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It is required to submit the signed Waiver form (Medical, Dental & Vision Enrollment Form-Page 3: E. Waiver
of Coverage) if you decline the company insurance benefit.

If you don’t make any change this time, you may default into the same or comparable coverage that you
elected last year.

 Please find attached: “Employee Benefit Handbook 2018”
The benefit handbook includes Benefit eligibility, benefit summaries, rate, and how to find a doctor in your area.
The contact information for Insurance agency, Chun-Ha Insurance and each carrier’s member service contacts are
attached for you to contact whenever you need assistance. It also contains how to log in to member portal.
The purpose of the Employee Benefit Handbook is to provide information and guidance to all employees to find a
right plan and understand your plan.

 Also attached: “Medical, Dental & Vision Enrollment Form(2018) ”.

Angeles Contractor, Inc. is delighted to announce that we will change our Dental Carrier to United Health
Care Dental effective
August 1, 2018:
* ACI continues with same insurance companies for Health and Vision.
* Current Dental subscribers and New Dental applicants need to FILL OUT the United Health Care Dental
application.
* If you decide to add your dependent(s), additional premium due to adding dependent(s) will be at your own cost.

**Also, see below the renewal effective dates:
Health: United Health Care 8/1/2018
Dental: United Health Care Dental 8/1/2018
Vision: Humana 8/1/2018

Chris Kim |Senior Vice President
ANGELES CONTRACTOR, INC.

783 Phillips Drive, City of Industry, CA 91748
T 626.923.3800 | F 626.923.3801 | C 714.709.3337

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