Note: A “week” starts on Sunday and ends on Saturday.
Only periods of work for which contributions are made to the Fund count toward your eligibility for benefits. If your employer’s collective bargaining agreement does not require that contributions be made for a certain number of days after you start working, those days will not be counted toward the requirements explained below.
YOUR INITIAL ELIGIBILITY DATE
The date you first become eligible is called your “initial eligibility date.”
If you are a new employee, your initial eligibility date is the first day of the calendar month following two full calendar months of employer contributions.
The Fund must actually RECEIVE the two months of contributions from your employer in order to establish your eligibility.
If your employer’s contributions are late, the Fund Office will not be able to verify your eligibility or issue I.D. cards. And, unfortunately, this means that if a hospital, doctor, or pharmacy calls, they will be told you are not eligible.
Your recourse will be to call your employer’s human resources department to discuss the matter with them.
Once the contributions are actually received, your eligibility will become effective—retroactively if necessary—as of the first day of the month after the month for which the two contributions were made.
You must remain employed (not laid off or terminated) by a contributing employer while you are working to establish your initial eligibility. If your employment terminates before the date that would otherwise have been your initial eligibility date, you will not become eligible on that date. If you are later rehired or start working for another contributing employer, you will have to resatisfy the initial eligibility requirements.
EFFECTIVE DATE OF BENEFITS (WHEN BENEFITS START)
Your benefits will start on your initial eligibility date unless your employment terminates before that date as explained above.
If you have dependents, their benefits will normally start on the date your benefits start. If you don’t have any dependents on the date your benefits start, benefits for any individuals who later become your dependents will start on the date you acquire them as dependents, provided you are eligible on that date.
Once you become eligible, you and your dependents will continue to be eligible for benefits as long as a contributing employer makes weekly contributions to the Fund on your behalf. (Also see “Termination of Active Plan Eligibility”)
In the Event of Layoff or Termination
Plan coverage is provided ONLY when your employer is making contributions to the Fund on your behalf. Employers are not required to make contributions for you while you are laid off—even if the layoff is temporary and the employer still considers you “active.” If you are laid off, or if your employment terminates for any other reason, your only option for maintaining your benefits is to make a timely election and self-payment for COBRA coverage.
If you are entitled to a leave of absence under the Family Medical Leave Act (FMLA), then your eligibility will be continued as long as your employer continues to make contributions on your behalf. Your employer—not the Welfare Fund—determines whether or not your leave is covered by FMLA.
You will cease to be eligible for benefit coverage under the Plan on the first to occur of the following dates unless you are entitled to COBRA coverage and an on-time COBRA self-payment is made by you or on your behalf:
Note: Your employer is required to notify the Fund Office in writing when you are laid off or your employment terminates. Your employer is required to continue making contributions to the Fund on your behalf until the termination notice is issued.
A dependent of yours will cease to be eligible for Plan coverage on the first to occur of the following dates unless the dependent is entitled to COBRA coverage and an on-time COBRA self-payment is made by or on behalf of the dependent:
AFTER TERMINATION OF COVERAGE
AFTER SERVICE IN THE UNIFORMED SERVICES OF THE UNITED STATES
If you leave covered employment with a participating employer to enter active duty in the uniformed services of the United States, your eligibility will be frozen during your period of active duty. After your release from active duty under circumstances entitling you to reemployment under federal law, your eligibility will be reinstated on the date you return to work with a participating employer, provided your return to work is within the time prescribed by federal law. More information about the reemployment rights of persons returning to work from the uniformed services of the United States is available from the Veterans’ Employment and Training Administration of the United States Department of Labor.