A. DIRECT SELF-PAYMENT

If you are already covered under this Plan and your accumulated credit for hours worked has fallen below 120 hours, you may, in order to maintain continuous coverage, make payments directly to the Plan under the following conditions:

1. Amount.

The amount of such payment is to be set by the Board of Trustees. In no event may hour bank reserves of less than 120 hours be used to offset the payment required to maintain one month of coverage.

2. No Break in Payments.

There may not be a break in payments. All payments must be received by the Plan Office by the 20th of the month prior to the month for which coverage is to be effective. The first such payment shall be accepted if remitted within 20 days of notice to you regarding loss of coverage.

3. Availability for Employment; Exceptions.

To qualify for continuation of coverage by direct self-payments, you must be available for immediate employment with a Contributing Employer. There are two exceptions:

1. Disability. If you are disabled and unable to work and present a Physician’s opinion satisfactory to the Plan Office to that effect. The Plan may designate a Physician or other medical provider to make such determination; or


2. Approved Leave of Absence. If you obtain written approval from the Board of Trustees to make direct self-payments during an extended leave of absence, subject to the time limits outlined in paragraph 4 below.

4. Maximum Period of Direct Self-Payment Coverage.

So long as you continue to qualify for direct self-payments, such payments may continue for up to a maximum of 12 consecutive months, provided that if at any time during the 12-month period you are disabled and unable to work, and present a Physician’s opinion to that effect, you may qualify for up to 12 months of temporary disability coverage as described in B.2, Temporary Disability Coverage, below. In no event, however, may the combination of direct self-payment coverage and/or temporary disability coverage exceed a total of 24 months for any single disability as defined below. All periods of direct self-payments will be included for purposes of determining eligibility for Retiree coverage.

5. Special Apprentice Rule.

The amount required to be paid under the Plan’s direct self-payment provisions shall be deemed paid if you are an apprentice attending day classes under the following terms and conditions:

1. you have actually attended day classes for a sufficient number of hours during the affected eligibility period that, had such hours been deemed by the Plan as “work performed in Covered Employment,” you would have achieved or maintained coverage under the Plan; and


2. you are eligible under rules adopted and/or implemented by the IBEW Local 6 JATC for reimbursement of self-payments paid to the Plan on account of time actually spent in apprentice training day classes; and


3. you actually pay to the Plan sufficient contributions, in a timely manner, to bring your number of hours, during the eligibility period, up to the minimum eligibility hours needed to maintain coverage under the Plan; and


4. the Director of Apprentice Training certifies to the Plan Office that you are eligible for this special rule.