Teamsters Local 170 Health and Welfare Fund

Participation

Participation

 
Active Employees – Full Time Participation

You are eligible for coverage in the Plan if you are covered by a Collective Bargaining Agreement between the participating employer and Teamsters Union Local 170, or you are employed by an organization established or maintained by the Union or by the Union jointly with a contributing employer. A participant or beneficiary may obtain a copy of the applicable collective bargaining agreement upon written request to the Fund Administrator, and a copy of the applicable bargaining agreement is available for examination by participants and beneficiaries as required by law.

New or Reinstated Employee
A new or reinstated employee will be eligible for insurance for the remainder of an insurance period on the first day of the month following the month during which you accumulate 500 hours of credited employment by contributing employers during 6 consecutive months.

Continued Eligibility
You will remain eligible for insurance as of the first day of each insurance period, provided contributions of 400 hours have been made to the Fund during the current eligibility period. Surplus hours in excess of 400 in the three (3) eligibility periods preceding the current eligibility period, will be credited to the period immediately following, provided you have not been credited with 400 hours in that eligibility period. * Surplus hours may only be used once.

Eligibility Period
400 Credited Hours In:

Mar., Apr., May
June, July, Aug.
Sept., Oct., Nov.
Dec., Jan., Feb.

Insurance Period
Gives Full Coverage In:

July, Aug., Sept.
Oct., Nov., Dec.
Jan., Feb., Mar.
Apr., May, June

You will only receive credit toward eligibility if the contributions are received by the Fund.

Pay-In Provision
An employee to remain insured, may contribute on his own behalf the balance of hours required in order to qualify for any given coverage period. The employee’s contribution will be calculated at a rate per hour upon which the employer contributions are based.

Should the employee not pay the balance of hours, the employees coverage will terminate on the last day of the eligibility period. The employee will have to work 500 hours to become eligible for reinstatement.

Failure to Self-Pay on Time
If you are eligible to make a self-pay contribution but choose not to make such self-pay contribution or fail to make the payment on time, you will be terminated as an Active participant on the last day of the eligibility period. You will forfeit all hours in your hour bank and you will have to meet the Plan’s eligibility requirement of 500 hours to become eligible again.

Re-establishment of Eligibility for Active Full-time Employees
The rules for re-establishing eligibility are the same as the rules for establishing “initial eligibility for full-time employees”.

*Notwithstanding anything contained herein, an employee who retires shall only be allowed to utilize surplus hours for a maximum period of the balance of the eligibility period for when the employee retires and the subsequent quarter.

Part Time Participation

Eligibility for Employee Insurance
You are eligible for coverage through the Plan if you are covered by a Collective Bargaining Agreement between the participating employer and Teamsters Union Local 170, or you are employed by an organization established or maintained by the Union or by the Union jointly with a contributing employer. A participant or beneficiary may obtain a copy of the applicable collective bargaining agreement upon written request to the Fund Administrator, and a copy of the applicable bargaining agreement is available for examination by participants and beneficiaries as required by law.

New or Reinstated Employee
A new or reinstated employee will be eligible for insurance for the remainder of an insurance period on the first day of the month following the month during which you accumulate 400 hours of credited employment by contributing employers during 6 consecutive months.

Continued Eligibility
You will remain eligible for insurance as of the first day of each insurance period, provided contributions of 250 hours have been made to the Fund during the current eligibility period. Surplus hours in excess of 250 in the three (3) eligibility periods preceding the current eligibility period, will be credited to the period immediately following, provided you have not been credited with 250 hours in that eligibility period. * Surplus hours may only be used once.

Eligibility Period
250 Credited Hours In:

Mar., Apr., May
June, July, Aug.
Sept., Oct., Nov.
Dec., Jan., Feb.

Insurance Period
Gives Full Coverage In:

July, Aug., Sept.
Oct., Nov., Dec.
Jan., Feb., Mar.
Apr., May, June

You will only receive credit toward eligibility if the contributions are received by the Fund.

Pay-In Provision
An employee to remain insured, may contribute on his own behalf the balance of hours required in order to qualify for any given coverage period. The employee’s contribution will be calculated at a rate per hour upon which the employer contributions are based.

Should the employee not pay the balance of hours, the employees coverage will terminate on the last day of the eligibility period. The employee will have to work 400 hours to become eligible for reinstatement.

Failure to Self-Pay on Time
If you are eligible to make a self-pay contribution but choose not to make such self-pay contribution or fail to make the payment on time, you will be terminated as an Active participant on the last day of the eligibility period. You will forfeit all hours in your hour bank and you will have to meet the Plan’s eligibility requirement of 400 hours to become eligible again.

Re-establishment of Eligibility for Active Part-time Employees
The rules for re-establishing eligibility are the same as the rules for establishing “initial eligibility for part-time employees”.

*Notwithstanding anything contained herein, an employee who retires shall only be allowed to utilize surplus hours for a maximum period of the balance of the eligibility period for when the employee retires and the subsequent quarter.

Eligible Dependent Coverage

You may also enroll the following members of your family in the Plan (“Eligible Dependents”) Eligible dependents can be defined as including the following:

Your spouse “Spouse” means the individual to whom you are legally married or in the event of a divorce, the participant’s former spouse may remain covered unless:

  • The divorce decree does not require ( or no longer requires) the participant to maintain coverage for his former Spouse;
  • or either the participant or his former Spouse remarries

The Plan Sponsor shall have the sole discretion to determine the legal status of a Participant’s marriage, which determination shall be based upon the laws of the state in which the Participant maintains his or her legal residence.

Your children
The Participant’s children until the end of the calendar month in which the child turns age 26, whether married or unmarried, regardless of his/her student or employment status and regardless of whether your home is his/her principal place of abode or whether you support him/her financially;

The Participant’s children over the age of 26 and are unmarried and (i) primarily dependent on you for support because of mental retardation or physical handicap; and (ii) first became disabled before turning the age of 26 and were covered by this Plan at that time.

  • A “Child” or “Children” may include the following: a son, daughter, step-son, step-daughter, adopted child, a child placed for adoption, a foster child, a child named in a Qualified Medical Child Support Order, a child for whom you are responsible under court order, a child for whom you are appointed legal guardian.

You may be required to verify the eligibility of your Eligible Dependents for coverage (e.g., by providing a birth or marriage certificate). If you fail to timely provide the documentation upon request to prove the eligibility of any of your Eligible Dependents or the Plan Administrator (or its delegate) is unable to verify the submitted documentation, your dependent (or dependents) will lose coverage under the Plan, whether or not he or she (they) is (are) otherwise eligible for benefits under the respective plan.

NOTE: IF YOU APPLY FOR OR CONTINUE COVERAGE FOR ANYONE WHO IS NOT AN ELIGIBLE DEPENDENT, IT MAY BE CONSIDERED FRAUD OR INTENTIONAL MISREPRESENTATION AND YOUR AND YOUR FAMILY’S COVERAGE MAY BE RESCINDED TO THE EXTENT PERMITTED BY LAW. IN ADDITION, IF THE PLAN EXPENDS FUNDS FOR COVERAGE OF INELIGIBLE INDIVIDUALS, YOU MAY BE LIABLE FOR PREMIUMS AND ALL COSTS RELATED TO COVERAGE FOR SUCH INDIVIDUALS WHO ARE NOT ELIGIBLE DEPENDENTS.

New Participating Employers

If you work full time when your employer begins participating with Teamsters Local 170 Health and Welfare Fund, you will be eligible for Teamster benefits on the first day of the month your employer contributes the required hours to the Health & Welfare Fund.

Continuation Of Coverage After Active Employee Becomes Disabled

Notwithstanding anything to the contrary, a disabled Active Employee’s benefits will not be terminated provided he remains eligible to receive short term disability income benefits and the disabled active Employee makes the necessary self- pay contributions, if necessary, to the Fund to remain eligible.

Continuation of Insurance After Active Employee’s Death

Notwithstanding anything contained to the contrary, a Dependent is eligible for Dependent Coverage when an active Employee dies while still eligible for coverage under this plan. The Dependent will remain eligible for coverage, at no cost, until the first to occur of:

  • One (1) year after the active Employee’s death;
  • As to the surviving spouse, the date he/she remarries;
  • The date the person would have ceased to be a Dependent, if the active Employee were alive; or
  • The date the Dependent becomes eligible to be covered under any group policy or other arrangements for benefits (insured or not) as an active employee or
  • as a Dependent of another active Employee.