Tuesday, February 10, 2026

Frequently Asked Health Care Questions


 ELIGIBILITY
Q. Who is eligible to become a Participant in the Plan?
A. Any person working in Covered Employment for which fringe benefit contributions are made on that person's behalf, pursuant to a Collective Bargaining Agreement, or other written Agreement.

Q. How do I become eligible under the Plan?
A.New Active Participants to the Plan, or existing Participants who must re-satisfy Initial Eligibility, must have 450 contribution hours in a consecutive 4-month, or less, period, ,or as an alternative, must have 675 contribution hours in a consecutive 12-month, or less, period. Coverage will begin on the first day of the second and third month following. Example: member worked 450 hours between January, February, March and April, coverage will start June 1st and continues for July.

Q. How do I maintain my monthly Health Care coverage?
A. Once you meet the initial eligibility rule, your continued coverage will be maintained as long as at least 150 contribution hours, or 160 for Vac Truck, are remitted on your behalf by your Employer.  There is a two month bookkeeping period. e.g. hours you work in January, will provide you with coverage in April, and so on. 

Q. What happens to hours I work in excess of 150?
A.Any hours you work over the required 150, or 160 for Vac Truck, will be put in an hour bank for you to use during months that you work less than 150, or 160 for Vac Truck. For new Participants with less than one-year of service, no hour bank may be accumulated until one year of service has been completed. Following the first contributions made to the plan by your employer on your behalf, after one-year of service, any hours you work that are in excess of those required for eligibility will go to your hour bank.
  
Q.
Is there a maximum number of hours that I can bank?
A.
The maximum number of hours you may keep in your Hour Bank is 600, or 640 for Vac Truck employees, which is equivalent of 4-months of coverage.

Q. What if I don’t work enough hours to maintain eligibility for the month?
A. If you do not have at least 150 hours contributed for a given month, you can continue coverage under the plan for yourself and your dependents by first drawing from your banked hours. If you do not have banked hours, you will have the option to make a self-payment to continue your coverage.
  
Q. How do I make a self-payment to continue coverage?
A.Each month you will receive a status report that will detail your Contribution Activity for that current month from your Employer(s). If you did not work enough hours, this will be indicated on the statement, and a notice for the self-payment amount owing will be attached. The maximum number of self-payments you can make is three (3) per calendar year period.
  
Q.
What if my coverage terminates, how can I become eligible again?
A.
You may reinstate coverage with 150 contribution hours in any one month, and coverage will begin again on the first day of the second month following, and continue for the third. You may only use the reinstate rule once in a consecutive 12-month period. Alternatively, you must meet the initial eligibility rule to requalify.
  
Q. Whom should I call if I have questions about my Eligibility Health Care Coverage?
A.Contact the Benefits Office at (800) 772-0459 or (248) 641-4907, choose Option #1, and then Option #3
  
 ELIGIBLE DEPENDENTS
Q. Who are my eligible dependents?
A.Your legal spouse, and / or child.  See the Summary Plan Description booklet for a detailed definition of an eligible dependent. 

Q. Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?
A. Yes, as long as such child is not eligible for health care coverage from his or her employer, or the employer of his or her spouse. 

Q. How do I add my new baby or spouse to my insurance plan?
A. A marriage or birth of a new baby must be reported to the Benefits office within thirty (30) days.  For a marriage, a copy of the marriage certificate is required,  and the spouse and any eligible stepchildren will then be covered from the moment of the marriage.  For a new baby, a copy of the birth certificate is required and the child will be covered from the moment of birth. 

Q. Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A.Divorce should be reported immediately and a copy of the full divorce decree must be filed in the Benefits office.  A former spouse is not eligible for benefits commencing on the date of the divorce, with the exception of continuation of coverage under COBRA.

Q. How do I obtain a replacement Medical and Prescription Card?
A.Contact the Benefit Office at (248) 641-4907 or (800) 772-0459. Effective 9/1/2021, access the CIGNA website at www.cigna.com, activate your account if you haven't already done so. From here you can order a new card and/or print a temporary one. 

Q. How do I inquire about the status of my medical claim?
A.Prior to 9/1/2021contact the Benefit Office at (248) 641-4907 or (800) 772-0459. After 9/1/2021, contact CIGNA at (800) CIGNA24 or (800) 244-6224.

Q. How do I inquire about the status of my dental claim?
A.Contact Delta Dental at (800) 524-0149

Q. How do I inquire about the status of my vision claim?
A.Contact VSP Vision at (800) 877-7195