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Health & Welfare SPD Design Element

B. TEMPORARY DISABILITY COVERAGE

1. Application for Coverage.

If you become temporarily disabled while Active member coverage is in force (excluding coverage through COBRA payments), you may submit to the Plan Office, in writing, evidence of such disability in the form of certification of continuing disability by your attending Physician, along with an Application for Temporary Disability Coverage if you meet the following requirements:

  1. you are unable to perform the duties of your regular occupation covered under an IBEW Local 6 Collective Bargaining Agreement; and
  2. your disability continues for a period of thirty (30) days.

Such application must be submitted no later than ninety (90) days from the date your hour bank reserve runs out. The Board of Trustees may designate a Physician or other medical provider to make the disability determination. The Board reserves the right to place a limit on temporary disability coverage.

2. Coverage Period.

If your Application for Temporary Disability Coverage is approved, you shall, upon expiration of your hour bank reserves, if any, have your Plan coverage extended without charge while you are disabled for a period not to exceed the lesser of:

  1. 12 months; or
  2. the number of months of Active member eligibility supported by your hours worked, hour bank reserves and/or direct self-payments in the 12-month period preceding the later of:
    1. the date of the onset of disability; or
    2. the date on which your Active member eligibility has run out.

Thereafter, you may make direct self-payments, but in no event shall the combination of temporary disability coverage and coverage resulting from the direct self-payment provision above, exceed a total of 24 months' coverage for any single disability.

3. Limited 3-Month Extension.

Temporary disability coverage will be extended for up to 3 months following the month of your recovery in order to allow you to accumulate the necessary hours of Covered Employment to re-qualify for eligibility under this Plan, provided:

  1. you have registered for immediate employment under an IBEW Local 6 Collective Bargaining Agreement; and
  2. such extended eligibility does not exceed the above 24-month maximum per a single period of disability.

4. Successive Disabilities.

For purposes of applying the limitation in paragraph 2, above, successive disabilities shall be treated as a single period of disability unless they arise from:

  1. different and/or unrelated causes, or
  2. the same or a related cause and are separated by at least 3 months of continuous Active employment with a Contributing Employer.

5. Subsequent Retiree Coverage.

If your temporary disability coverage has continued for the maximum period, you may qualify for Retiree coverage if you meet all of the requirements set forth in II.B.3. Periods of temporary disability coverage will be counted for purposes of determining eligibility for Retiree coverage.