Has This Happened?
At some point, you may experience a “life event” that affects your health benefits. Click on the links below to find out what needs to be done to ensure you and your dependents have the correct benefit coverage.
Birth or Adoption of a Child
Divorce or Separation
- Notify the Fund Office of your divorce or separation by calling 1-304-525-0331 or 1-888-466-9094 or sending an e-mail to the Fund Office.
- Complete a new Enrollment Form.
- Submit a copy of your divorce decree.
- In most situations, if your ex-spouse wants to continue coverage under COBRA, you or your ex-spouse have 60 days from the date eligibility would otherwise end to request COBRA information from the Fund Office.
Child’s 26th Birthday
Child Loses Eligibility. Eligible children include your natural, legally adopted, children placed for adoption and stepchildren until the date they reach age 26. You may also cover disabled children age 26 and older. If your child is no longer eligible for coverage:
- Notify the Fund Office by calling 1-304-525-0331 or 1-888-466-9094 or sending an e-mail to the Fund Office if your dependent is no longer eligible for coverage.
- If your child wants to continue coverage under COBRA, contact the Fund Office within 60 days from the date your dependent’s eligibility would otherwise end.
Out of Work Due to Disability
If you are out of work due to a disability:
- Notify your employer and the Fund Office as soon as you become ill or injured.
- Complete a claim form or call the Fund Office at 1-304-525-0331 or 1-888-466-9094. Be sure to file your claim as soon as possible.
- Send the claim form and required documentation to the Fund Office at the address listed on the form.
- Apply for Social Security or pension disability benefits, if you are eligible to do so.
In the event of your death:
- Your surviving spouse or another family member should contact the Fund Office by calling 1-304-525-0331 or 1-888-466-9094 or sending an e-mail to the Fund.
- Your surviving dependents may be able to continue coverage for up to two years.
- If your dependents want to continue coverage under COBRA after your death, they should contact the Fund Office within 60 days of the date of your death.
Returning to Work
- If you leave covered employment and later return to work, you must again meet the initial eligibility requirements. Contact the Fund Office for more information.
If you are in the Building Trades or Flexible Choice Plans, you are eligible for retiree benefit if you:
- Retire from the industry under a qualified pension plan;
- Are at least age 57 1/2;
- Have been eligible for benefits for at least 48 of the most recent 60 months; and
- Have been eligible for Plan benefits at the time of retirement.
If you meet the above requirements, you may continue your benefits by making quarterly self-contributions for you and your dependents. Contact the Fund Office at 1-304-525-0331 or 1-888-466-9094 for more information.
If you are disabled and retired, you may continue your benefits by making self-contributions for you and your dependents. Contact the Fund Office at 1-304-525-0331 or 1-888-466-9094 for more information.
If you are a retiree, you can waive Fund coverage if you are covered as a dependent under your spouse’s employer’s plan. You can then reinstate coverage under the Fund if you lose the other coverage (except due to non-payment of premiums), acquire a dependent, or become entitled to Medicare. If the retiree or spouse fails to reinstate Fund coverage within 30 days of the earliest to occur of the events listed above, he or she will lose the ability to reinstate coverage in the Fund permanently.
If a Local Union withdraws from the Fund, retiree coverage will end for all retired members of that Local. Coverage will end for all participants of that Local ninety (90) days after the last day of the month for which contributions are required to be paid to the Fund under the terms of the applicable Collective Bargaining Agreement.
If Your Coverage Ends
In compliance with a federal law referred to as COBRA Continuation Coverage, this plan offers its eligible participants and their covered dependents (known as qualified beneficiaries) the opportunity to elect temporary continuation of their group health coverage when that coverage would otherwise end because of certain events (called qualifying events).
Qualified beneficiaries are entitled to elect COBRA when qualifying events occur, and, as a result of the qualifying event, coverage of that qualified beneficiary would otherwise end. Qualified beneficiaries who elect COBRA Continuation Coverage must pay for it at their own expense.
Qualifying events include termination of employment, reduction in hours of work making the participant ineligible for coverage, death of the participant, divorce/legal separation, or a child ceasing to be an eligible dependent child. The maximum period of COBRA coverage is generally either 18 months or 36 months, depending on which qualifying event occurred.
In order to have the opportunity to elect COBRA coverage after a divorce/legal separation or a child ceasing to be a dependent child under the plan, you and/or a family member must inform the plan in writing of that event no later than 60 days after that event occurs. The notice should be sent to the Fund Office via first class mail and is to include the participant’s name, the qualifying event, the date of the event, and the appropriate documentation in support of the qualifying event (such as divorce documents).
If you have questions about COBRA, contact the Fund Office at 1-304-525-0331 or 1-888-466-9094.