REQUIREMENTS FOR COVERAGE AND EXTENSIONS
All employees must file an enrollment card with the Fund office and keep it updated in order to avail themselves of the benefits provided by the Fund. Obtain a card from your payroll representative. It is essential for the orderly processing of claim forms. After filling out and filing the card, you are required to promptly notify the Fund, in writing, of any of the following:
- Change of Name
- Change of Address and/or Telephone Numbers
- Change of Marital Status
- Any Addition of Dependents
- Any Loss of Dependents Due to Marriage, Death, or Their Change of Residence
The Fund reserves the right to request any documents necessary to establish eligibility of a member or dependent.
- As an employee, you must be in an active payroll status with an employer who has funded the required contribution. This establishes the period of employment for which contributions are paid or should have been paid to the Benefit Fund by the employer.
- Eligibility for benefits commences on the first of the month after completion of at least two full months, but not more than three months, of such status. In other words, if you start work on the first of the month, you will be able to participate in benefits in exactly two months. However, if you start on the second day of the month (or later) the remainder of that month must be added to the two full-month minimum.
Example: Hired January l, benefits start March l. Hired January 2, benefits start April l.
Benefit Payment Requirements
Once the waiting period is over, and provided the eligible employee has filed a Fund enrollment card, benefit coverage starts. Before starting payment of benefits to you, the Fund may request confirmation from you or your employer of pertinent payroll, address, and dependent data. Payment of benefits can be put in jeopardy if the employee fails to notify the Fund of changes in marital status, dependent status, or domicile; or neglects to confirm college attendance status of a dependent child of their household. College attendance must be confirmed directly to the Fund each semester. Benefits are payable to those eligible members or their dependents only to the extent of the terms of each benefit as defined in this booklet.
Ending of Coverage
Coverage and eligibility ends upon the effective date of termination of employment for the employee; this includes all spouse and dependent participation except as provided for under Status, Sections 3 and 4. Participation in benefits end for dependents with a change in their status, such as in cases where they cease to be dependents of the employee or otherwise cease to be a dependent as defined by the Fund. Extension of benefits for a terminated member or dependents under various circumstances may be available under COBRA.
Eligibility For Future Retiree Benefits
Effective January 1, l998 members who leave or retire from employment with a participating employer and have 20 or more years of service, but have not reached the age of 55, are not eligible for Retiree Benefits until such time as they reach the age of 55 providing the employee has made continuous self payments for coverage to the Benefit Fund during the period of time since leaving employment until age 55. The length of time a future retiree may continue benefits under COBRA has been extended to accommodate any additional months needed for retirees’ eligibility. COBRA notifications are mailed directly to the member’s home by the Fund as soon as the employer has advised the Fund of termination of employment. The member has 60 days from receipt of the COBRA notification to choose to continue benefits. Payments must be made continuously, without delinquency, in order to receive retiree benefits at a future date. Failure to select the self-payment of premium option under COBRA will result in a loss of retiree benefits.