Any journeyman steamfitter, apprentice or trainee whose employment is covered by a collective bargaining agreement between Enterprise Association Local Union 638 and an employer obligated to contribute to the Steamfitters’ Industry Welfare Fund;
Dependent children are covered under your health coverage until the end of the month that they attain age 26.
You become Medicare eligible under the following conditions:
• When you turn age 65* [if you are not actively employed, if you are actively employed, the Secondary Payor Rules apply.
• Two [2] years after you are awarded Social Security Disability benefits regardless of your age
• You are diagnosed with End Stage Renal Disease {ESRD}
Part A is free. Part B coverage requires a monthly premium payment which is deducted from your social security benefit payment if you are already collecting at age 65 or if you are not, Medicare will send you a quarterly invoice for you to pay. Your Medicare premium is based on what your taxable income was 2 years prior to your Medicare eligibility. There is also a charge for Medicare Part D as well based on your taxable income.
Yes, if you are retired and have qualified for lifetime retiree coverage, you are required to enroll in both Medicare Part A and Part B effective the first of the month that you turn 65.
Our plan uses Met Life, they do not require cards. Whenever you go to the dentist, just give the dental office your Social Security number for you and any dependents and your appropriate group number 1630609.
The baby will automatically be covered for 30 days with Empire after the birth. It is your responsibility to provide the Welfare Fund with a copy of the baby’s birth certificate and a copy of the baby’s social security card. You can upload these documents securely by logging on to your member portal.
The Express Scripts plan allows the original prescription plus one refill; any refill after that must go through mail order.
As soon as your divorced is signed by the judge and entered into court, you are responsible for submitting a complete copy of the judgement of divorce together with the Stipulation agreement to the Welfare Fund. It is important that you do so in a timely manner as if there are any claim expenses incurred by the Fund after your divorce date, you will be held responsible.
When you retire from the Steamfitters’ Industry Pension Fund, your coverage will continue for yourself and your eligible dependents if you meet the following criteria:
"Regular Pension" Retiree Health Coverage Eligibility (age 60+)
In order to qualify for regular pension retiree lifetime health coverage, a participant must have:
1. earned 20 years of credited service in the Steamfitters' Industry Pension Fund, and
2. worked at least a total of 30,000 aggregate life-time hours in the construction trades division and
3. be covered in the Welfare Fund the day before the pension effective date or 20 of 40 quarters immediately prior to the pension effective date
"Disability Pension" Retiree Health Coverage Eligibility
In order to qualify for any type of disability pension retiree lifetime health coverage, a participant must have:
1. earned 15 years of credited service in the Steamfitters' Industry Pension Fund, and
2. worked at least a total of 22,500 aggregate life-time hours in the construction trades division, and
3. be covered in the Welfare Fund the day before the pension effective date or 20 of 40 quarters immediately prior to the pension effective date.
“Early Pension” Retiree Health Coverage Eligibility (age 55-59)
There are two types of early pension retiree health coverage: one is lifetime and the other is limited retiree health coverage.
In order to qualify for early pension retiree lifetime health coverage, a participant must have:
a. earned 30 years of credited service in the Steamfitters’ Industry Pension Fund, and
b. worked at least a total of 30,000 aggregate life-time hours in the construction trades division, and
c. be covered in the Welfare Fund the day before the pension effective date or 20 of 40 quarters immediately prior to the pension effective date.
In order to qualify for early pension retiree limited health coverage (coverage for participant or dependents only until the earliest of age 65 or Medicare eligibility; if participant coverage terminates, coverage for all dependents simultaneously terminates), a participant must have:
a. earned 20-29 years of credited service in the Steamfitters’ Industry Pension Fund, and
b. worked at least a total of 30,000 aggregate life-time hours in the construction trades division, and
c. be covered in the Welfare Fund the day before the pension effective date or 20 of 40 quarters immediately prior to the pension effective date.
For each category of retiree health coverage listed above, the Participant's status is determined as of the date of retirement. The date of retirement shall be deemed to be the first date paid by either the Steamfitters’ Industry Pension Fund or the Metal Trades Branch Local 638 Pension Fund for those participants included by virtue of a participation agreement. As qualifying factors for those included based on a participation agreement, years of credited service and aggregate life-time hours of employment shall mean total years of employment since hire date and hours worked for the Steamfitters Industry Trust Funds. A Participant's status remains intact and unalterable after the Participant's date of retirement, regardless of any future employment activity of any future employment activity
Medicare is a federal health insurance program which provides health care for:
• People 65 or older,
• People younger than 65 who have certain disabilities, and
• People of any age who have permanent kidney failure
You are covered on the first day of the second calendar quarter following any period of four or less consecutive calendar quarters in which you are paid for 1000 hours by an employer obligated to contribute to the Welfare Fund.
For Example:
• You start work in covered employment in January.
• Between January 1 and June 30 you are paid for 1000 hours in covered employment.
• You allow for the waiting period of one calendar quarter – from July 1 to September 30.
• Your coverage becomes effective on October 1.
Once your initial coverage begins, it lasts for at least one year from the time it started. Thereafter, your hours are reviewed at the end of each calendar quarter. You will continue to be covered as long as you are paid for 1000 hours in covered employment during every four consecutive calendar quarters.
If you are not paid for the required 1000 hours within four consecutive calendar quarters, your coverage will terminate at the end of the next calendar quarter.
Yes, However if your calculation was less than a 1,000 but above 800 hours for the first time in your career, you will be granted a once in a career quarter eligibility extension.
. A federal law, commonly referred to as COBRA, requires that group health plans offer participants and their families whose coverage would otherwise end, the opportunity for a temporary extension of health coverage called "Continuation Coverage" at their own expense. If your loss of coverage is due to insufficient hours, you and your qualifying dependents may continue coverage for up to 18 months. In certain disability situations, coverage may be available for an additional 11 months for a total of 29 months of continued coverage. Spouses of deceased employees upon re-marrying, divorced or legally separated spouses and dependent children who are no longer covered when they reach the age specified in the Plan may extend coverage for up to 36 months. If you become divorced or legally separated or your children no longer qualify as dependents, you must notify the Fund Office in writing within 60 days to protect their COBRA rights.
The Welfare Fund will charge those electing COBRA coverage up to 102 percent of the Fund’s cost of coverage, except that for the extended coverage available only to disabled employees, the cost will be 150 percent of the cost of coverage. Employees covered by COBRA must request the extended coverage in writing within 60 days from the date the employee is notified of the right to continue coverage.
Complete details concerning the COBRA coverage are available from the Fund Office.
You are required to submit a copy of your marriage certificate, [not your license] and a copy of your spouse’s social security card directly to the Welfare Fund. You can upload these documents securely by logging on to your member portal.
The Health Reimbursement Account benefit has been designed specifically to provide you and your families with the ability to pay Medical Care Expenses which are not covered by insurance, not covered by the Steamfitters’ Industry Welfare Fund or otherwise not covered under another arrangement.
You, the participant of the Steamfitters’ Industry Welfare Fund, as well as your eligible dependent(s) in the Welfare Fund, are eligible for benefits from the Health Reimbursement Account
The Health Reimbursement Account will accept properly documented claims for benefits for dates of service up to one year from the date the reimbursable expense was incurred.
If, at any time your application is received and your claim is for an amount greater than the balance in your HRA account, the difference between the application amount and your HRA account balance can be transferred to your HRA account from your Security Benefit Fund subject to your authorization. The transfer amount cannot exceed your Security
The following expenses, not already covered by insurance, are reimbursable:
Medical, hospital, dental, vision care, hearing aids, Medicare part B & D premiums, COBRA premiums, qualified long-term care services, assisted living medical costs, other healthcare insurance premiums, and over-the-counter medicinal products.
Yes, items including but not limited to Advil, Motrin, Tylenol, bandages, braces, suntan lotion, and most FSA items are covered and reimbursable.
Unfortunately, the Fund Office does not accept HRA claims via email. You must either mail or drop off the application and related documents to the Fund Office.
