Health & Welfare
Eligibility

Eligibility for Healthcare Coverage

When you become eligible for benefits through the Southwest Carpenters Trust Health & Welfare Plan you will receive an Eligibility Packet in the mail.

You are eligible to enroll when you meet the eligibility requirements below:

Active Carpenter Eligibility

• Employees performing hourly work under a collective bargaining agreement or under the C4A program.
• At least 120 hours between your hours worked and your Hour Bank are required to maintain monthly eligibility.
• The schedule below indicates when eligibility is granted after 120 hours are deducted for monthly coverage.

Initial Eligibility

• "Initial" means that you have NEVER before been eligible for health coverage through the plan.
  • Establishing initial eligibility requires that you accumulate 360 work hours within a minimum of 3 months and a maximum of 6 months for eligibility in the following eligibility month.
• If Initial Eligibility is not established during the 3-6 month window, any hours accumulated in your Hour Bank will continue to roll forward. Only the recent 6 months will be used to establish coverage.
• Initial Eligibility will be granted on the first day of the second month after reaching the required 360 hour threshold but cannot be granted earlier than the 1st of the 5th month after qualifying hours are reported.
  • After initial eligibility has been established, 120 hours per month are required to maintain eligibility.

Hour Bank Balance/Reserve Bank

• Any hour remaining after deducting 120 hours for coverage (360 hours for first time participants), will be credited to your reserve bank.
• The maximum reserve bank accumulation is 720 hours.
• Eligibility is granted during any eligibility month through work hours (if any) plus hours in the reserve bank totaling 120 hours.

Loss of Coverage and Regaining Initial Eligibility

• If you lose coverage due to lack of work hours and/or not enough hours in your Hour Bank, your remaining Hour Bank Balance will carry forward and any hour worked will be added to your Hour Bank.
• If 6 months have passed and less than 120 hours have been accumulated, your hour Hour Bank balance will be forfeited, and you must follow the rules for Initial Eligibility to re-establish.

Disability

If you become disabled and are unable to work, you may be eligible to continue your health coverage with Disability Hours Credit. If you qualify, you may be credited with disability hours up to 8 hours per day for each day (excluding weekends and holidays), and up to 120 hours per month for a maximum of 6 consecutive months.

You must submit your Disability Hours Claim Form within 120 days of the date of your disability. Other rules may apply.

See https://lifeevents.carpenterssw.org/#disability for information and the claim form.

Self-Payment/Hours Buy Back

Participants who lose eligibility due to a lack of reported work hours, or reserve bank hours, have the option to make a self-payment to the Administrative Office.

The following conditions apply:

• This provision does not apply to those who are establishing Initial Eligibility.
• You are allowed to pay up to 20 hours multiplied by the current Health & Welfare contribution rate to maintain eligibility.
• This self-payment is offered 3 times per calendar year for no more than 20 hours each time to avoid a lapse in coverage.
• Payment must be received by the Administrative Office within 31 days of receipt of Hours Buy Back Letter.
• You must be eligible in the immediately preceding month.

If you qualify for the Hours Buy Back, a letter will be sent to your address on file with information regarding the amount of hours required to keep eligibility for the next month and the amount due. Payment must by made by cashiers check or money order.

Non-Bargaining Eligibility

• Eligibility is based on monthly premiums due by the 15^th of the month prior to the month of coverage.
• The employer must be voluntarily signed to the Employer Participation Agreement for Non-Bargaining Employee Coverage and continue to meet all requirements for participation.
• All non-bargained employees must be covered under the Participation Agreement unless an employee has other health coverage, lives outside the jurisdiction of the SWRCC or is a construction worker not represented by a union.
• The employer must pay a minimum of 50% of the employee's monthly premium. Dependent coverage may be subject to additional payroll deduction at the employer's discretion.
• Employees become eligible the 1^st of the month following 30 calendar days of full-time employment.
  • Examples:
    • Employees starting employment on April 15^th would become eligible on June 1^st.
    • Employees starting employment on April 1^st would become eligible on May 1^st.

COBRA Continuation

COBRA, a federal law, allows covered participants and their dependents to continue health care coverage for a limited period at their own expense under certain circumstances when health coverage would otherwise end under the terms of the Plan because of a qualifying event.

See https://lifeevents.carpenterssw.org/#cobra for additional details.

Military Service Credit

If you are absent from employment due to Military Service, you may be entitled to continue your Health Coverage under the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA).

See https://lifeevents.carpenterssw.org/#military for additional details.