Summary of Eligibility Rules

QUESTIONS AND ANSWERS

  1. How do I become eligible for benefits?  An Active participant must be reported by a signatory employer for 200 hours or more during a qualifying work quarter, or on a monthly basis.
  2. Do I have to enroll?  Do I have to take a physical?  Enrollment in the Plan is automatic once you satisfy all the eligibility requirements. No proof of good health is required. Existing illnesses or injuries are not excluded from coverage, except for treatment for alcohol and drug detoxification and counseling.
  3. If I don’t have 200 hours reported in a qualifying work quarter but I do have 200 hours reported in a three-month period, can you shift my hours to make me eligible?   No. Eligibility can only be established by being reported in the appropriate quarter. No shifting of hours is permitted.
  4. How much coverage is provided by the reserve hour bank?   The maximum additional coverage provided by a Reserve Hour Bank of 500 hours is six months.
  5. How many hours are used from my reserve hour bank to give me eligibility?  An Active quarterly participant uses 200 hours from his Reserve Hour Bank to be eligible for one quarter. An Active monthly participant uses 83 hours from his Reserve Hour Bank to be eligible for one month.
  6. I have been a member in good standing for 15 years and my eligibility has terminated. Can I receive additional reserve hours based on the number of years I have participated in the plan?  No. Past years of service have no bearing on the Reserve Hour Bank.
  7. What happens when unused hours remain in my reserve hour bank?  Any unused hours in your Reserve Hour Bank will remain in your account for four consecutive eligibility quarters (one year). These hours can be combined with future hours reported on your behalf to extend your eligibility. If no hours are reported during these four consecutive quarters, the Reserve Hours Bank is forfeited.
  8. Are my dependents eligible immediately?  All Active dependents are eligible for Health & Welfare benefits as soon as the participant becomes eligible. A spouse becomes eligible on the date of marriage, children on the date of birth or adoption. The only exception is that a baby is not eligible for the life insurance benefits until he or she is 14 days old. Dependents of Retirees are not eligible for Health & Welfare benefits until the Retiree enrolls them in the Plan and pays the appropriate fee. New dependents (spouse or child) must be added within 31 days of marriage or birth of the child, or they cannot be added to the Plan until Open Enrollment.
  9. Are step-children covered?  Yes, step-children are covered on the same basis as other dependent children. Coordination of benefits with another group insurance carrier may be a factor with step-children. As each situation is unique, please get in touch with the Fund Office with any questions.
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