HMO Plan Option
You may elect to participate in an HMO plan if you live within the service area of one of the HMO plans listed below and are otherwise eligible for coverage under the Retiree Plan. If you elect an HMO plan, your medical, prescription drug, and mental health and chemical dependency benefits will be provided through your HMO instead of the Trust’s Indemnity Medical Plan.

Rules for Electing and Revoking Election of HMO Plan Coverage
If you live within the service area of one of the HMO plans listed below, you will have an opportunity at the time you become initially eligible, and once each year during open enrollment to choose whether or not to participate in an HMO plan. If no election is made, you will automatically receive the Indemnity Medical Plan. If you have previously elected to participate in an HMO plan, that election will be honored until you revoke it. Further information about your HMO plan options is available from your Area Administrative Office.

The annual open enrollment period is July 15th to August 15th of each calendar year for a September first effective date. During this period you will be sent written materials explaining the options available to you. If for any reason you fail to receive such material, contact your Area Administrative Office and additional copies will be sent.

HMO Plans Available - The HMO plans available and the areas they serve are:

• Arizona - Secure Horizons
• California - Kaiser or Secure Horizons
• Colorado - Kaiser
• Oklahoma - Secure Horizons
• Oregon - Kaiser or Secure Horizons
• Texas - Secure Horizons
• Washington - Group Health or Secure Horizons

Indemnity Medical Plan Option
The indemnity medical benefits described as Program Two in this booklet are your Plan benefits if you are Medicare eligible have enrolled in Medicare parts A and B, and did not elect to enroll in one of the HMO plans identified above. The medical benefits in this section are provided on a self-funded basis by the Western Teamsters Welfare Trust.

For Those Eligible for U.S. Medicare
The Trust provides major medical and prescription drug benefits for retirees and dependents who are eligible for U.S. Medicare. Some of the other benefits included here are:

• Inpatient Hospital
• Outpatient Hospital
• Surgical Treatment
• Physician Office Visits
• X-ray and Laboratory Tests