Health & Welfare → Plans → Healthy Structures Program


The Board along with your Union and employer have taken steps to address the rising costs of health care that are adversely affecting the hospital-medical plans. The focus of the changes is based on two goals: First, they want you and your eligible Dependents to live the healthiest lives possible; and second, they want you and your eligible Dependents to make smart, informed choices when purchasing health care services. Taking both of these steps will help you save money as well as help the Fund remain financially sound. Beginning in 2011, the Board adopted a concept designed around these two goals called “Healthy Structures, Your Tools for a Smart Finish”. Under “Healthy Structures”, there are several programs specifically designed to help you obtain the quality health care services you expect and save money for both you and the Fund at the same time.

CAUTION: The various Healthy Structures programs described below apply to the Direct Payment Plan only with the exception of the Promise program which applies to both the Direct Payment and Kaiser Permanente Plan. 

The Promise program (Active benefits only);

  • A Care Counseling (Care Counselor) and Pre-Authorization Review program through Pacific Health Alliance for non-emergency outpatient services;
  • Value-Based Site program for routine total hip or knee replacement surgery; non-emergency outpatient arthroscopy, cataract and colonoscopy procedures (California based only);
  • A new Preferred Provider Plan network, Anthem Blue Cross Advantage PPO, if you live within California;
  • A custom Formulary Drug program; and
  • The Future Moms’ program (Active benefits only)

If you are a Retired Participant or the Dependent of a Retired Participant enrolled in the Direct Payment Plan who is Eligible for Medicare, these programs do not apply to you. 

Understanding how the Healthy Structures programs work and apply to you and your eligible Dependents, will help you use your health plan to the fullest, receive quality health care services and save money.

For a complete description of the Healthy Structures Program, Continue Reading.