Health Care Reimbursement Benefits for Family

Family Coverage

The CCPU Health Care Fund is expanding the Reimbursement Program to provide benefits for eligible dependents—your spouse and/or children.

Providers enrolled on certain plans with their eligible family members will now be able to submit reimbursement requests for the whole family.

These new benefits will be offered at no cost to the childcare providers.

Below is a summary of the new family benefits by Qualified Health Plan:

How to Add Your Family

To enroll your family members, providers will fill out an application addendum and submit all relevant documentation to the Fund staff for processing.

If approved, family members will only maintain Health Care Fund benefits as long as the primary childcare provider maintains eligibility.

If dependents are added, they can only remain on these benefits until the age of 26, and they will be removed at the end of their birthday month. (Exceptions apply if the dependent is an overage disabled dependent.)

If any household member becomes a childcare provider and begins receiving state subsidized payments for the care of a child, they can be removed from their family plan and begin their own CCPU Health Care Reimbursement benefits as long as they meet eligibility criteria. Click on the links below to access the forms.

Medi-Cal/Medi-Medi & Medicare/Medicare Advantage Enrollees**

Providers and their family members must be on the same qualified health plan, as outlined in the Health Care Reimbursement Program eligibility criteria. The exceptions to this rule are as follows:

• Medi-Cal and Covered California – Providers may apply for family coverage if they are on a Covered California mixed household plan. This means, due to income reasons, part of the family is on Medi-Cal and the rest are enrolled in a Covered California plan. To qualify, the family members on the Covered California plan must be enrolled in a Silver-level HMO or the lowest cost silver-level EPO or PPO if no HMO is available in their area.
• Medicare/Medicare Advantage – Providers with households with one person enrolled in Medicare Advantage must have the other household member enrolled in a qualified health plan, as outlined by the Health Care Reimbursement plan criteria.

For the list of qualified health plans please review the ‘Qualified health insurance plans section’ on the eligibility page.