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Skip Navigation LinksHome » Health Benefit Info Active » Eligibility Enrollment  
 

General Eligibility
Eligibility for coverage under the Active Plan of benefits (“Plan”) is based on:

  • Work performed for an employer for which contributions for hours worked are required to be made to the Welfare Fund under a collective bargaining agreement, participation agreement or other written agreement;
  • The number of hours that you work in a calendar quarter; and
  • Your employer paying contributions on your behalf

Initial Eligibility
You will initially become an eligible participant on the first day of the coverage quarter (starting March 1, June 1, September 1 or December 1) following one but not more than two consecutive calendar quarters (starting January 1, April 1, July 1 or October 1) during which a total of at least 500 hours of contributions have been paid to the Welfare Fund on your behalf.

Initial Eligibility for Apprentices
You will initially become an eligible participant on the first day of the coverage quarter (starting March 1, June 1, September 1 or December 1) following one but not more than two consecutive calendar quarters (starting January 1, April 1, July 1 or October 1) during which a total of at least 400 hours of contributions have been paid to the Welfare Fund on your behalf.
 
Apprentices qualifying under the "400 Hours Rule" will be eligible for all benefits except the prescription drug and dental benefits.
 
If you are an apprentice, and a total of at least 500 hours of contributions have been paid to the Welfare Fund on your behalf during one but not more than two consecutive calendar quarters, you will initially become eligible for full Plan benefits on the first day of the next coverage quarter. Full Plan benefits include the prescription drug and dental benefits.

 
Continuing Eligibility
After you meet the initial eligibility requirements, you are an eligible participant for a three-month coverage quarter. To maintain your coverage, you must have contributions of at least 250 hours paid on your behalf to the Welfare Fund during each calendar quarter.
 
If you do not receive credit for 250 contribution hours in a calendar quarter but receive credit for at least 1000 contribution hours (1200 hours prior to March 1, 2009) in the current and the three immediately preceding calendar quarters, you will remain eligible for coverage for the next three month coverage quarter.

 
Continuing Eligibility for Apprentices
You must have contributions of at least 200 hours paid on your behalf to the Welfare Fund during each calendar quarter to continue your eligibility for another three-month coverage quarter. As a reminder, if you are an apprentice and meet the reduced hours requirements, you will remain eligible for all benefits except prescription drug and dental.
 
If you do not have 200 hours in a calendar quarter, but receives credit for at least 760 hours in the current and the three immediately preceding calendar quarters, you will remain eligible for coverage (except the Prescription Drug Benefit and Dental Benefit) for the next three month coverage quarter.
 
You can maintain eligibility for full benefits (including the Prescription Drug Benefit and Dental Benefit) during a coverage quarter if you have contributions for at least 250 hours paid to the Welfare Fund on your behalf during an immediately preceding calendar quarter. Also, your eligibility for full benefit coverage can be maintained for an coverage quarter if you receive credit for at least 1000 contribution hours in the current and three immediately preceding calendar quarters.

 
Termination of Eligibility
Your eligibility for benefits will terminate on the last day of the second calendar month immediately following any calendar quarter (coverage terminates on February 28 or 29, May 31, August 31 and November 30) in which you fail to meet either of the two requirements below:

  • You do not have contributions of at least 250 hours or 200 if an apprentice paid on your behalf by contributing employers during the calendar quarter, or

  • You do not have contributions of at least 1,000 hours or 760 if an apprentice paid on your behalf by contributing employers during the current quarter and the three immediately preceding consecutive calendar quarters.

Reinstatement of Eligibility
If you lose eligibility for benefits because you did not have the required contributions, you may again become eligible on the first day of the coverage quarter following a calendar quarter in which contributions of at least 250 hours were made on your behalf by one or more contributing employers.
 
However, if you return to work after being away longer than twelve consecutive quarters (three years), with no contributions paid on your behalf, you must again meet the initial eligibility requirements.

 
Dependent Eligibility
Once you are eligible for benefits, you may also choose to cover your spouse and your dependent children.  In order to establish coverage for dependents, you must provide certain documentation to the Fund Office. Currently, the Plan covers eligible dependent children up to the age of 26. 
 



 

 

 
 

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