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  • CCPU Health Care Fund
  • CCPU Health Care Fund
  • CCPU Health Care Fund

© 2026 CCPU Health Care Fund administered by Pinnacle Claims Management, Inc.
All rights reserved.

Reimbursement Program Benefits

Once approved with a Qualified Health Plan (QHP), you’ll unlock the Reimbursement Program — covering health insurance premiums, copays, deductibles, prescriptions, and more. With up to $9,800 each year (effective 1/1/2026), the Fund helps reduce your costs and strengthen your health coverage.

Information on immigration status is not required to apply. CCPU will not ask for this information.

 

Benefits

Reimbursement Benefits

Once your enrollment is approved and your health plan qualifies, the CCPU Health Care Fund will help you offset your health care costs in meaningful ways. Here’s what you can expect:

  • Premium Reimbursement
    Depending on your Qualified Health Plan, the Fund may cover 100% of your monthly health insurance premium or reimburse a portion (e.g., up to $200/month in certain cases).

  • Out-of-Pocket Medical & Pharmacy Expenses
    You can submit claims for costs like copays, deductibles, coinsurance, and prescription costs — up to  $9,800 each year (effective 1/1/2026), depending on your plan.

  • Initial Premium Support
    If you need help making your first premium payment to your health plan, you can submit a request using your billing statement and proof of coverage.

  • Plan-Specific Benefits
    The benefits available to you may depend on the type of health plan you have (e.g. Covered California, employer-sponsored plan, Medicare, Medi-Cal, TRICARE, carrier direct).

Each section below provides details based on your health plan.

Note: Fund benefits build on top of your existing health insurance — they do not replace it. You must remain enrolled in a Qualified Health Plan to maintain reimbursement coverage.

 

Reimbursement Program Benefits

Covered California

For providers enrolled in Covered California, the Fund will reimburse 100% of your provider-only medical insurance premium and cover up to $9,800* each year (effective 1/1/2026) in health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance. 

Fund benefits are only available if you are enrolled in a Silver-level HMO plan.  

If you have a second job that offers medical insurance, you must be enrolled in that plan to receive Fund benefits. 

If you have access to an employer plan as a dependent through your spouse, you can enroll in either the employer plan or a qualified Covered California plan and receive Fund benefits. 

*If no HMO plans are available in your area, the lowest-cost EPO/PPO option will be considered a qualified health insurance plan.

Employer-Sponsored Medical Insurance/COBRA

If you have a second job that offers employer-sponsored medical insurance, the Fund will reimburse your medical insurance premium up to $200 per month and cover up to $9,800 each year (effective 1/1/2026) in health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance.

Medicare

If you are enrolled in Medicare, the Fund will cover up to $$9,800 (effective 1/1/2026) per year in eligible health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance. Medicare expenses also include reimbursement of Medicare Part B premiums up to $202.90 (effective 1/1/2026) per month and Medicare Part D premiums up to $100 per month.

Medi-Cal

If you are enrolled in Medi-Cal, the Fund will cover $200 per month for permissible health care expenses. Permissible health care expenses include many over-the-counter medications, acupuncture, physical therapy, wheelchairs, and more. 

The permissible health care expense benefit is only available to providers who are enrolled in Medi-Cal. It is not available to providers who are enrolled in one of the other qualified medical insurance plans.

This benefit is different from other qualified health plans because Medi-Cal often pays 100% of premiums and out-of-pocket expenses.

Medi-Medi

If you are enrolled in both Medi-Cal and Medicare, the Fund will cover $200 per month for permissible health care expenses. Permissible health care expenses include many over-the-counter medications, acupuncture, physical therapy, wheelchairs, and more.

In addition, the Fund will cover up to $9,800 each year (effective 1/1/2026) in eligible health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance. 

The permissible health care expense benefit is only available to providers who are enrolled in Medi-Cal. It is not available to providers who are enrolled in one of the other qualified medical insurance plans.

Carrier Direct

If you do not have a social security number or TIN* and you purchased an insurance plan directly through an insurance carrier, the Fund will reimburse your medical insurance premium up to $100 per month and cover up to $9,800 each year (effective 1/1/2026) in health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as co-pays, deductibles, and co-insurance. Fund benefits are only available if you are enrolled in a Silver-level HMO equivalent plan.

*You do not need a SSN/TIN/ITIN to purchase health insurance directly through a carrier, however, you must have an ITIN/TIN to participate in the Health Care Fund.

Veterans Affairs

If you are enrolled in Veterans Affairs Health Care benefits, the Fund will cover up to $9,800 each year (effective 1/1/2026) per year in eligible health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance.

TRICARE

If you are enrolled in TRICARE, reimbursement benefits differ by plan type. 

If you are enrolled in TRICARE Prime, TRICARE Select, TRICARE Reserve Select, or TRICARE Retired Reserve, the Fund will reimburse your medical insurance premium up to $200 per month and cover up to $9,800 each year (effective 1/1/2026) in health plan expenses. This includes reimbursement of out-of-pocket medical and pharmacy expenses, such as copays, deductibles, and coinsurance.

If you are enrolled in TRICARE for Life, the Fund will reimburse your Medicare Part B premium up to $202.90 per month (effective 1/1/2026).

Using Your Benefits

The CCPU Health Care Fund works with the health insurance you already have (or that you enroll in) and reimburses you for your out-of-pocket costs like doctor visit copays, prescription drug copays, and in most cases, the monthly premiums.

The Fund does not replace your health insurance. In fact, to be eligible for Fund benefits, you must be enrolled in a qualified health insurance plan. 

How to Use Your Benefits

Once approved, using and maintaining your reimbursement benefits is straightforward — if you follow a few important steps:

Pay for the Service

When you visit a provider or pharmacy, pay for your portion of the cost (copay, deductible, etc.) using your CCPU Fund debit card or out of pocket (if needed).

Submit a Claim (or Request)

Upload or submit your documentation — e.g. receipts, proof of coverage — within the allowable timeframe. You can email your reimbursement requests and documents or upload directly to the Reimbursement Portal.

Get Reimbursed

After your claim is approved, the Fund will reimburse you for eligible expenses, up to your plan’s benefit limits.

Maintain Your Account & Documentation

To keep your benefits active:

  • Provide up-to-date proof of coverage (your name, plan name, effective dates, premium amount)

  • Submit receipts with name, service date, description, cost

  • Upload documents promptly — delays can trigger holds

  • Use your debit card only for eligible expenses

  • Respond quickly to any requests for additional info

  • Monitor your portal account regularly for alerts or messages

If your debit card is suspended for any reason, reimbursements cannot be processed until you resolve the issue — so staying on top of documentation and account activity is key.

Why Reimbursement Benefits Matter

This program is designed to give you more financial breathing room:

  • Reduce your out-of-pocket burden

  • Help manage monthly insurance premium costs

  • Give you access to high quality health care without sacrificing your income

  • Offer flexibility across different plan types and provider circumstances

When you enroll and actively participate, you’ll be leveraging one of the most powerful benefits the Fund offers.

Am I eligible for CCPU Heathcare Reimbursement Fund benefits?

Answer these simple questions to determine your potential program eligibility.

Get Started

2026 CCPU Health Care Fund administered by Pinnacle Claims Management, Inc. All rights reserved.

To complete your application online, you’ll need proof of coverage for your health plan (a document showing your name as the policyholder, the name of your insurance plan, the coverage period, and the amount you pay for coverage).

If you don’t have an account for the CCPU Health Care Fund portal, you can sign up now with your email address and mobile phone number.

Complete Your Application

Questions? Call the PRC at (888) 583-CCPU(2278) or Email: [email protected]