Employers' Health Program

/uploadedImages/Member_Services/Affinity_Partners/AGC Employers' Health Program.pngThe AGC Employers' Health Program is a tax exempt employee benefit plan. The program complies with all rules and regulations of the Employee Retirement Income Security Act (ERISA).  As required by law, each provider maintains its own appeals process. For example, you can appeal the denial of medical services or benefits directly to WHA or Kaiser.  Under a federal law call the Consolidated Omnibus Budget Reconciliation Act, or COBRA for short, you may continue your health care coverage provided by your employer when coverage would otherwise end. Coverage is for a temporary period. The Administrators of the AGC Employers' Health Plan administer COBRA coverage for participating employers. Contact the Administrative Office or your employer for details.

 


AGC Employers' Health Program Plans 

For more information on the AGC Health Program, please contact

Michael Navin(916) 371-2422
navinm@agc-ca.org 
 

Eligibility and Participation Requirements 

1. Employers of the Associated General Contractors of California not currently enrolled in the health plan, may do so on the first day of any month. This applies to all available plans.

2. Subject to the exceptions noted below, any member who elects to participate must report and pay for all his employees who are eligible for the plan. To be eligible, an employee must be full time, which is defined as working at least 30 hours per week. The job classifications covered include executives, administrative personnel, timekeepers, guards, etc. The individual owner or partners of a participating firm are also to be included, provided they devote a substantial part of their time to the firm's business.

The Trustees recognize that in certain instances, an employee may wish to decline plan participation because he/she is covered under their spouse's insurance, an individual or government plan, etc. In such cases an employee must complete and sign a "Declination of Coverage" form.

3. A choice of two Dental Plans is also available on an optional basis. However, if the Dental Plan is elected, all eligible employees must be covered.

Eligibility Rules 

4. Medical/hospital, dental, life insurance, accidental death and dismemberment, and vision care for eligible employees becomes effective on the first (1st) of the month after completion of 30 (thirty) days of continuous full-time employment.

5. Participating employers must be members of the Associated General Contractors of California to enroll in any of the benefit plans. Employers who discontinue membership in the Associated General Contractors of California will be ineligible for continued participation in the AGC Employers' Health Plan after 60 days following termination of AGC membership.

6. The Plan requires that a participating employer sign a Participation Agreement. Generally, other than sending in the monthly remittance report, members will have no other paperwork. The Administrative Office will handle all premium accounting, maintenance of records to the benefit providers, COBRA billings, and all other details connected with the efficient operation of a health and welfare program.

Employer Billings 

7. Monthly billings are due one month in advance of the coverage month. For example, coverage (premium) for the month of June is due on May 1st. There is a 10-day grace period until the 10th of the month. For example, premium for June is due May 1st and must be received at the band no later than May 10th.

8. Delinquencies. Employer contribution reports are considered delinquent if:

A. Report or contribution is received after the 10th of the month.
B. No report is received.
C. The required contribution is not received.
D. No coverage will be provided if payment is not received by the 20th of the month.
E. If a late payment is accepted, a flat fee of $25 will be charged each month that the payment is late.

Enrollment Cards 

All employees should complete enrollment cards for the plan(s) selected. Newly hired personnel should complete and sign an enrollment card upon the date of hire, and forward it immediately to the Administrative Office.

What Else You Should Know 

The AGC Employers' Health Program is a tax exempt employee benefit plan. 

As required by law, each provider maintains its own appeals process. For example, you can appeal the denial of medical services or benefits directly to WHA or Kaiser.

Under a federal law call the Consolidated Omnibus Budget Reconciliation Act. Or COBRA for short, you may continue your health care coverage provided by your employer when coverage would otherwise end. Coverage is for a temporary period. The Administrators of the AGC Employers' Health Plan administer COBRA coverage for participating employers. Contact the Administrative Office or your employer for details.

 

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