Engaged Care Plan

The Engaged Care Plan provides medical and prescription drug coverage for all active participants and their dependents.

Plan Details

The Engaged Care Plan is a self-insured plan, which means the claims are paid by the Fund rather than an insurance company. The plan promotes the Fund’s Family Wellness Centers, provided in partnership with Marathon Health, as your first stop and primary source for health care services. By using the Fund’s wellness centers when you need care, your out-of-pocket expenses will be lower compared with seeing providers outside the wellness centers.

The wellness centers offer high-quality medical and preventive care, a board-certified primary care physician (PCP), access to prescription drugs, telemedicine visits, and lab work at no cost to you. Due to popular demand, the wellness centers have expanded their staff and in 2026 will offer new services such as physical therapy and access to a registered dietitian/health coach. Whenever you need care, whether it be primary care, specialty care, or urgent care, the Fund’s Family Wellness Centers are there to support you first.

Medical Plan Comparison Chart

* If your emergency isn’t life-threatening, both the PPO and Engaged Care Plan pay $75 toward the total of emergency room charges and you pay the balance, which could be as much as $3,000 per visit.

How It Works

The Engaged Care Plan encourages and promotes the use of the Family Wellness Centers as your first stop whenever you need to seek health and wellness care. In circumstances when you are unable to seek care at a Family Wellness Center (e.g., needing care after hours, in cases of emergency or medical urgency, or to seek out a specialist), the plan does provide access to the Anthem Blue Cross Blue Shield PPO national network. However, if you seek care outside the PPO network, services will not be covered (except in the case of an emergency or if referred by a Family Wellness Center).

Here are the guidelines you need to follow under the plan:

• Whenever you choose to seek care under the Engaged Care Plan, you must first make an appointment at one of the wellness center locations.
• If you receive care at one of the wellness centers within the most recent 12-month period and/or you receive a referral from a provider at one of the centers, you can choose a provider from the Anthem Blue Cross Blue Shield PPO network at a reduced copay for health care services.
• If you do not receive care at a wellness center within the most recent 12-month period and/or you do not receive a referral from a wellness center provider, you will be subject to higher copays. If you choose not to receive a referral for care before going out-of-network, you will be responsible for the full cost of services.

Note: You do not need a referral to receive OB-GYN, pediatric, or mental health care as long as you stay within the Anthem Blue Cross Blue Shield PPO network (or Harmony network for mental health care). For more details on the PPO coverage you receive when you visit a Family Wellness Center, visit the Where to Go for Medical Care page.