ dàng. Quý vị có thể tìm thấy các địa điểm Chăm Sóc Khẩn Cấp tại www.ghc.org hoặc www.kp.org Cấp tại www.ghc.org hoặc www.kp.org

Quản Lý Toa Thuốc của Quý Vị Quản Lý Toa Thuốc của Quý Vị

Nếu hiện quý vị đã có toa thuốc, chuyển các toa thuốc này đến Group Health hoặc Kaiser. Tiếp Nếu hiện quý vị đã có toađường thuốc,bưu chuyển thuốc nàytại đến Health theo, đặt mua thêm qua điệncác trựctoa tuyến hoặc bộGroup phận dịch vụ hoặc kháchKaiser. hàng Tiếp để tiết theo, đặt mua thêm qua đường bưu điện trực tuyến hoặc tại bộ phận dịch vụ khách hàng để tiết kiệm thời gian và tiền bạc. kiệm thời gian và tiền bạc.

HOÀN HOÀN THÀNH THÀNH BA BA HOẠT HOẠT ĐỘNG, ĐỘNG, KIẾM KIẾM ĐƯỢC ĐƯỢC $100! $100!

★ ★ Khi quý vị đã có thẻ ID của mình, quý vị có thể đăng ký trực tuyến tại www.MyGrou-

Đăng Ký Trực Tuyến và Điền Vào Hồ Sơ Y Tế của Quý Vị Đăng Ký Trực Tuyến và Điền Vào Hồ Sơ Y Tế của Quý Vị

Khi quý vị đãhoặc có thẻ ID của mình, có thể trực tạinhà www.MyGroupHealth.org www.KP.org để quý nhậnvịdịch vụ đăng chămký sóc tốttuyến nhất từ cung cấp pHealth.org hoặc www.KP.org để nhận dịch vụ chăm sóc tốt nhất từ nhà cấp dịch vụ y tế của quý vị. Khi quý vị đã được đăng ký, hãy hoàn thành Hồ Sơcung Y Tế trực dịch vụ y tế của quý vị. Khi quý vị đã được đăng ký, hãy hoàn thành Hồ Sơ Y Tế trực lý tuyến. Hồ Sơ là tập hợp các câu hỏi trực tuyến và một báo cáo để giúp quý vị quản tuyến. Hồ Sơ là tập hợp các câu hỏi trực tuyến và một báo cáo để giúp quý vị quản lý sức khỏe của mình. sức khỏe của mình.

Hoàn Thành Cuộc Hẹn Chăm Sóc Phòng Ngừa Hoàn Thành Cuộc Hẹn Chăm Sóc Phòng Ngừa

★ ★

Sử dụng danh bạ nhà cung cấp dịch vụ trực tuyến tại www.ghc.org hoặc www.kp.org Sử tìm dụng danh bạcung nhà cung cấpvụ dịch vụ trực tại www.ghc.org hoặc để kiếm nhà cấp dịch chăm sóc tuyến chính phù hợp với quý vị. Sauwww.kp.org đó đặt cuộc để tìm kiếm nhà cung cấp dịch vụ chăm sóc chính phù hợp với quý vị. cuộc hẹn chăm sóc phòng ngừa. Trong lần thăm khám của quý vị, hỏi bác sĩ Sau của đó quýđặt vị địa hẹn chăm phòng Trong lầnnhất thăm quý vị, hỏi củanếu quýquý vị địa điểm cơ sởsóc Chăm Sóc ngừa. Khẩn Cấp gần đểkhám quý vịcủa biết được cầnbác đếnsĩđâu vị điểmđược cơ sở Cấp gần quý nhấtvịđể quý vịrỗi. biết được cần đến đâu nếu quý vị cần trợChăm giúp Sóc y tế Khẩn khi bác sĩ của không cần được trợ giúp y tế khi bác sĩ của quý vị không rỗi.

★ ★ Sức khỏe răng miệng là một phần quan trọng của sức khỏe tổng quát của quý vị.

Hoàn thành Cuộc Hẹn Vệ Sinh Răng Miệng/Khám Sức Khỏe Tổng Quát Hoàn thành Cuộc Hẹn Vệ Sinh Răng Miệng/Khám Sức Khỏe Tổng Quát

Sức khỏe miệng một phần quan trọng củacho sứcnụ khỏe tổng của quýDental vị. Chọn mộtrăng nha sĩ, hoànlàthành vệ sinh răng miệng cười rạngquát rỡ! Dental Chọn một nha sĩ,hoặc hoànWillamette thành vệ sinh răng miệng cho nụ cười rạng rỡ! Dental Dental 1-800-554-1907 Dental 1-800-359-6019. 1-800-554-1907 hoặc Willamette Dental 1-800-359-6019.

★ ★

Hoàn Thành Ba Hoạt Động Được Đánh Dấu Sao và Nhận Được $100! Hoàn Ba Hoạt Động Đánh Dấu Sao và Nhận Được $100! Nếu quýThành vị đã 1) hoàn thành Đánh GiáĐược Sức Khỏe của quý vị; và 2) hoàn thành thăm khám

Nếu quý vị đãtại1)văn hoàn thànhvà Đánh Giá Sức Khỏe củasức quýkhỏe vị; vàrăng 2) hoàn thành khámđược phòng ngừa phòng; 3) hoàn thành khám miệng, quýthăm vị sẽ nhận phòng văn phòng; và 3)viên hoàn khám sức Các khỏe răng quýđến vị sẽ8-10 nhận được tấm sécngừa trị giátại$100. (Các thành củathành Group Health: tấm sécmiệng, được gửi tuần tấm séc trị giá $100. (Các thành viên của Group Health: Các tấm séc được gửi đến 8-10 tuần sau khi tất cả ba hoạt động được hoàn thành. Các thành viên của Kaiser: Gọi số 1-866-771sau khi tấtkhi cảhoàn ba hoạt động được hoàn thành. Các thành viên của Kaiser: Gọi số 1-866-7717359 sau thành.) 7359 sau khi hoàn thành.)

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TABABAR: BILAABISTA SIDA LOOGA HELO FAA’IIDADA UGU BADAN TABABARKAAGA Fahan shuruudaha Shahaado Qaadashada DOH Haddii lagaa doonayo in aad qaadatid shahaado, haka daahin – waxaad u bilaawdaa hanaanka sida ugu dhakhsiyaha badan ee suurtagalka ah. Wac Xarunta Macluumaadka Xubinka si aad ugala hadasho wakiil shuruudahaaga.

Isugu diiwaangeli Xili Hore Tababarka Haddii aad u baahantahay Tababar Aasaasi ah, waxaan kugu dhiirigelinaynaa in aad isku diiwaangelisid fasaladaada labada toddobaad ee ugu horreeya ee shaqaalaynta si aad u heshid doorashooyinka ugu fiican ee ikhtiyaaraadka fasalka. Haddii aad doonaysid in aad qaadatid fasallo Waxbarasho Siiwadasho Macalinka-Horkaca (CE) , isku diiwaangeli xili hore ee suurtagalka ah si aad u heshid doorashada ugu fiican ee ikhtiyaaraadka fasalka kahor wakhtiga kama dambayska (maalintaada dhalashada).

Qaado Barashada Onlineka ee loogu talogalay Darajooyinka Aqoon Qaadashada ee Waxbarasho Siiwadasho Koorsooyinka Waxbarasho Siiwadashada ee Onlineka ah waa hab fudud oo sahal ah ee lagu helayo Saacadaha Waxbarasho Siiwadasho (CE) ee aad ugu baahantahay sida Kaaliye Daryeel Guri ahaan. Waxaad ka eegi kartaa koorsooyinka la heli karo, ka qaadan kartaa fasallo kana eegi kartaa darajooyinkaaga dhammaan kumbuyuutarkaaga – 24 saacadood maalintii, toddobo maalmood toddobaadkii.

Ka raadso Onlineka Adeeg iyo Taageero Kugu Habboon Cinwaanka mareegtada www.myseiubenefits.org waa macluumaadkaaga dhammeystiran ee fasallada la heli karo, xaalkaaga tababarka ee hadda la joogo, u-qalmitaanka dheefaha iyo wax badan. Soo gal mareegtada marka hore si aad u heshid jawaabaha aad u baahan tahay.

Cusboonaysii Macluumaadkaaga Xiriirka Hubso in aad helaysid macluumaadka ugu dambeeya ee ku saabsan tababarkaaga adigoo ka cusboonaysiinaya macluumaadkaaga xiriirka loo-shaqeeyahaaga.

Miyaad u Baahan tahay Tababar ama Dheefo Caafimaad oo Luuqadaada ah? Ka wac Xarunta Macluumaadka Xubinka 1-866-371-3200 ama iimayl u dir http://www.myseiubenefits.org/contact-us kadibna wakiil ayaa kaagaga soo jawaabaya su’aalahaaga luuqadaada. 12 Luuqadood oo Lagu Daray Ingiriiska oo loogu talogalay Tababar, Imtixaanka Shahaado Qaadashada Carabi Kantoniis Kamboodhiyan Kuuriyaan

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Laoshiyaan Samoan Soomaali Isbaanish

MYSEIUBENEFITS.ORG

Ruushiya Tagalog Yukreeniyaan Fiitnaamees

Waxaa siidheer, in ardayda ay u wici karaan MRC si ay u helaan turjumaanidda luuqado kale oo ku saabsan aasaas imaanshaha-hore.

DHEEFAHA CAAFIMAADKA: WAXA AAD U BAAHAN TAHAY IN AAD OGGAATID WAAN KU CAYMINAY: 3DA ALBAAB EE CAYNSANAANTA HEALTH BENEFITS TRUST

MEDICAID/ APPLE HEALTH

WA HEALTH BENEFITS EXCHANGE

• Waa in uu shaqeeyo qofka ugu yaraan 86 saacadood bil kasta 3 bilood oo isku xigga si loogu qalmo

• U-qalmitaanka waxay ku xiran tahay dakhliga

• Karashka wuu kala duwanyahay

• $25 bil kasta • Caafimaad, ilkaha, aragga dhammeystiran

• Kharash la’aan

• Isqor inta lagu guda jiro isqoritaanka furan Nof. 15,2014Feb. 15, 2015 • Isqor wakhti kasta haddii aad leedahay dhacdo "u-qalmaysa" (sida guur, ilmo)

Haddii uu ku caymiyay ururka Health Benefits Trust aadna u waynaysid caynsanaanta sabab ah yaraanta saacadahaaga ama aanan waligaa lagu cayminin, waxaan wali doonaynaa in adiga iyo qoyskaaga aad heshiin caynsanaanta aad u baahantihiin. Ayadoo ku xirantahay dakhliga reerkaaga, waxaad u-qalmi kartaa caynsanaan daryeel caafimaad oo lacag la’aan ah ayadoo loo maraya Medicaid. Booqo Washington Healthplanfinder si aad ugu hesho macluumaad baddan www. wahealthplanfinder.org Xitaa haddii aadan u-qalmin Medicaid waxaa jiri kara ikhtiyaaro kale oo la awoodi karo. Waxaad iibsan kartaa caynsanaanta daryeelka caafimaad wakhti kasta haddii aad lahayd ‘dhacdo u-qalmitaan’ ama inta lagu guda jiro isqoritaanka furan (Nofeembar 15, 2014 illaa Febaayo 15, 2015). Booqo Washington Healthplanfinder si aad ugu hesho macluumaad baddan www.wahealthplanfinder.org

U-qalmitaanka Caynsanaanta ururka Health Benefits Trust

Waa in aad shaqeysid ugu yaraan 86 saacadood bil kasta seddax bilood oo isku xigga si aad ugu qalantid dheefahan. Uma baahnid in aad sugtid illaa aad ugu qalantid in aad codsatid, waxaad dhammeytiri kartaa hanaanka isqoritaanka kadib marka lagu shaqaaleeyo..

Isqor ■ Bixiyeyaasha Shakhsi2] Waxaad isqori kartaa adigoo ku gelaya Mareegtada Aqoonsigaaga Ardayga kadib guji foomka Isqoritaanka Onlineka ee Bixiyeyaasha Shakhsi (IP). Waxaad sidoo kale isqori kartaa adigoo daabacaya foomka waraaqda ah (oo laga helayo www. myseiubenefits.org) dhammmeystir kadibna u soo gudbi cinwaanka ama lambarka fakis ee ku dul qoran foomka. Ka wac MRC 1-866-371-3200 haddii aad u baahan tahay caawimaad. ■ Bixiyeyaasha Hay’adda ah Kala hadal loo-shaqeeyahaaga wixii ku saabsan isqoritaanka.

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HEALTH BENEFITS TRUST: BILAABISTA Raadso Kaarkaaga Aqoonsiga ee Caymiska Caafimaad Kadib marka aad isqortid aadna u-qalantid waa in aad ku heshid kaar Aqoonsi boostada. Haddii aadan helin kaarka 15ka bisha ee caynsanaantaadu bilaabanayso, ka wac MRC 1-866371-3200 haddii aad tahay Bixiye Shakhsi ama, haddii aad tahay Bixiye Hay’ad ah, la hadal loo-shaqeeyahaaga. Haddii aad u baahantahay in aad aragtid dhakhtarkaaga kahor inta aadan helin kaarkaaga Aqoonsiga, wac Bixiyahaaga Qorshaha Caafimaad (Caafimaadka Kooxda 1-888901-4636 ama Kaiser 1-800-813-2000) si aad u heshid lambarka Aqoonsigaaga. Waxaad ugu baahanaysaa lambarkan Aqoonsiga booqashadaada xafiiska.

Baro Meesha Ay Ku Talo Xarunta Daryeelka Degdega ah ee Kuugu Dhow URGENT CARE

Sida ugu dhakhsiyaha baddan ee suurtagalka ah, waa in aad heshid aadna ku qortid Xarunta Daryeelka Degdega ah ee kuugu dhow xagga hore ee buuggan ee loogu talogalay tixraaca fudud. Waxaad ka heli kartaa goobaha Daryeelka Degdega ah boggaan intarnatka www.ghc.org ama www.kp.org

Maarey Rijeetooyinkaaga Daawada Haddii aad haysatid rijeetooyin daawo ee jira, ha laguugu wareejiyo Caafimaadka Kooxda ama Kaiser. Marka ku xigta, aasaas dalab-boosto oo dib loogu buuxinayo onlineka ama adeeg macmiil si aad u badbaadisid lacag iyo wakhti.

DHAMMEYSTIR SEDDAX WAXQABAD, KASBO $100!

★

Iska diiwaangelin Onlineka kadibna Dhammeystir Haybsashada Caafimaadkaaga

Marka aad heshid kaarkaaga aqoonsiga waxaad iska diiwaangelin kartaa onlineka www.MyGroupHealth.org ama www.KP.org si aad uga heshid daryeelka ugu wanaagsan bixiyehaaga caafimaad. Marka aad isdiiwaangelisid, dhammeystir Haybsashada Caafimaadka ee onlineka ah. Haybsashada waa su’aalo onlineka ah oo diyaarsan iyo warbixin kugu caawinaysa in aad maareysid caafimaadkaaga.

Dhammeystir Ballanta Daryeelka Ka Hortagga

★

Adeegso tusiyaha bixiyaha onlineka ee www.ghc.org ama www.kp.org si aad u heshid bixiyaha daryeelka aasaasiga ah ee sida fiican adiga kuugu habboon. Kadibna sameeyso ballanta daryeelka ka hortagga. Inta lagu guda jiro booqashadaada, wayddii dhakhtarkaaga halka ay ku taalo xarunta Daryeelka Degdega ee ugu dhow sidaas awgeed waxaad garanaysaa meesha la tagayo haddii aad u baahantahay caawimaad caafimaad marka dhakhtarkaaga aanan la heli karin.

Dhammeystir Ballanta Baaritaanka/Nadiifinta Ilkaha

★

Caafimaadka afkaaga waa qayb muhiim ah oo kamid ahcaafimaadkaaga guud. Dooro takhtarka ilkaha, dhammeystir nadiifin – dhoolla-cadday! Ilkaha Ilkaha 1-800-554-1907 ama Ilkaha Willamette 1-800-359-6019.

★ 112

Dhammeystir Seddaxda Waxqabad ee Ku Calaamadeysan xiddigta kadiba Hel $100! Haddii aad 1) dhammeystirtay Qiimeyntaada Caafimaad; aadna 2) dhammeystirtay booqashada xafiiska ee ka hortagga; aadna 3) dhammeystirtay baaritaanka ilkaha, waxaad helaysaa jeeg $100 ah. (Xubnaha Kooxda Caafimaadka: Jeegagga waxaa la soo diraa 8-10 toddobaad kadib marka la dhammeystiro dhammaan seddaxda waxqabad. Xubnaha Kaiser: Wac 1-866-771-7359 kadib dhammeystirka.)

MYSEIUBENEFITS.ORG

NOTICES About This Guide This handbook is intended to be an overview of your benefits and a general resource. For more detailed information about your health and dental benefits, you should consult the Summary Plan Description (SPD) and Certificate of Coverage for those benefits. This handbook is not a “Plan document” or the official SPD. In case of any conflict between this document and any “Plan document,” the terms of the Plan Document shall govern. The handbook is not a promise of benefits. All benefits described in the handbook are provided pursuant to existing collective bargaining agreements (CBA) and employer participation agreements with the SEIU Healthcare NW Health Benefits Trust and Training Partnership. Should the CBA or other agreements with the Health Benefits Trust and/or Training Partnership terminate, change or otherwise become ineffective, the benefits described in this book may also terminate or change.

Equal Opportunity The SEIU Healthcare NW Training Partnership (“Partnership”) admits students regardless of race, color, national origin, ethnic origin, gender, age, disability and sexual orientation to all the rights, privileges, programs, and activities generally accorded or made available to students by the Training Partnership. It does not discriminate on the basis of race, color, national origin, ethnic origin, gender, age, disability and sexual orientation in administration of its training and educational policies, admissions policies, scholarship and loan programs, and other Training Partnership administered programs.

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Not required

For Workers Who Have a Current NAC Credential, the Chart Below Applies (Not LPN or RN)*** Providers with a renewed NAC or Special Education Endorsements Providers with an new NAC or Special Education Endorsements

If CE is required in the table above, then your CE is due by your second birthday following you NAC Credential issuance date.**

If CE is required in table above, then your CE is due by your first birthday after you start working as an HCA IP or AP.

By your birthday

Parent Individual Provider (HCS/AAA)

Standard HCA

Individual Provider (IP)

Agency Provider (AP)

HCA Credentialed

Home Care Aide (HCA)

Home Care Aide who does not work with their own parent or child. Works more than 20 hours a month or has more than one consumer.

Home Care Aide (HCA) whose employer of record is DSHS.

Home Care Aide (HCA) employed by a private, Medicaid homecare agency.

A worker who has successfully passed a test and been credentialed by Department of Health as a Home Care Aide.

Provides care to a consumer living in his or her home. Employed by a private, Medicaid homecare agency or DSHS.

HOME CARE AIDE DEFINITIONS

Parent DD Individual Provider (DDA)

This is any IP who provides care 20 hours a month or less for one consumer.

This is an IP who provides care to his/her own adult child with a developmental disability and is contracted through the Developmental Disability Administration. An adult child providing care for his/her biological, step or adoptive parent.

Limited Service Provider Adult Child Individual Provider

This is an IP that provides DDA Respite services at 300 hours or less in a calendar year.

This is an HCA with a current healthcare credential, such as a Registered Nurse (RN), Licensed Practical Nurse (LPN) or Nursing Assistant Certified (NAC).

Respite Non-HCA Credentialed

MYSEIUBENEFITS.ORG

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TRAINING STANDARDS UPDATED JULY 2014

ORIENTATION AND SAFETY

BASIC TRAINING

CREDENTIAL

INITIAL CONTINUING EDUCATION (CE)

Continuing Education 12 Hours

ONGOING CE

By your birthday

Continuing Education 12 Hours

By your birthday

HCA Credential Required?

By your birthday following your last HCA credential renewal date

By your birthday

Parent Provider (DDD Only) Class 7 Hours

Yes

By your birthday in next calendar year after completing Basic Training

Not required, unless you voluntarily obtain your HCA credential

Basic Training 70 Hours

Not applicable

Not required, unless you voluntarily obtain your HCA credential

Accelerated Basic Training 30 Hours

Not applicable

Not required, unless you voluntarily obtain your HCA credential

Safety Training 3 Hours

Not applicable

Not required

Not required, unless you voluntarily obtain your HCA credential

By your birthday

Orientation 2 Hours

Not applicable

Not required

Within 120 days of starting to provide care

By your birthday in next calendar year after completing Accelerated Basic Training

Not required

Yes

Not applicable

Within 120 days of starting to provide care

Not required

Standard HCA IP or AP hired after 1/7/2012 renewed certification Not applicable Completed prior to providing care

Not required

Standard HCA IP or AP hired before 1/7/2012 Completed prior to providing care

Completed prior to providing care

Within 120 days of starting to provide care

Not required

Completed prior to providing care

Parent Individual Provider (HCS/AAA)* Completed prior to providing care

Completed prior to providing care

Within 120 days of starting to provide care

Not required

Completed prior to providing care

Parent DD Individual Provider (DDD)* Completed prior to providing care

Completed prior to providing care

Within 120 days of starting to provide care

If your first renewal period is less than a full year from the date of certification, no CE will be due for the fist renewal period.**

Limited Service Provider*

Completed prior to providing care

Within 120 days of starting to provide care

Adult Child Individual Provider*

Completed prior to providing care

Standard HCA Individual Provider (IP) & Agency Provider (AP) hired after 1/7/2012 in process or Newly Issued HCA credential

Respite

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