Wednesday, April 1, 2026

Frequently Asked Health Care Questions


Q. When do I become eligible for benefits?
A. You must work three hundred (300) hours or more in one quarter which gives eligibility on the first day of the third (3rd) month following. Eligibility continues for the Benefit Quarter.
Hours worked In: Calendar Quarter
January, February, & March
April, May & June
July, August & September
October, November, & December 		Gives Eligibility In: Benefit Quarter
June, July, & August
September, October, & November
December, January, & February
March, April, & May
Q. How do I maintain my monthly health care coverage?
A. You must work Three hundred (300) hours in the calendar quarter, or Six hundred (600) hours in the immediate two (2) calendar quarters, or Nine hundred (900) hours in the immediate three (3) calendar quarters, or One thousand two hundred (1,200) hours in the immediate four (4) calendar quarters.
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 300 per quarter will accumulate in a Reserve Dollar Bank up to a maximum of $2025.00 to use to maintain your coverage if your work hours fall short or you become unemployed. Once your Reserve Dollar Bank is depleted, you will be able to make timely self payments to remain eligible.
Q. Whom should I call if I have questions about my eligibility?
A. Please contact the Benefit Fund Office Toll free at: (855) 641-4966.
Q. Whom should I contact if I'm getting a divorce and what documents do I need to submit?
A. Please call the Benefit 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 the Benefit Fund Office.
Q. How do I obtain a replacement Prescription Card?
A. Please contact the Benefit Fund Office Toll free at: (855) 641-4966.
Q. How do I obtain a replacement Medical Card?
A. Please contact the Benefit Fund Office Toll free at: (855) 641-4966.
Q. Who are my eligible dependents?
A. Your eligible dependents are:
  • Your lawful spouse
  • Your natural children up to age 26
  • Your legally adopted children up to age 26
  • Your step-children up to age 26
  • Child for whom you have been appointed legal guardian by court for length of guardianship or to age 26, which occurs first.
Q. How do I add my new baby or spouse to my insurance plan?
A. You must submit other legal documentation to the Benefit Fund office along with a completed Vital Information Form. You can download the Vital Information Form off of this website located under documents and mail it into the Benefit Fund Office. You must enroll your new dependent within 30 days of birth, adoption, marriage or other important life changes.

Forms Required Are:
  • 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. Will my child(ren) who is/are age 19 through age 26 be covered under the Plan?
A. Yes. Due to the new Healthcare Reform Act, dependent children are now eligible to remain on the coverage until the age of 26, regardless of student status.

Please contact the Benefit Fund Office Toll free at (855) 641-4966 for more information.