Health & Welfare Plan
Health and Welfare Benefit Summaries
Buy-Up, COBRA, and other Continuation Coverage
When you lose eligibility for active coverage, there are four possible ways that you may continue coverage described below:
- Buy-Up Plan
- Active Disability
- Family Medical Leave Act
If you die while eligible, your surviving eligible dependents have a self-payment option in addition to the available of COBRA.
If an Active Member on hourly eligibility falls short of continuing eligibility for a given Eligibility Quarter by 50 or fewer hours, that member will have the option to buy-up the shortfall in hours at the same hourly contribution rate his or her employer would have paid.
COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985) provides individuals the right to continue their health coverage by paying a monthly premium if they lose coverage under the Plan because of a qualifying event. If COBRA is elected and premiums are paid in a timely manner, health coverage starts from the date coverage ends because of a qualifying event.
Who is Eligible
A qualified beneficiary is any individual who was covered under the Plan on the day before the qualifying event.While a Participant’s COBRA coverage is in effect, the Participant may add:
- a new spouse
- a newborn child
- an adopted child or a child placed with the Participant for adoption (for whom the Participant has financial responsibility).
What Are Some Qualifying Events?
Qualifying Event Length of COBRA Coverage Participant – Loss of Eligibility due to: Termination of employment for reasons other than gross misconduct; Reduction in hours; Voluntary resignation 18 months Spouse – Loss of eligibility due to Termination of employee’s employment for reasons other than gross misconduct 18 months Death of employee; Divorce 36 months Dependent Child – Loss of eligibility due to Termination of employee’s employment for reasons other than gross misconduct 18 months Death of employee; Divorce of parents; Death of employee; Attainment of age 26; Death of employee; Parent’s eligibility for Medicare 36 months
COBRA Notification Requirement
In order to be eligible for COBRA coverage, the Fund Office must be notified, in writing within 60 days of the qualifying event. If the qualifying event is a divorce or a child losing dependent status, you or the dependent must notify the Fund Office within 60 days of the date of the qualifying event.
If the Fund Office is not notified, in writing, within this time frame, the individual losing eligibility as a dependent will forfeit his or her right to enroll in the COBRA continuation plan.
Who pays for COBRA
You are responsible for the entire cost of COBRA coverage. The Fund Office will notify you of the COBRA premium amounts, which can change on a yearly basis.
Termination of COBRA Coverage
COBRA continuation coverage will terminate on the earliest of:
- The first of the month for which you or your Dependents do not pay the premium by the due date; or
- The first of the month following the expiration of the maximum COBRA coverage period for which the individual qualifies.
Click here for the full list of events that could terminate COBRA Coverage.
The Family Medical Leave Act provides that in some situations certain employers are required to grant leave to employees, and in such situations the employer is required to continue medical coverage for the employees.