Eligibility Requirements

Eligibility requirements for Health Care Coverage

In order to become eligible to receive benefits as an Active Covered Participant from the Plan at the beginning of any 6-month Benefit Period, you must be in the eligible class and have a Qualifying Work Period.

For a more in-depth explanation of your benefits, please refer to the full Health & Welfare Summary Plan Description.

Active Eligibility FAQs

If I or one of my dependents become ineligible for Health Coverage, does the Fund Office have any coverage we may elect to enroll in?

Yes, you may elect to enroll in COBRA coverage. COBRA information is sent to any eligible member or dependent who is losing Health Coverage. You may elect to enroll in the COBRA coverage up to 18 months if you are losing eligibility due to lack of hours. A dependent may elect COBRA for up to 36 months in the event of a divorce, the death of the Member, or if a dependent child turns 26 and is no longer eligible to be covered under the Member.

What are the requirements to be eligible for Active Health Coverage?

In order for Active Members to be eligible for Health Benefits, you must be in the eligible class and have the required amount of hours in the qualifying work periods:

 

To be eligible for May 1st:

600 hours between August 1st through January 31st, or

1200 hours between February 1st through January 31st

 

To be eligible for November 1st:

600 hours between February 1st through July 31st,

1200 hours between August 1st through July 31st

 

Please be sure to check your hours regularly for discrepancies. You can view them on the Work Record Report that is mailed out quarterly or click here to view your real time hours. If hours are not reported on your behalf please click here to have the Fund Office review your hours.

 

If I should pass away how long will my spouse and any dependent children have Health Coverage for?

If you have Health Coverage at the time of your death your Spouse and any dependents will be covered for the Benefit Period in which you pass away plus one additional year.

I am losing my coverage. What are my options?

COBRA is sent to any Participant who is losing their coverage, as well as any Qualifying Beneficiary. You may also elect to purchase coverage through the Health Insurance Exchange at https://www.healthcare.gov.

How long does COBRA coverage last?

8 or 36 months, depending on the reason for loss of coverage.

What is the cost of COBRA Coverage?

The type of coverage you elect will determine your cost for COBRA coverage. For additional information, please contact the Fund Office at (215) 568-0430 and ask for the Medical Department.