Tuesday, April 14, 2026

Frequently Asked Health Care Questions


Q.Who is eligible to become a Participant in the Plan?
A.Any Employee working under the jurisdiction of a Participating Union, any Employee of a Participating Union, full-time Office, Official or Supervisory Employees of a Participating Employer (providing such Participating Employer has executed an Agreement assenting to participate), and any member of a Participating Union may become eligible by virtue of meeting the eligibility requirements. Once eligible, participants can enroll their spouse and eligible Dependents.
Q.What if I don’t work enough hours to gain eligibility for the quarter?
A.If you do not work the required hours during the Work Period, the next eligibility test would be the 4-Quarter Look-Back provision, checking if you have 1040, 1500, 940, or 700 hours. If there’s still an hour shortage, it may be covered by the Hour Bank or by making a Self-Payment for the differential based on the chosen plan option.
Q.How do I maintain my Health Care coverage?
A.To maintain eligibility for future Benefit Periods, you must meet the Work Period Hours Requirement or the 4-Quarter Look-Back Hours Requirement.
Q.How do I make a payment towards the continuation of my Health Care coverage?
A.

All Self-Payments must be made before the first of the month of the eligibility quarter or by the first of the month if you qualify to make monthly payments.  Checks and money orders should be made payable to the BRICKLAYERS AND ALLIED CRAFT WORKERS WELFARE FUND OF WESTERN PENNSYLVANIA. Payments should be mailed to the following address:

Bricklayers Combined Funds, Inc.

PO Box 640032

Pittsburgh, PA 15264-0032

Q.Who are my eligible dependents?
A.Dependents include the Participant’s spouse and children under age 26, regardless of marital status, residency, employment, or student status. This includes biological children, legally adopted children, stepchildren, or children under legal guardianship. Disabled dependents over age 26 can continue coverage if they meet specific criteria.
Q.Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?
A.Yes.
Q.How do I add my new baby or spouse to my insurance plan?
A.Complete a Vital Information Form and provide a copy of the Marriage and/or Birth Certificate to the Fund Office. For further information, contact the Fund Office at the provided number.
Q.Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A.Provide a copy of the divorce decree. For more information, contact the Fund Office at the provided number.
Q.How do I obtain a replacement Medical and Prescription Card?
A.Contact Highmark at (800) 241-5704 for a replacement card, claims inquiries, locating in-network providers, or other questions. You can also access these services at www.highmark.com.
Q.Will I have coverage once I become eligible for Medicare?
A.When you qualify for Medicare, all benefits except the Death Benefit will be terminated. Coverage for eligible Dependents can continue with the required Self-Payment. Notify the Fund Office when you or your dependents become eligible for Medicare.
Q.What option do I have when I become eligible for Medicare?
A.Contact the nearest Social Security office for information on Medicare Part A & B enrollment. Several Medicare Supplemental coverage options are available; contact Labor First at (856) 780-6218 for details.
Q.Can I provide changes over the phone?
A.The Administrator is not permitted to make any changes to your address, dependents, etc. via a telephone conversation. You will be required to submit your changes in writing. Changes need to be mailed to the fund office.
Q.Do I have dental and vision coverage?
A.Dental and Vision benefits are available under Plan B and Plan E.
Q.I'm having issues with my MRA (Benny Card), who do I contact?
A.Contact the Fund office at the provided number.
Q.Is there a member assistance program?
A. Yes, the Plan provides access to professional counselors for a variety of issues, available 24/7. Contact (855) 209-8762 or visit www.lifesolutionsforyou.com (use Organization Code BRICK).
Q.How do I become eligible for Disability Benefits?
A. Active Employees who are covered under the Plan are eligible for Weekly Disability benefits.
Q.Does the fund offer any extensions? 
A. No, the fund does not offer any extensions.
Q.How much does the Disability Benefit Pay per week? 
A. The Disability Benefit pays $600.00/week.

Q. How long can I collect a Disability Benefit?
A. Benefits will be payable as long as you remain disabled and under the care of a doctor, up to a maximum of fifteen weeks during any period of disability.
Q.Is there a waiting period?
A. Benefits will begin as of the eighth day of disability, or the first day confinement as a resident bed patient in the hospital, whichever is earlier. 
Q.When am I not eligible for the Disability Benefit?
A. Injuries or sickness sustained on the job, or which are compensable under Workmen’s compensation, are not covered. In addition, Weekly Disability Benefits will not be paid during any period for which you are receiving retirement income under a construction industry pension or retirement plan. Further, no benefits will be payable during any period for which you are receiving unemployment benefits. 
Q.Are there any Death Benefits Available?  How do I qualify for Death Benefits? 
A. Active Employees, Disabled Employees, Office, and Early Retiree Eligibility Classes are eligible for death benefits after one Year of Participation.  Retirees age 65 and older are eligible for death benefits while retired if they have completed five Years of Participation immediately preceding retirement.  One Year of Participation is defined as twelve (12) consecutive months of Plan participation immediately preceding your death.  Five Years of Participation is defined as sixty (60) consecutive months of Plan participation immediately preceding your retirement.
Q.Is there a filing limit for Death Benefits?
A. Written proof of your death must be filed at the Fund Office by the claimant within 180 days from the date of such event. Failure to furnish such proof within 180 days shall not invalidate the claim if it shall be shown not to have been reasonably possible to furnish such proof within the time required. However, effective as of July 1, 2020, all liability on the part of the Plan and the Trustees shall cease and any person’s claim to benefits shall be forfeited unless notice and the required proofs are submitted within 12 months from the date of death. 
Q.How Much Does the Benefit Pay?
A.
For Active Employees, Disabled Employees, Office and Early Retiree Eligibility Classes:One Year of Participation - $2,500.00Two Years of Participation - $5,000.00Three Years of Participation - $7,500.00 For Retirees Age 65 and Over:Less than Five Years of Participation - NoneFive Years of Participation immediately preceding retirement - $5,000.00
Q.How are benefits paid out, who receives the benefits when I pass?  
A. In the event of death from ANY CAUSE, the amount shown in the Schedule of Benefits will be paid to the named Beneficiary.  It is MOST IMPORTANT that you designate the person to whom the proceeds are to be paid.  If no designated Beneficiary has survived you or no Beneficiary has been designated as of the time of your death, payment will be made in equal parts to the person or persons designated as your Beneficiary in the following order: (a) your surviving spouse, (b) your surviving children if you are not survived by a spouse, (c) the person or persons designated on the Union beneficiary designation card who survive you if you are not survived by a spouse or any children, or (d) your estate otherwise
Q.Are there any A&D Benefits Available?  How do I qualify for AD&D Benefits? 
A. Active Employees, Disabled Employees, Office, and Early Retiree Eligibility Classes are eligible for Accidental Death and Dismemberment benefits after one Year of Participation.  A Year of Participation is defined as twelve (12) consecutive months of eligibility immediately preceding your death or dismemberment.
Q.Is there a filing limit for AD&D Benefits?
A. In case of your death, written proof of your death must be filed at the Fund Office by the claimant within 180 days from the date of your death. Failure to furnish such proof within 180 days shall not invalidate the claim if it shall be shown not to have been reasonably possible to furnish such proof within the time required. However, all liability on the part of the Plan and the Trustees shall cease and any person’s claim to benefits shall be forfeited unless notice and the required proofs are submitted within 12 months from the date of death.
Q.How Much Does the AD&D Benefit Pay? 
A.
If you sustain any of the following losses solely through external and accidental means, you (or your Beneficiary) will be paid the indicated benefit shown below:
One Year of Participation - $2,500.00Two Years of Participation  - $5,000.00Three Years of Participation - $7,500.00
Loss of life - Full AmountLoss of two limbs, sight of both eyes, or loss of one limb and sight of one eye - Full AmountLoss of one limb or sight of one eye - ½ Amount
Q.How are benefits paid out, who receives the benefits when I pass?
A. In the event of death from ANY CAUSE, the amount shown in the Schedule of Benefits will be paid to the named Beneficiary.  It is MOST IMPORTANT that you designate the person to whom the proceeds are to be paid.  If no designated Beneficiary has survived you or no Beneficiary has been designated as of the time of your death, payment will be made in equal parts to the person or persons designated as your Beneficiary in the following order: (a) your surviving spouse, (b) your surviving children if you are not survived by a spouse, (c) the person or persons designated on the Union beneficiary designation card who survive you if you are not survived by a spouse or any children, or (d) your estate otherwise
Q.Are there any exceptions to the AD&D Benefit? 
A.

Loss must occur within 90 days from the day of the accident. Loss of limb means dismemberment by severance at or above the wrist or ankle joint. Loss of sight means the total and irrevocable loss of sight.  If more than one of the losses set forth above is suffered as the result of any one accident, not more than the full amount of Accidental Death and Dismemberment Benefit will be payable.

No payment will be made for death or any loss resulting from or caused directly, wholly or partly, by bodily or mental infirmity, hernia, ptomaine's, bacterial infections (except infections caused by pyogenic organisms which shall occur with and through an accidental cut or wound), or disease or illness of any kind, or intentional self-destruction, or intentional self-inflicted injury, while sane or insane, or participation in the committing of a felony, or war or an act of war, or service in any military, naval or air force of any county while such country is engaged in war or police duty as a member of any military, naval or air organization