Sunday, October 17, 2021

Frequently Asked Health Care Questions

Q. What do I need to do if I am working under a Local outside Local 4's area and need my hours transferred to Local 4?
A. To have your employer contributions transferred from the Local you are working under to Local 4 please complete the Reciprocity Form under the Health and Welfare Forms section of this page and turn it into the Local you are working under so that your hours can be transferred back to your home Local (Local 4).
Q. Will my child(ren) who is/are under the age of 26 be covered under the Plan?
A. As of May 1, 2011 dependents under the age of 26 are now covered under an eligible participant's plan regardless of the dependent child's full time student status.
Q. Who are my eligible dependents?
A. The term "Dependent" means: a) the Covered Employee's lawful spouse or registered same sex domestic partner in accordance with AB 2208 (opposite sex at age 62 or older), except for those benefits set forth in Articles III, IV, V, VI, VIII, XI, XVI and XVII; b) the Covered Employee's children, from birth to age 26, including step-children, adopted children and foster children. Adult children who are eligible to enroll in an employer-based group health plan provided by their employer or the employer of their spouse are not eligible for coverage.

Please contact the Trust Fund Office if you have any questions regarding whether an individual will qualify as a Dependent under the Plan.

*Please note per plan rules The Fund will not cover dependents of Mason Finishers under any circumstances
Q. How do I add my new baby or spouse to my insurance plan?
A. You must fill out either a UnitedHealthcare (formerly PacifiCare) or Kaiser/Fee-for-Service Enrollment Form. You can download one off of this website located under "Forms" and mail it into the Trust Fund Office. You must enroll your new dependent within 30 days of birth, adoption, marriage or other important life changes.
Q. How do I obtain a replacement Prescription Card?
A. Please contact the Trust Fund Office at: (877) 516-0586.
Q. How do I obtain a replacement Medical Card?
A. If you are currently enrolled in Kaiser, please call Kaiser at (800) 464-4000.

If you are currently enrolled in UnitedHealthcare (formerly PacifiCare), please call UnitedHealthcare at (800) 624-8822.

If you are currently enrolled in the fee-for-service medical plan, please call the Trust Fund Office at (877) 516-0586.
Q. Whom should I call if I have questions about my eligibility?
A. Please contact the Trust Fund Office at (626) 646-1080 or (877) 516-0586.
Q. When can I choose what plan I would like to enroll in?
A. You cannot change plans until either the next open enrollment period or 12 months, whichever comes first.
Q. When do I become eligible for benefits?
A. Eligibility begins on the first day of the second calendar month following any consecutive period of four calendar months or less in which the number of hours for which contributions are made on your behalf by an employer total 400 hours.

Example: You work 400 hours in May, June, July, & August work (100 hours per month). Coverage will begin October 1.
Q. What documents are required to add a new dependent to my plan?
  • Spouse – copy of your marriage certificate
  • Child – copy of your child’s birth certificate
  • Step-child –copy of child’s birth certificate
  • Adopted child –copy of legal decree of adoption
  • Child for whom you have been appointed their legal guardian – original copy of legal guardianship documents (if temporary guardianship, status updates will be required every 6 months).
Q. What if I don’t work enough hours to gain eligibility for the month?
A. While you are working, any hours you work over 120 hours per month will be added to the bank (up from 100).
Q. Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A. Please call the Trust Fund Office and advise the Eligibility and Pension Departments that you are getting a divorce or have already gotten divorced. You will also need to submit a FULL copy of your Dissolution of Marriage Judgment and QDRO (Qualified Domestic Relations Order) to this office.
Q. What if I become disabled?
A. If you are an Active Employee and while eligible you become totally disabled and unable to work as a result of a Sickness or accidental injury occurring on or off the job, the plan will pay to the Active Employee a weekly benefits of $25 (subject to state and federal taxes). Payment is contingent upon completing a Disability Application you can download off of this website under “Forms” and the Employee’s proof of entitlement to either California Unemployment Compensation Disability Benefits or Workers Compensation benefits.

Payment will begin the first day of a disability due to an accident and 8th day of disability due to Sickness. The number of weeks payable will be thirteen weeks per disability.
Q. How do I maintain my monthly health care coverage?
A. You must work at least 120 hours per month to continue coverage.