Your Benefits With the Trust
Eligible Sound Health & Wellness Trust Kaiser Permanente Plan participants and their covered dependents can receive $0 co-pay flu shots at Kaiser Permanente medical centers and in-network pharmacies.
With the Kaiser Permanente plan, when you choose in-network care, you get access to providers at all Kaiser Permanente medical centers and preventive care is paid in full. In addition, you have access to a number of contracted community physicians in the area. If you choose out-of-network care, you can see First Choice Health Network or Beech Street providers at a discounted rate. Or you can see any licensed provider you want for most covered services. Your out-of-pocket costs will be higher than if you choose care inside the Kaiser Permanente network.
Find a provider online by using the Kaiser Permanente Provider Directory.
Get More Information in Your Benefits Booklet
Find the details of your medical coverage in your Summary Plan Description booklet in the sidebar at right. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. It is printed on the far left-hand side under the Trust logo.
With the Kaiser Permanente plan, when you choose in-network care, you get access to providers at all Kaiser Permanente facilities. Or you can see any licensed provider you want for most covered services. Your out-of-pocket costs will be higher than if you choose care inside the Kaiser Permanente network.
Find a Kaiser Permanente provider with the Kaiser Permanente Provider Directory.
Covered services:
- Exam: 80% for Kaiser Permanente (In-Network) Providers / 60% for Out-of-Network Providers not subject to deductible or coinsurance; once every 12 months.
- Lenses, frames and contact lenses*: 100% up to $200** for both In-Network and Out-of-Network Providers; once each 12 consecutive months, subject to a 12-month benefit wait period.
* Including contact lens evaluations and examinations associated with their fitting.
** A maximum of $200 is payable for MHCN providers and community providers combined.
Get More Information in Your Benefits Booklet
Find the details of your vision coverage in your Summary Plan Description booklet (choose the link below based on whether you are in the “Sound” or “SoundPlus” plan).
DDWA Preferred Program
This option allows you to see any licensed dental provider. Search for a dentist using the Delta Dental of Washington site. Your reimbursement will depend on the dentist’s contract with DDWA:
- DDWA Preferred (PPO) Providers: Seeing a Preferred Dentist will provide the highest level of benefits and the lowest out of pocket costs.
- DDWA Participating Providers: These dentists provide a discount, but your benefits percentage is lower, resulting in higher out of pocket costs vs. a Preferred Dentist.
- Non-DDWA Dentist: If your dentist is not Preferred or Participating, your benefits will be lower, and you will have higher out of pocket costs. Reimbursement is made based on maximum allowable fees, which may leave you with higher patient responsibility.
Schedule Plan
This option allows you to see any licensed dental provider. Benefits will be paid according to the schedule of allowances. Dental charges in excess of the schedule will be your responsibility.
DeltaCare Program
DeltaCare is a dental HMO plan. This option requires you to choose from a smaller list of approved dentists and clinics. You MUST choose a DeltaCare primary care dentist who coordinates all of your care, including any referrals to specialists. Under this plan you cannot just see any licensed dentist for treatment. A list of DeltaCare providers can be found at www.deltadentalwa.com. Make sure you have a DeltaCare provider in your area and that they are accepting new patients before enrolling in this option.
Get More Information in Your Benefits Booklet
Find the details of your dental coverage in your Summary Plan Description booklet in the sidebar at right. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. It is printed on the far left-hand side under the Trust logo.
Kaiser Permanente provides mental health care and alcohol and drug treatment through the Kaiser Permanente Behavioral Health Services department. Sound Health & Wellness Trust participants are also able to use benefits for mental health and chemical dependency at the out of network benefit level.
Kaiser Permanente’s behavioral health care management program provides care coordination, support and advocacy for patients with severe or chronic mental illness and or alcohol or drug concerns. Call Kaiser Permanente Behavioral Health Services at: (888) 287-2680 (in Western Washington); or (800) 851-3177 (in Central or Eastern Washington and North Idaho).
Your call will be answered by a trained and licensed counselor who will ask you a few questions to best direct you to the services that meet your needs and preferences. Phone lines are open Monday-Friday, 8 a.m. to 5 p.m. After-hours crisis care is provided by a strong system of Consulting Nurses and on-call psychiatrists.
For additional information, visit www.kp.org/wa. The website is an excellent resource for information on behavioral health topics.
Get More Information in Your Benefits Booklet
Find the details of your mental health & substance abuse coverage in your Summary Plan Description (choose the link below based on whether you are in the “Sound” or “SoundPlus” plan).
Effective December 1, 2021 the Sound Health & Wellness Trust has partnered with WellDyneRx to administer the Trust’s prescription drug benefit through three options for your convenience – retail pharmacies, WellDyneRx Mail and WellDyne Specialty Pharmacy (for specialty drugs).
The Sound Health & Wellness Trust uses a pharmacy network managed by WellDyne to provide discounts on prescription drugs. The Trust Custom Pharmacy Network (PDF) consists of pharmacies owned by employers who participate in the Trust, as well as pharmacies at many Kaiser clinic facilities.
To learn more about your prescription drug benefit, including what is covered, copays, out-of-pocket maximums, and exclusions and limitations, visit the new Prescription Drugs page.
Eligible Sound Health & Wellness Trust Kaiser Permanente Plan participants and their covered dependents can receive $0 co-pay flu shots at Kaiser Permanente medical centers and in-network pharmacies.
The Sound Health & Wellness Trust uses a pharmacy network managed by WellDyne to provide discounts on prescription drugs. The Trust Custom Pharmacy Network (PDF) consists of pharmacies owned by employers who participate in the Trust, as well as pharmacies at many Kaiser clinic facilities.
Getting a flu shot is the single best way to protect against the flu. Children from 6 months to 19 years of age, pregnant women, people 50 and older, and people with certain chronic medical conditions are especially encouraged to get a flu shot.
Employee Life Insurance—The employee life insurance benefit is $15,000. This amount will be paid to your beneficiary in the event of your death from any cause.
Dependent Life Insurance—The spouse or State Registered Same Sex Domestic Partner’s benefit is $1,000. This amount will be paid to you in the event of your spouse or partner’s death from any cause.
Employee Accidental Death or Dismemberment—This benefit is payable to your beneficiary in the event of your death, or to you in the event of your loss, if your death or loss is caused by an accidental injury while you are covered under the Plan.
Get More Information in Your Benefits Booklet
Find the details of your life insurance coverage in your Summary Plan Description in the sidebar at right. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. It is printed on the far left-hand side under the Trust logo.
If you are totally disabled because of your injury or sickness, you may be eligible for weekly disability benefits. To qualify, you must have worked at least 80 hours during your eligibility month (which was two months before the onset of your disability). Your time-loss payments will range from $135 to $225 per week (less Social Security taxes), depending on the number of hours you worked during your eligibility month.
Get More Information in Your Benefits Booklet
Find the details of your time loss coverage in your Summary Plan Description in the sidebar at right. To determine whether you are covered under the “Sound” or “SoundPlus” plan, look at the front of your Sound Health & Wellness Trust ID card. It is printed on the far left-hand side under the Trust logo.
