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Pennsylvania Builders Association (PBA) Benefits Trust
Offers Self-Insured Plan through Builders Benefits
Builders Benefits is organized to provide and administer health care benefits to the Pennsylvania Builders Association and other licensed associations' members, their employees, and their dependents through the PBA Benefits Trust. The PBA Benefits Trust is switching to Builders Benefits, a self-insured plan, from insured plans offered by licensed companies. Builders Benefits operates on a self-insured, risk assuming basis through a preferred provider organization (PPO) structure.
The PPO coverage offered by Builders Benefits is somewhat unique. We provide every potential member company with a written disclosure to explain the differences between the Builders Benefits health plans and those offered by other licensed health plans.
The following chart compares some of the general benefits offered to you through Builders Benefits plans with those you may be able to secure elsewhere. You can investigate your outside options before deciding to sign on with any health care plan.
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Builders Benefits Plan |
Licensed Plans |
| Co-pay |
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| Deductible |
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| Coverage limitations |
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| COBRA Availability |
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| Appeal Rights |
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A complete disclosure and detail of the Builders Benefits plans is included in the Summary Plan Description provided to all member firms and participants. In addition, Builders Benefits will notify participating member firms in writing and on a timely basis if any material changes are made to the coverage plans.
Builders Benefits is regulated by the Department of Labor and governed by a number of federal laws and regulations, including those of the Employee Retirement Security Income Act of 1974 (ERISA). Builders Benefits has also agreed with the Pennsylvania Department of Insurance (PID) to follow a number of state laws and regulations as required by the Pennsylvania Department of Health and the Pennsylvania Department of Insurance (PID). In particular, Builders Benefits must comply with an April 11, 2006 PID Consent Order requiring Builders Benefits to:
- Report financial and audit information to the PID,
- Comply with minimum capitalization and risk-based capital financial requirements,
- File quarterly financial statements for the first two years of operation and post these statements on www.buildersbenefits.com,
- Comply with producer licenser requirements,
- Comply with the mandated benefits (mandated before April 11, 2006),
- Comply with records retention rules, and
- Comply with the Unfair Insurance Practices Act.
Builders Benefits is not required to:
- Get a license or certificate of authority under PPO or other law,
- File certain financial statements to the National Association of Insurance Commissioners (NAIC), or
- Comply with anti-subrogation provisions, Insurance Holding Company Law or rates and forms filings.
Should you have any questions on this disclosure notice or wish to obtain a copy of the consent order, please contact Builders Benefits at 888-221-2550.
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