MICHIGAN CARPENTERS’ HEALTH CARE FUND

COMMON QUESTIONS ASKED

 

How are my benefits Funded?

 

The primary source of financing for the benefits provided under the Health Care Fund and for the expenses of Fund operations is employer contributions.

 

What are the Fund’s eligibility requirements?

 

Initial eligibility requires $553.00 of contributions within one (1) months or less. There is a two (2) month bookkeeping period in which you are not eligible.

 

Continuing eligibility requires at least $553.00 of employer contributions within one (1) month. There is a two (2) month bookkeeping period in which you are not eligible.

 

Any contributions in excess of $553.00 per month, is applied to a dollar bank which can be utilized when you do not have sufficient contributions to maintain eligibility

 

What do I do if my employer does not remit my fringes?

 

First call your employer. There may be a very good reason that the fringes have not been remitted. If your employer cannot explain the reason to your satisfaction, you should contact the Local Union.

 

How can I add my dependents to the Plan?

 

Complete a “Membership and Record Change Form” and submit copies of marriage or birth certificates.

 

What do I do when I get divorced?

 

You must send a copy of your complete divorce decree otherwise coverage will be maintained for your ex-spouse. If the Fund pays for benefits that should not be paid because your spouse no longer meet the definition of a dependent, you will be held responsible.

 

When does coverage stop for my dependent children?

Dependent children are covered through the end of the year in which they turn 19 unless they meet the requirements for maintaining coverage. The Plan requires the following to maintain coverage beyond the age of 19; the child is dependent on the participant for more than half of their support, related to the participant by blood, marriage or legal adoption and is a full time student for at least five months of the year.

 

Can I continue coverage when I retire?

 

Yes provided you meet the retiree requirements for maintaining coverage.

 

What are the self-payment rates?

 

Active participant and family -----------------------------       $553.00 per month

Retiree not Eligible for Medicare--------------------------      $553.00 per month

Retiree eligible for Medicare------------------------------     $129.00 per month

 

What is COBRA?

 

COBRA is the Consolidate Omnibus Budget Reconciliation Act of 1986. COBRA requires that the Fund provide coverage for participants and their dependents that may not otherwise be offered. COBRA is available for dependents who no longer meet the definition of a dependent as defined by the Plan. The rates are 102% of the actual cost of providing benefits.

 

What is Coordination of Benefits?

 

Coordination of Benefits or COB coordinates benefits with other health benefits you may have such as coverage through your spouses employer.

 

What are Flex Benefits?

 

Flex benefits are provided for participants on the Supplement to Medicare program and can be utilized for prescription drugs only.  The maximum payable is $750 per family, per fiscal year (September 1, through August 31).

 

When will I be eligible for Flex Benefits?

 

In order to be eligible for Flex Benefits you must have been eligible for at least 6 months prior to utilizing the benefits.