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Q.
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A.
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The current monthly insurance benefit cost is $850. A person will become eligible
when their bank has reached $2,550, which is equal to $850 per month for 3 months.
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Q.
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A.
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Your insurance information packet will be sent to you in the middle of the month
prior to the month in which you have accumulated $2,550 in your insurance bank.
Please be sure to complete and return the forms, along with any requested documents,
as soon as possible. You will NOT
have coverage until you return these documents.
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Q.
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A.
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$850 dollars per month is required to maintain your health & welfare coverage.
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Q.
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Yes, there is a 12-month bank which is equal to $850 x 12 months, or $10,200. When
your contributions for the month are not sufficient to meet the $850 requirement,
the bank will be used to make up the difference for your eligibility.
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Q.
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If your bank becomes depleted and your contributions fall short of the $850 requirement,
a self-payment notice will be sent to you.
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Q.
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Yes, a participant can make 3 consecutive payments. After these 3 payments the participant will be sent a verification form to be filled out by an area business agent for the member to be able to make an additional 3 payments.
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Q.
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In order to add a spouse or dependent child to your insurance, the Fund office must be notified within 31 days of a qualifying life even. If the Fund office is not notified within 31 days of the event open enrollment for adding a dependent is April 1st through April 30th. The documents required once the Fund office is notified will be an updated vital information form along with a copy of the Birth Certificate [for dependent children] and/or the Marriage License [for a spouse]. Step Children are not automatically eligible as a dependent child, the participant will need to send in legal documents stating the participants responsibility for the child to the Fund office for review. Children under the guardianship of a participant and foster children do not qualify for dependent benefits. In addition, we must have the Social Security number for everyone placed on your insurance.
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Q.
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A child will be covered until the end of them month of their 26th birthday, unless the child is totally and permanently disabled. If your child is permanently disabled, you must notify the Fund Office for continued coverage after the child turns 26 years of age. The Fund office will also require proof from the doctor of the dependent stating they are unable to work and will then be unable to provide themselves with insurance coverage. When a dependent loses coverage under the plan they will be offered COBRA.
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Q.
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A.
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A child will be covered until the end of them month of their 26th birthday, unless the child is totally and permanently disabled. If your child is permanently disabled, you must notify the Fund Office for continued coverage after the child turns 26 years of age. The Fund office will also require proof from the doctor of the dependent stating they are unable to work and will then be unable to provide themselves with insurance coverage. When a dependent loses coverage under the plan they will be offered COBRA.
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Q.
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For Hospital, Medical, Master Medical, Vision and Hearing present your
BLUE CROSS BLUE SHIELD PPO card.
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Q.
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Coordination of benefits between Plans is as follows:
- The Plan under which the Health Fund participant is an employee is primary for that
person.
- The birthday rule is used for insured dependent children. The Plan of the Parent
whose birthday is first in the calendar year is primary for the dependent children.
- If in a married couple, one is actively employed and the other has Medicare coverage,
the Plan for the actively employed spouse is primary.
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Q.
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If a divorce takes place the member will have to notify the Fund office and will also have to provide a copy of the full divorce decree. After this is received the ex-spouse will be removed from the coverage effective the last day of the month the divorce accrued in. They will then be given the option to take up COBRA coverage.
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Q.
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If you do not send in the proper documentation, such as the full divorce decree, you are responsible for any charges or expenses billed to your health insurance for that dependent. The Fund office will not be able to remove the spouse from the coverage without first receiving the full divorce decree. Not notifying the Fund Office of changes in your dependent status is considered fraud, and you will be liable for payment of all unauthorized charges.
For Prescription Drugs present your OptumRx Card
For Dental Coverage present your DELTA DENTAL or DENCAP card (these cards are not sent to a participant automatically, you will need to follow the directions for the consumer toolkit provided in your insurance information packet to print an identification card. If you do not have or want a card you can be found in Delta Dental or Golden Dental’s system with your social security number.)
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