Health Resources
These links are provided as a convenience and for informational purposes only and do not constitute an endorsement by the Northern California Cement Masons Trust Funds. The Northern California Cement Masons Trust Funds bear no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.
Administrative Office
Health Services & Benefit Administrators
4160 Dublin Boulevard, Suite 400
Dublin, CA 94568-7756
(925) 208-2280
www.hsba.com
Anthem Blue Cross - Self-Funded Medical Plan PPO
800-810-BLUE
www.anthem.com/ca
Provider Directory www.bluecares.com
iPhone
Android
Blue Shield of CA - HMO
1-855-256-9404
www.bsca.com
Network Providers www.blueshieldca.com/fad
iPhone https://apps.apple.com/us/app/blue-shield-of-california/id728293729
Android https://play.google.com/store/apps/details?id=com.blueshieldca.prod&hl=en_US&gl=US
Delta Dental of California
(888) 335-8227
www.deltadentalins.com
EyeMed
(866) 804-0982
https://www.eyemed.com/en-us
Health Insurance Marketplace 1-800-318-2596 www.HealthCare.gov
ING Employee Benefits (Life Insurance and AD&D)
Call the Administrative Office at (925) 208-2280
Kaiser Permanente
(800) 464-4000
1 800 788-0616 (Spanish)
Appointments and Nurse Advice Line: 1-866-454-8855 iPhone Android
Medicaid or CHIP 1-877-KIDS NOW 1-877-543-7669 www.insurekidsnow.gov
Met Life Dental
(800) 880-1800
www.metlife.com
CVS Caremark
Member Services / Pharmacy Helpdesk: (833) 894-0677Pre-Authorizations: (800) 294-5979Specialty Pre-Authorizations: (866) 814-5506Specialty Pharmacy: (800) 237-2767Member Portal: http://www.caremark.com/StartNow
U.S. Department of Health & Human Services www.cms.hhs.gov
U.S. Department of Labor (EBSA Office) 1-866-444-EBSA www.dol.gov/agencies/ebsa
Forms
Authorization for Release of Protected Health Information
Beneficiary
Change of Address
Dual Coverage Questionnaire
Enrollment
Participant Information
Notices
Pharmacy Benefit Manager Changes - Effective 1-1-2025
COBRA Rate Changes – Effective January 1, 2025
Domestic Partners Imputed Income Rates - Effective December 1, 2024
Early Retiree Self-Pay Premium Rates – Effective January 1, 2025
Non-Medicare Dependent COBRA Rates - Effective January 1, 2025
Notice of Creditable Coverage - 2025
Notice of Creditable Coverage - 2024
Notice of Creditable Coverage - 2023
Notice of Privacy Practices
Summary Annual Report - Plan Year 2023
Summary Annual Report - Plan Year 2022
Women's Health & Cancer Rights
Plan Documents & Amendments
Health & Welfare Summary Plan Description
Amendment No. 4
Amendment No. 5
Amendment No. 6
Amendment No. 8
Summary of Benefits & Coverage
Anthem PPO Plan SBC
Blue Shield of CA HMO Plan SBC
Kaiser HMO Plan for Actives SBC
Kaiser HMO Plan for Early Retirees SBC
Summary of Material Modifications
March 2025 SMM - Disabled Adult Child Eligibility
March 2025 SMM - Gene Therapy Clarification, Skilled Nursing Facility Admissions, Exclusion for Learning Disabilities
October 2019 SMM - Claims & Appeals Procedures Waiver of Class, Collective & Representative Actions
Some PDF forms on this site are fillable online. You can type information directly onto the PDF.
By default, Firefox does not currently support forms in fillable format. To use this feature, view the site in Chrome or Microsoft Edge.Transparency in CoverageFederal Transparency in Coverage regulations require that as of July 1, 2022, group health plans must post machine readable files containing (1) negotiated in-network rates and (2) out-of-network billed charges and allowed amounts. To access this information, click the links below.Anthem Important Transparency in Coverage Machine Readable File Information
Kaiser Permanente https://healthy.kaiserpermanente.org/front-door/machine-readable
