- Active Health
- Retiree Health
- DB Pension
- DC Pension
- SUB Plan
The Plan provides benefits for specialized footwear, sometimes known as "orthotics." The annual benefit of $400 may be used to defray the costs of consulting with a certified orthotist or other provider certified by the American Board for Certification in Orthotics, Prosthetics and Pedorthics and the cost of fabricating and fitting the specialized footwear. Specialized footwear includes orthopedic shoes and custom-made, rigid plastic or polypropylene inserts for the shoe. This benefit is available to all eligible Participants and eligible dependents enrolled for medical benefits under the Plan. Participants enrolled in the Kaiser HMO Plan may utilize this benefit or they may choose to obtain orthotics through Kaiser.
Eligible expenses subject to reimbursement shall include expenses for the professional services provided by an orthotist, prosthetist, pedorthist or other provider certified by the American Board for Certification in Orthotics, Prosthetics and Pedorthics when professional services are in connection with the treatment of foot disfigurement. For purposes of this benefit, foot disfigurement means foot disfigurement resulting from cerebral palsy, arthritis, polio, spina bifida, diabetes, accidental injury or abnormal condition.
Eligible services for specialized footwear shall include the cost of fabricating custom-made rigid (plastic or polypropylene) foot orthotics (shoe inserts) and/or custom-made standard orthopedic shoes.
The maximum annual benefit payable per eligible Plan Participant and eligible dependents for eligible expenses incurred for the procurement of specialized footwear shall be $400.
Claims for eligible expense reimbursement under this provision shall be submitted to Coast Benefits Inc at:
Coast Benefits, Inc.
3444 Camino Del Rio North, Suite 101
San Diego, CA 92108
Claims must include the name and address of the provider, the date services are rendered, the diagnosis or condition being treated, and an itemized listing of services rendered. Reimbursement shall be made directly to the Participant or Member and not to the provider.
No benefits shall be provided under the terms of this provision for: