MICHIANA AREA ELECTRICAL WORKERS HEALTH & WELFARE FUND

COMMON QUESTIONS ASKED

 

How are my benefits Funded?

The primary source of financing for the benefits provided under the Health & Welfare Fund and for the expenses of Fund operations is employer contributions.

 

What are the Fund’s eligibility requirements?

Initial eligibility –  Requires 120 hours of employer contributions in one month.  There is a one (1) month bookkeeping period in which you are not eligible and coverage begins the first day of the third month.

Continuing eligibility requires 120 hours of employer contributions in one month.  There is a one (1) month bookkeeping period in which you are not eligible and coverage begins the first day of the third (3rd) month. 

If the participant has more than 120 hours of employer contributions remitted, any excess hours are placed in an hour bank to be utilized when the participant does not work sufficient hours to be eligible. 

If the participant has less than 120 hours of employer contributions remitted, the additional hours will be taken from the participants hour bank. 

If the participant does not have 120 hours of employer contributions remitted and does not have 120 hours of employer contributions remitted, he may remit the number of hours that are short based upon the currently hourly contribution rate.

 

What do I do if my employer does not remit my fringes?

First call your employer.  There may be a very good reason that the fringes have not been remitted.  If your employer cannot explain the reason to your satisfaction, you should contact the Local Union.

 

How can I add my dependents to the Plan?

Complete a “Membership and Record Change Form” and submit copies of marriage or birth certificates.

 

What do I do when I get divorced?

You must send a copy of your complete divorce decree otherwise coverage will be maintained for your ex-spouse.  If the Fund pays for benefits that should not be paid because your spouse no longer meets the definition of a dependent, you will be held responsible.

 

When does coverage stop for my dependent children?

Dependent children are covered until they turn 19 unless they meet the requirements for maintaining coverage.  The Plan requires the following to maintain coverage beyond the age of 19; the child must be enrolled in an accredited educational institution and must be dependent on the Employee for the major portion of financial support.  Full Time Student is defined as twelve (12) credit hours.  Coverage terminates on the date the child turns twenty-four (24).

 

Can I continue coverage when I retire?

Yes provided you meet the retiree requirements for maintaining coverage.

 

What do I do if I am injured and cannot work?

The Fund provides disability benefits which may continue your coverage for health care benefits.  You should complete a disability form.

 

What is COBRA?

COBRA is the Consolidate Omnibus Budget Reconciliation Act of 1986.  COBRA requires that the Fund provide coverage for participants and their dependents that may not otherwise be offered.  COBRA is available for dependents who no longer meet the definition of a dependent as defined by the Plan.  The rates are 102% of the actual cost of providing benefits. 

 

What is Coordination of Benefits?

Coordination of Benefits or COB coordinates benefits with other health benefits you may have such as coverage through your spouses employer.