|Operating Engineers Local 66 Welfare Fund|
Active Employees - Active Employees working at the trade under the jurisdiction of the Union who have been credited with the minimum contribution requirement in a given Work Period, shall be eligible (on the first day) of the Benefit Period that immediately follows the Work Period. Coverage for the Active Employee's dependents, if any, will also become effective on the same first day of the Benefit Period. An Active Employee who in his first Work Period has sufficient contributions credited to meet the Minimum Contribution Requirement for:
Special Agreement Employee - Special Agreement Employees working under the jurisdiction of the Union must refer to the Summary Plan Description.
Special Categories - Special categories are employees who are no longer working or dependents of former working employees, spouses and dependent children of deceased employees, early retirees, retirees, totally disabled employees and their dependents. Initial eligibility for them was established when the employee last worked. Provided the Voluntary Contribution required is received, coverage will become effective on the first day of the next Benefit Period.
Dependent Child Working as an Operating Engineer - An eligible dependent child who works sufficient hours at the trade may become eligible and be covered in their own right, as a member in either PLAN ONE or PLAN TWO. If the working dependent child is also eligible as a dependent child under the parents' eligibility, the dependent child's coverage will be in the plan which provides the better benefits. If the dependent child is covered in the parents' plan, there will be no accumulation of the child's employer contributions nor will there be any Reserve of Contributions created.
Husband and Wife Working as Operating Engineers - Plan eligibility will be determined as if the husband and wife were one individual, but both husband and wife's employer contributions and Reserve of Contribution balance, if any, will be used. The plan of benefits will be based on applicable minimum contribution requirements (PLAN ONE or PLAN TWO). The husband, wife and dependent children will always be covered under the same plan. The definition of dependents shall be the same as those listed in the Rules of Eligibility. The husband and wife must both be working as Operating Engineers and give written notification to the Fund Office of their desire to follow these rules. Either individual may during any subsequent eligibility period cancel their selection. If there is a divorce, the individual will retain their own Reserve of Contributions, if any.
At Welfare Fund Statement time, the following method will be used in determining HUSBAND AND WIFE WORKING AS OPERATING ENGINEERS eligibility - The actual cost for the benefit period will be applied on a 50/50 basis against the contributions and reserves of each individual. If the balance in either of the accounts is not sufficient to establish eligibility, then an amount may be transferred from the other spouse's account (if any is available) to establish eligibility. If there is still an amount due, a Voluntary Contribution will be required. Any excess of contributions not necessary to meet the cost of plan benefits will be added to the individual's own reserve at 100% of the excess.
Medicare - If an employee or dependent qualifies for Medicare benefits, they must enroll when the Health Care Finance Administration's rules permit in both Medicare Part A and Part B. All employees, retirees and/or their dependents should apply for Medicare Part A and Part B coverage about three months prior to becoming age 65. Benefit payments from this Welfare Fund, Blue Cross and/or Blue Shield will take into account payments from Medicare.
Medicare Rules (Retirees) - Federal Medicare Rules have been changed recently to affect all retirees who return to work in the industry. Medicare benefits are secondary to Operating Engineers Local 66 group health plan benefits if an individual is employed and covered, by reason of employment, under a Welfare Fund.
The Operating Engineers Welfare Fund (PLAN ONE or PLAN TWO) automatically becomes the primary provider of health coverage when a retiree, covered by Medicare, returns to work unless the retiree refuses coverage (by electing to waive PLAN ONE or PLAN TWO coverage). The Operating Engineers Welfare Fund cannot induce a retiree returning to work to waive PLAN ONE or PLAN TWO coverage - for example, by offering a MEDICARE SUPPLEMENTAL PLAN or a cash payment. The same benefit and eligibility rules must apply to retirees returning to work as to other active employees. To coordinate the Fund with Medicare, the following Welfare Fund rules will apply:
Medicare Eligible Retirees - If an employee initially retires at age 65 or older, or is disabled and eligible for Medicare, with a Reserve of Contributions or Employer Contributions in a work period, they will remain in Plan One or Plan Two and charged retiree rates until their Reserve of Contributions and/or Employer Contributions run out. An employee will be eligible for the Medicare Supplemental Plan or Freedom Blue plan, with a credit from the Retiree's Contribution Account, in the eligibility period following the period in which the Reserve of Contributions and/or Employer Contributions run out.
Retirees Not Eligible for Medicare - If an employee initially retires prior to age 65 as an early retiree with a Reserve of Contributions and/or Employer Contributions in the Work Period, they will remain in PLAN ONE or PLAN TWO and charged retiree rates until their Reserve of Contributions and/or Employer Contributions run out, even if this period extends beyond age 65 when an employee would otherwise be eligible for Medicare. If the employee is age 62 or older, they will become eligible for the credit from the Retirees' Contribution Account in the eligibility period following the period their Reserve of Contributions and/or Employer Contributions run out.
All Retirees - Employees should apply for Medicare Part A and Part B three months before they reach age 65 even though they may be covered under PLAN ONE or PLAN TWO. Timely enrollment in Medicare Part A and Part B will avoid any surcharge or delay once an employee becomes eligible for Medicare as their primary plan.
Maintenance of Eligibility of Active Employees - Active Employees shall continue to be eligible for benefits in subsequent Benefit Periods, provided they have been credited with the Minimum Contribution Requirement in the preceding Work Period.
RESERVE OF CONTRIBUTIONS - Employer Contributions received in a Work Period which are in excess of the minimum contribution requirement for a Benefit Plan may be accumulated as Contribution Credits in a Reserve of Contributions Account. Employer Contributions not used for eligibility will be accumulated in the Reserve of Contributions as Contribution Credits at the rate of 100% of the amount of the excess of the minimum contribution requirement for Benefit Plans.
Contribution Credits held in the Reserve of Contributions Account will automatically be withdrawn, to the extent necessary, in order to maintain the eligibility of an employee who fails to meet the Minimum Contribution Requirement in a subsequent Work Period. Should the Employer Contributions and/or the Contribution Credits held in the employee's Reserve of Contributions Account be insufficient to meet the Minimum Contribution Requirement, the employee may then be required to make up the shortage in contributions through a Voluntary Contribution. If an employee fails to make the Voluntary Contribution, coverage will be terminated and any balance in the Reserve of Contributions Account and any Employer Contributions Credits will be canceled. Application of the Reserve of Contributions is automatic, when needed to maintain eligibility and cannot be waived for any reason. The credits in the account are for maintaining eligibility in the Welfare Fund only and cannot be applied for any other purpose nor withdrawn.
Presently there is a $30,000 maximum that can be accumulated in a Reserve of Contributions Account.
VOLUNTARY CONTRIBUTIONS - Active employees, who were eligible for PLAN ONE in the preceding Benefit Period and who fail to earn sufficient contributions to maintain their eligibility in a subsequent Benefit Period, may make a Voluntary Contribution for the difference between the total contributions credited on their behalf and the Minimum Contribution Requirement for either PLAN ONE or PLAN TWO. An Active Employee who in the previous Benefit Period was covered for PLAN TWO and who does not meet the current Minimum Contribution Requirement for PLAN TWO will have to meet the Minimum Contribution Requirement for PLAN TWO. This employee cannot make a Voluntary Contribution for PLAN ONE. An Active Employee who in the previous Benefit Period was covered for PLAN TWO and who has Employer Contributions plus a Reserve of Contributions balance which equals the Minimum Contribution Requirement for Plan One, will be given the choice of selecting either Plan One or Plan Two. If an employee is eligible in the immediately preceding Benefit Period, Voluntary Contributions will be permitted to be made for a maximum of 18 months (six quarterly eligibility periods). After which time, if the Active Employee has not been re-employed in the industry, no further Voluntary Contributions will be accepted. The Active Employee and any eligible dependents will then be eligible for COBRA and/or conversion rights. Voluntary Contributions will not be accepted from any Employee who was not eligible in the immediately preceding Benefit Period. If an Active Employee has not been eligible in the previous Benefit Period and has employer contributions made in the current Work Period which are less than the minimum contributions requirement for PLAN TWO, the employee will not be able to make a Voluntary Contribution for eligibility in the current Benefit Period. These contributions will be accumulated for up to 12 months, on a quarterly basis. If sufficient contributions to meet the minimum eligibility requirement for at least PLAN TWO are accumulated during the 12 month period, the employee will be eligible for the next Benefit Period. See the Summary Plan Description for further information regarding Voluntary Contributions.