Eligibility for employees is based on hours worked under a collective bargaining agreement between IBEW Local 6 and a contributing employer. To initially establish eligibility you need 300 hours of covered work within a 12 month period. When you become eligible, you may select one of the three available plans. If you do not make a selection, you will automatically be enrolled in the Self Funded PPO Plan.
A Dependent of an Eligible Participant becomes eligible at the same time that the Participant becomes eligible, or the date the Dependent is acquired, if later. If you fail to enroll a new Dependent within 30 days after they first become eligible, you may not enroll him or her until the Plan's open enrollment period. However, if you decline enrollment for any eligible individual who has other health insurance coverage, you may later enroll that individual in the Plan if you request enrollment within 30 days after that other coverage ends.
Dependents include your lawful spouse, your State or other municipality registered domestic partner, dependent children under age 19, Adult Children up to age 26, regardless of marital or tax status. . A Dependent Child includes: natural child, stepchild, legally adopted child, foster child, our Domestic Partner's child, a child for whom you have been appointed legal guardian or are required to provide dependent coverage under a Qualified Medical Child Support Order.
Because the Trust office needs to process the contributions sent in by your employer, there is a lag month between the month your accumulated hours reach 300 and the month your eligibility begins. So, if you reach 300 hours for initial eligibility in December, then your coverage will begin on February 1st.
After you establish initial eligibility you must work at least 120 hours per month to remain covered. Note that for work prior to 11/2006, 125 hours were required.
The hour bank helps to keep you covered during months when you work less than 120 hours. Each month after that, if you work more than 120 hours, these hours will be added to your hour bank. If you work less than 120 hours and you have sufficient hours in your hour bank, hours will be withdrawn from the hour bank to make up the 120 hours needed for continued eligibility. The maximum number of hours you can save up in your hour bank is 1000. Note that for work prior to 11/2006, 125 hours were required.
Your coverage will end when the combined sum of your worked hours and/or your hour bank is less than the 120 required for continued coverage. When you lose coverage you may be able to make payments under the Plan's Continuation Coverage program through COBRA to continue coverage for a limited time. If you qualify under temporary disability rules, you may also be able to continue coverage for a limited period.
You have 12 months after you lose coverage to reinstate without having to reestablish initial eligibility. To reinstate, you need to obtain a combination of worked and bank hours totaling 120 (125 before 11/06). Keep in mind that the lag month applies when you reinstate eligibility.
See also: Notice of USERRA Rights