Friday, May 16, 2025

Frequently Asked Health Care Questions


Q. What documents are required to add a new dependent to my plan?
A.
  • Spouse – original copy of your marriage certificate
  • Child – original copy of your child’s original birth certificate
  • Child that does not reside in your home – copy of child’s birth certificate along with copy of Qualified Medical Child Support Order.
  • Step-child – original copy of child’s original birth certificate
  • Adopted child – original copy of legal decree of adoption
Q. When can I choose what plan I would like to enroll in?
A. When you become eligible for benefits a New Member Packet will be sent to you with information regarding your benefits and the required forms to be completed. You may obtain these forms from the Trust Fund Office.
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 360 hours per quarter will accumulate in a Reserve Hour Bank up to a maximum of 720 hours to use to maintain your coverage if your work hours fall short or you become unemployed.

If you would otherwise lose your eligibility due to insufficient hours and you have used up all of your Hours Bank, then you will be allowed to purchase up to 40 credit hours to maintain your eligibility. You can do this if you had eligibility during any eligibility quarter in the last four eligibility quarters. You must pay the full journeyman contribution rate for the full health and welfare contribution including dental and disability stated in the applicable collective bargaining agreement in effect at the time of your credit hour purchase. Please contact the Trust Fund Office to discuss the full terms and conditions of the Purchase of Eligibility Hours benefit.

You may also be eligible to continue coverage by self-pay for all benefits except dental and Special Disability benefits.
Q. Whom should I call if I have questions about my eligibility?
A. The Trust Fund Office at (626) 646-1075 or toll-free at (877) 908-9996, and please then select option 2.
Q. How do I obtain a replacement Medical Card?
A. Please call Kaiser at (800) 464-4000 and select option #4 or UnitedHealthcare (formerly PacifiCare) at (800) 624-8822.
Q. How do I obtain a replacement Prescription Card?
A. Please contact the Trust Fund Office at (877) 908-9996.
Q. How do I add my new baby or spouse to my insurance plan?
A. You must fill out a UnitedHealthcare (formerly PacifiCare) or Trust Fund Enrollment Form depending on your medical plan. You can download either enrollment from from this website located under "Health & Welfare 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 maintain my monthly health care coverage?
A. You must work at least 360 hours per quarter to maintain your benefits.
Q. When do I become eligible for benefits?
A. Initially, after you have been credited with 360 or more hours in a qualifying quarter, you will be eligible for benefits during the eligibility quarter as shown below.

Qualifying Quarters=Eligibility Quarters
FEB/MAR/APR           JUL/AUG/SEP
MAY/JUN/JUL OCT/NOV/DEC
AUG/SEP/OCT JAN/FEB/MAR
NOV/DEC/JAN APR/MAY/JUN
For example, if you work and are credited with 100 hours in November 2013, 125 hours in December 2013, and 100 hours in January 20114, then you will be eligible for benefits during the months of April, May and June 2014.
Q. Who are my eligible dependents?
A.
  • Your lawful spouse (husband or wife).
  • Your Dependent Children. A dependent child shall be -
    • A blood descendant of the first degree;
    • A legally adopted child;
    • A stepchild residing in the employee's household.
Dependent children are covered until the age of 26 provided they are not eligible to enroll in another employer sponsored plan (other than that of a parent).

A dependent child also includes a child after their 26th birthday for all benefits provided herein provided the child is -

  • Permanently and totally disabled;
  • Dependent upon you for more than one-half of their support and maintenance; and
  • Live with you for more than one-half of the year.
Proof of permanent and total disability must be furnished to the Plan or Trust by you within 31 days of the child's 26th birthday.
Q. What if I become disabled?
A. If you are eligible for Workers Compensation or State Disability Insurance (SDI), you may be eligible to receive Disability Income Benefits and you may be eligible for 6 to 12 months of health care coverage. Please contact the Trust Fund Office to learn more about your eligibility for these benefits.
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 Judgment of Dissolution of Marriage and QDRO (Qualified Domestic Relations Order) to this office.