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COBRA.

The Consolidated Omnibus Budget Reconciliation Act (COBRA)is a Federal law which requires most employer sponsored health care plans to offer temporary continuation of health care coverage to certain categories of employees and their eligible dependents when there is a termination of coverage because of a qualifying event.

Qualifying Event - A "Qualifying Event" is a situation that involves a covered participant and/or their eligible dependents that results in the loss (or termination) of group health coverage (for reasons other than gross misconduct).

Qualifying Events
Employees termination of employment or reduction in hours of employment. Employee, Spouse and dependent child 18 months (29 months if qualified beneficiary is disabled).
Death of an Employee. Spouse and dependent child. 36 Months.
Employees divorce or legal separation from spouse. Spouse and dependent child. 36 Months.
Dependent child is no longer an eligible dependent. Spouse and dependent child. 36 Months.

Dependents - Dependent coverage normally will terminate on the same date the employees coverage terminates. However, coverage of a dependent will terminate when the dependent ceases to be a dependent, as defined herein.

In case of divorce, spouse's coverage will terminate on the last day of the month in which the divorce occurred. 

Coverage is provided for each child who has not achieved their 26th birthday.  Upon turning 26, dependent children are terminated from the plan.

Spouses and Children of Deceased Employees - A deceased employee's dependent's coverage will terminate either, (1) on the last day of the benefit period in which death occurred, or (2) in the event the required Voluntary Contribution was made, the last day of the benefit period for which a Voluntary Contribution was made. However, in the event of remarriage, the spouse's coverage will be terminated on the earlier of, (a) 90 days from the date of remarriage, or (b) the last day of the benefit period in which remarriage occurred. A dependent child, in this case, can make a Voluntary Contribution to continue his or her coverage as long as he or she qualifies as a dependent.

Retired Employees and Their Eligible Dependents - The coverage of retired employees and their eligible dependents shall be terminated on the day immediately preceding any Benefit Period following a Work Period in which the amount of the required Voluntary Contribution is not received.

Field Supervisory Employees - The coverage of a Field Supervisory Employee will be terminated on the day immediately preceding any Benefit Period following a Work Period in which the amount of the required Voluntary Contribution is not received.

Totally Disabled Employee - Coverage of totally disabled employees and their eligible dependents shall terminate on the last day of the Benefit Period in which the disabled employee recovers or on the day immediately preceding any Benefit Period following a Work Period in which the amount of the required Voluntary Contribution is not received. An employee who recovers shall no longer be considered a totally disabled employee.

Uniformed Services - Coverage of an employee entering the uniformed services will be governed by the requirements of the Uniformed Services Employment and Reemployment Rights Act of 1994. USERRA permits covered employees to elect to continue coverage for themselves and their dependents during a period of absence for uniformed service. Upon reemployment with a contributing employer, the employee will be reinstated to coverage without any exclusions or waiting periods, except for coverage of any injury or illness determined by the Veterans Administration to have been incurred or aggravated during the period of uniformed service. Subsequent eligibility will be based upon employment in the industry, in accordance with the rules of eligibility then in effect.

 



Eligibility.

Termination.

COBRA Continuation Coverage.

Medical Claims.

Vision.

Prescription Drugs.

Disability Benefits.
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