<p> Frequently Asked Questions - Health & Welfare </p><p>When will I be insured?</p><p> Initial eligibility = 700 hours or more, within 6 consecutive months. The effective date of eligibility is on the 1st day of the 2nd month following the completion of the hours worked.</p><p> Reinstatement = 160 hours or more within 2 consecutive months. The effective date of eligibility is on the 1st day of the 2nd month following the completion of the hours worked.</p><p> Accelerated initial eligibility = a new participant that previously had group insurance in their own name before joining IBEW 481. Eligibility would be the same as the 160 hour reinstatement requirements.</p><p> PLEASE NOTE; The work month ends on the last Sunday of the month for reporting purposes.</p><p>How do I maintain coverage?</p><p> Please refer to the eligibility matrix for the 100 hour monthly rule / 300 hour quarterly rule / 1440 hour annual rule. (can direct them to the matrix)</p><p>If I don’t have enough hours worked how can maintain coverage?</p><p> As long as you don’t terminate coverage you can buy Alternative Self-Pay hours to continue coverage. Based on eligibility requirements of the 100 / 300 / 1440 hour rule, you can buy the hours needed for your monthly premium coverage payment.</p><p> If you are buying all 100 hours, you must be on the “ready for work referral book” and actively seeking employment. You are allowed to buy up to 12 months of coverage before you would terminate coverage.</p><p> You can elect to take the COBRA option of coverage. COBRA allows for extension of benefit coverage for up to 18 months. For extended coverage you must choose either Alternative Self-Pay or COBRA; not both. </p><p>How can I buy hours?</p><p> You can make payment by credit card, check or by transfer of monies out of your Health Reimbursement Account (HRA) no cash will be accepted.</p><p>When can I make payment for health care coverage?</p><p> Typically payment is due before the 1st day of the coverage month. Currently, the Trustees have allowed for payment any time during the coverage month. If payment is not received in the coverage month your eligibility will terminate. You will then have to reinstate for coverage (see reinstatement rules for details). </p><p>When I retire will I be eligible for Retiree insurance?</p><p> Retiree insurance is offered only once at the time of your election of your Local Union Pension. Eligibility is described in the SPD, Article VII.</p><p>What happens to my banked hours and the balance of my HRA monies, when I retire?</p><p> If you elect Retiree Health coverage, your banked hours are the first to be exhausted, after that, the balance of your HRA monies can be used for premium payments until the account balance is zero.</p><p>What if I am Medicare eligible and retire, what happens?</p><p> You will need to sign up for Medicare Part A & Part B. We will sign you up for the prescription Part D. We will not become secondary to Medicare until you have exhausted all of your banked hours. When Medicare becomes primary our Health Care Plan will only pay 20% of medical cost on your behalf. We will need a copy of you and your spouse’s Medicare card for our files, at least 30 days before you become Medicare Primary.</p><p> When you (as the participant member) become Medicare Primary your premium will decrease and your Retiree Pre-Funding will be credited at 75% of the previous benefit.</p><p>What If I pre-decease my spouse, will they be eligible for coverage under our Plan?</p><p> Yes, provided that your spouse does not remarry and doesn’t have other group insurance.</p><p>To collect my Health Reimbursement Account monies, can I submit to the Benefit Office a copy of my check for the provider as proof of payment? </p><p> Due to HIPPA laws, your provider will not verify a payment on your account to anyone but you. The Benefit Office must be able to verify payment for a reimbursement. Acceptable methods of verification would include a copy of your cancelled check or bank statement showing the check has cleared as proof of payment.</p><p>Can my provider be paid directly out of my Health Reimbursement Account? </p><p> Yes, the provider can be paid directly. You must indicate “pay the provider” on the HRA claim form.</p>