Child Care Providers United (“CCPU”) won $100 million for eligible child care providers to reduce or eliminate their healthcare costs. These benefits are provided by the Child Care Providers United California Workers Health Care Fund (the “CCPU Health Care Fund”), a health care trust governed by the Board of Trustees, who are appointed by SEIU Local 521, SEIU Local 99 and the United Domestic Workers/AFSCME Local 3930.

The CCPU Health Care Fund is offering the following benefits to meet the goal to reduce or eliminate health care costs so that eligible providers can access high quality health care coverage.

The information provided below is to assist you in your enrollment decision about your health insurance during this Open Enrollment.

*THE CCPU Health Care FUND PROVIDES ONLY INDIVIDUAL PROVIDER COVERAGE – IT DOES NOT PROVIDE ANY FAMILY BENEFITS.

What benefits does the CCPU Health Care Fund expect to offer providers?

The CCPU Health Care Fund offers the following benefits to eligible providers:

  • Reimbursement of health plan out of pocket expenses up to $8,750 per year
  • Reimbursement of your insurance premium cost on qualified health plans
  • Special benefits for Medi-Cal enrollees
  • Special benefits for providers covered under an employer or other group health insurance plan
Out of Pocket Expenses
Covered by CCPU Health Care Fund
NOT covered by CCPU Health Care Fund

Health insurance plan copayments, coinsurance, deductibles

Copayments, coinsurance, deductibles for prescription medications

Costs for services denied or not covered by your health insurance/pharmacy plan, including expenses outside your health insurance plan like glasses, braces, over-the-counter medicine

Premium Expenses

The CCPU Health Care Fund helps providers cover up to 100% of the cost of a qualified health insurance plan, after applying the maximum amount of federal assistance available

Health insurance Plan
Premium reimbursed by CCPU Health Care Fund

Covered California Silver HMO* plan

Covered at 100% except for if provider has access to employer plan as an employee

Medi-Cal

N/A

Medicare

Part B premiums up to $164.90/month
Part D/Medicare Adv up to $50/month

Both Medi-Cal and MediCare
(Medi-Medi)

N/A

Employer/Group sponsored health insurance plan

Up to $100/month

*if no HMO plans are available in your zip codes in California, the lowest cost EPO/PPO option is a qualified health insurance plan.

Medi-Cal Reimbursement Sample List
Acupuncture
Alcoholism treatment
Ambulance
Birth control
Body scans
Braille books and magazines
Breast pumps and lactation supplies
Chiropractor
Cough, cold and flu
Crutches or canes
Diabetic supplies
Diagnostic services
Digestive aids
Drug addiction treatment
Fertility enhancements
Flu shots
Guide dogs or other service animals
Hearing aids and batteries
Hospital services
Insulin
Laboratory fees
Lamaze classes
Learning disability treatments
Menstrual care products
Mastectomy-related special bras
Medical equipment and repairs
Medical monitoring and testing devices
Medical supplies
Many over-the-counter medications
Nursing services
Office visits
Oxygen
Physical exams
Physical therapy
Pregnancy tests (over-the-counter)
Prescription drugs
Prosthesis
Psychiatric care
Physical therapy
Pregnancy tests (over-the-counter)
Prescription drugs
Prosthesis
Psychiatric care
Reconstructive surgery following
Respiratory treatments
Mastectomy
Smoking cessation (programs/drugs)
Speech therapy
Sterilization
Surgery
Travel expenses (essential to receive
medical care; subject to IRS limits)
Vaccinations
Vasectomy
Wheelchair
X-ray fees
Braces
Dentures
Dental care
X-rays
Contact lenses
Examinations and glasses
Laser eye surgery
Reading glasses (over-the-counter)
Reimbursement Program Benefits
Qualified Health Plan
Amount

Silver level HMO plan offered through Covered California

  • Up to $8.750 per vear for out -of-pocket expenses
  • Reimbursement of provider’s portion of premium expense

Silver HMO equivalent individual health plan
(if you are not eligible for Covered California)

  • Up to $8,750 per year for out -of-pocket expenses
  • $100 per month for premium expense

Employer-sponsored group health plan

  • Up to $8,750 per year for out -of-pocket expenses
  • $100 per month for premium expense

Medi-Cal

  • Up to $100 per month for permissible expense

Medicare or Medicare Advantage

  • Up to $8,750 per year for out -of-pocket expenses
  • Premium reimbursement for Part B up to $164.90 per month
  • Premium reimbursement for Part D up to $50 per mont

Dual MediCal & Medicare (Medi-Medi)

  • Up to $8,750 per year for out -of-pocket expenses
  • Up to $100 per month for permissible expenses

Veterans Affairs (VA) Health Care

  • Up to $8,750 per year for out -of-pocket expense

TRICARE Prime, TRICARE Select, TRICARE
Reserve Select, TRICARE Retired Reserve

  • Up to $8.750 per ear for out-of-pocket expenses
  • $100 per month for premium expense

TRICARE for Life (COB)

  • Premium reimbursement for Medicare Part B up to $164.90 per month

Who is eligible for the CCPU Health Care Fund benefits?

Eligibility Criteria 1 of 3: State funding for this health benefit is tied to the state’s child care subsidy program. For the CCPU Health Care Fund’s initial eligibility for January, 2023, you must have been paid for work with a subsidized child in at least three of the six months during the initial lookback period of April 2022 – September 2022. For ongoing eligibility, after initial eligibility is satisfied, you must have been paid for work with a subsidized child in at least one month out of three.

* If you are not eligible initially, you can become eligible later.

Initial Eligibility Work Requirements
Payment months
Benefit Eligibility Period
# Months of Work required

4/2022 – 9/2022
(6 months)

Initial: Q1/2023
January – March

3

Ongoing Eligibility Work Requirements
Payment months
Benefit Eligibility Period
# Months of Work required

10/2022 – 12/2022
(3 months)

Ongoing: Q2/2023
April – June

1

1/2023 – 3/2023
(3 months)

Ongoing: Q3/2023
July – September

1

4/2023 – 6/2023
(3 months)

Ongoing: Q4/2023
October – December

1

Eligibility Criteria 2 of 3: Provider must be enrolled in a qualified health insurance plan (as specified in the table below) that maximizes the federal assistance available to you (if any). Providers that are not insured under any health insurance plan are not eligible for the CCPU Health Care Fund benefit. If you are currently uninsured, you will become eligible by enrolling in a qualified health insurance plan if you meet the other criteria.

Qualified Health Insurance Plans
If you are eligible for…
You must enroll in…

Covered California

Silver-level HMO plans on Covered California*

Medi-Cal

Medi-Cal

Medicare

Medicare

Both Medi-Cal and Medicare
(Medi-Medi)

Both Medi-Cal and Medicare

Employer sponsored health insurance plan as an eligible employee

Your employer’s plan

Employer sponsored health insurance plan as an eligible dependent (i.e. the plan from your spouse’s employer)

Your spouse’s employer plan
OR
Silver-level HMO plans on Covered California*

* if no HMO plans are available in your zip codes in California, the lowest cost EPO/PPO option is a qualified health insurance plan.

Eligibility Criteria 3 of 3: Provider must enroll in the CCPU Health Care Fund. Submit your application today.

*Special rules apply to licensed, subsidy payees where more than one provider is on the payment record.

When will the benefits be available?

  • The current goal is for benefits to be effective January 1, 2023.
  • Since it will take time to set up the CCPU Health Care Fund, payments and reimbursements for benefits likely will have a delayed start until Spring 2023 but are expected to cover your expenses back to January 1st if you are eligible for January, 2023. Important: To be eligible for Fund benefits starting January 1st, you must enroll in a qualified health insurance plan during Open Enrollment for the 2023 plan year.

How can I get help enrolling?

Click below to see how to get help enrolling in a qualified medical plan.

Help Enrolling