Eligibility FAQs

Category 1 Employees: “Bargaining Unit” Employee

Eligibility

A Category 1 employee works under a collective bargaining agreement between an employer and certain Local Unions of the I.B.E.W. Employers who have a collective bargaining agreement with certain Local Unions of the I.B.E.W. will pay the hourly contribution rate stipulated in the collective bargaining agreement to the Trust for each hour of service you have worked. All hours, for the purpose of calculating contributions, will be treated as straight-time hours.

All employers contributions for work you have performed are credited in dollars to your Reserve Account up to a maximum balance of $10,305.00 (9 months). Your Reserve Account cannot accumulate more than that amount. This is a continuing process. You may contact the Fund Administrator to determine the dollars in your Reserve Account.

You and your eligible dependents will be covered on the first day of the second month following the last day of any month in which you have accumulated a reserve of $1150 and if contributions have been made and received in your name for the hours you have worked for one or more participating employers.

On the first day of the calendar month for which you are covered, $1150 is deducted from your reserve accumulation for one (1) month of coverage. The $1150 deduction covers Medical, Prescription Drug, Dental, Vision, Short Term Disability, Life Insurance, Accidental Death and Dismemberment and Member Assistance Program benefits.

You may use your reserve accumulation to extend certain coverages while you are unemployed or working insufficient hours to equal the $745 monthly requirement.

To become eligible and to maintain coverage, you must accumulate a sufficient balance (in dollars) in your Reserve Account in any qualifying month to meet the required charge in the corresponding coverage month for one month’s coverage, as shown in the table below.

Sufficient Balance in the Qualifying Month of…
Provides Coverage for the Corresponding Month of…
May July
June August
July September
August October
September November
October December
November January
December February
January March
February April
March May
April June

 

Category 2 Employees: “Non-Bargaining” Employee

Eligibility

A NECA employer contributing to the Trust for regular employees “Category 2”, may include by executing, one month in advance of initial coverage, a “non-bargaining subscription / participation agreement” that allows coverage for non-bargaining employees subject to the following rules and regulations:

  1. Contributing employers under a Collective Bargaining Agreement with an I.B.E.W. Local Union and who are NECA members, may elect to cover their employees not covered by a Collective Bargaining Agreement, but must cover all such employees if there are less than 5 employees in this Category. Employers with more than 5 employees must cover 80% in this Category. “Employee” does not include the spouse of an owner, unless the spouse is performing bargaining unit work.
  2. Employers electing to cover Category 2 employees must cover newly hired Category 2 employees the first of the month following completion of ninety (90) days of continuous full-time employment by paying the applicable monthly contribution for such coverage in advance. “Full time” means at least eighty (80) hours per month or equivalent pay period.
  3. Contributing employers not electing to cover their Category 2 employees initially may thereafter apply on each successive anniversary date of the Plan, which is January 1st of each year, to enroll their Category 2 employees. All applications and payments must be in the Fund Administrator’s Office by December 15th and thereafter the monthly charge for this group must be paid in advance each month to the Fund Administrator. Acceptance of Category 2 contribution payments is subject to Trustee audit and compliance with the foregoing. An employee may be required to provide satisfactory evidence of good health to the Board of Trustees.
  4. Non-Bargaining Unit Employees do not have a reserve dollar bank accumulation but are eligible for all benefits under this Plan except the Short Term Disability Benefit.
  5. The Trustees shall establish the monthly payment required for Category 2 participants from time to time. The amount of this monthly payment may be obtained by contacting the Fund Administrator’s Office.
  6. Employers electing to cover their non-bargaining unit employees must sign a written subscription / participation agreement acknowledging the above rules and agreeing to be bound by the terms of the Trust Agreement for the I.B.E.W. / NECA Sound and Communications Health and Welfare Plan, and specifically to comply with Trust rules concerning compliance with payroll audits and assessment of liquidated damages and other costs if contribution payments are not received on time.

Self-Payments

Termination of Coverage

Coverage for yourself and your Dependents will terminate:

  1. On the last day of any month in which your account has less than the minimum reserve; or
  2. On the last day of any month in which you fail to maintain the minimum reserve because your employer failed to pay the required contributions; or
  3. On the last day of the calendar month in which you enter military service.

The coverage for a Dependent will terminate when the Dependent ceases to be an eligible Dependent.

Partial Self-Payments

Any participant who loses coverage under this plan due to delinquent payment of contributions by a signatory employer shall be eligible to make self-payments to this Plan for a period not to exceed four (4) months at a rate equal to that charged participants eligible to make payments pursuant to COBRA. In the event the participant’s employer ceases being signatory to an I.B.E.W. Local Union Collective Bargaining Agreement the right to self-pay under this provision shall automatically terminate.

A partial self-payment is equal to the difference between the amount in your Reserve Account and the required monthly deduction. There must be no lapse in coverage, and you must have had coverage in the month immediately proceeding the month for which you want to make a partial self-payment. The prior month’s coverage must not have been provided through COBRA self-payment. If you do not make a partial payment to continue coverage, you will not be eligible to make future self-payments until your Reserve Account has enough employer contributions to pay for a month’s coverage, except as set forth under the Continuation of Coverage rules as outlined in this Benefit Booklet. You must make the required self-payment by the 10th day of the month for which you are self-paying the premium. Such payments shall be payable to the I.B.E.W./NECA Sound and Communications Health and Welfare Plan and remitted to the Fund Administrator.

Requirements to Make a Partial Self-Payment or Use Your Reserve Account

To be eligible to make a partial self-payment or use your Reserve Account to obtain benefits you must be:

  1. Employed by a NECA contributing employer who is signatory to an I.B.E.W. Local Union Collective Bargaining Agreement; or
  2. Available for immediate dispatch to a contributing employer by being registered on the appropriate Local Union’s out-of-work list; or
  3. Working for a NECA employer contributing to another trust that is a party to a reciprocity agreement with the I.B.E.W./NECA Sound and Communications Health and Welfare Plan; or
  4. Eligible to receive, currently receiving or have received an I.B.E.W. Pension, not working in the electrical industry, or disabled.

If you fail to qualify under one or more of the above paragraphs for twelve (12) consecutive months, at the end of the twelfth 12th month your Reserve Account will be forfeited and revert to the unallocated reserves of the Trust.

Other Eligibility Info

If You Are Out of Work

As long as you maintain a Reserve Account balance and comply with one of the preceding paragraphs 1, 2, 3, or 4 above, your benefits will be continued.

If you fail to maintain a sufficient reserve in your dollar bank but then return to work and accumulate the required amount, your benefits will be automatically reinstated as of the first day of the coverage month corresponding to the qualifying month as previously described.

Utilization or Freezing of Reserve Bank

Upon leaving covered employment a participant having reserve hours to his or her credit under this Plan will have the option of:

  1. Running out his or her reserve dollar bank account, or
  2. Serving written notice to the Board of Trustees subsequent to leaving covered employment of his or her desire to freeze his or her reserve dollar bank account for a period not to exceed one year.

This option is for the purpose of avoiding duplicate primary coverage of the participant which would result in unnecessary utilization of their reserve account while primary coverage through another I.B.E.W. health and welfare plan exists. This option is not available unless the participant, upon leaving covered employment becomes a participant in another I.B.E.W. health and welfare plan.

The freezing of reserve hours will become effective on the 1st day of the calendar month beginning subsequent to the date of serving said notice, provided said notice is received by the Plan Manager prior to the 20th of the month. If received after the 20th of the month the freezing will become effective on the 1st of the second following calendar month.

Upon re-entry into covered employment within the one year period from date of serving of the above notice, said participant shall be allowed thirty (30) days within which to file notice of their intention to unfreeze their reserve account.

It is further provided that such unfrozen reserve account shall be reassigned effective the first day of the second month after said participant has returned to covered employment or is available for immediate employment under coverage of this plan.

Reserve dollar banks amounting to less than the required amount for one month of coverage may not be frozen.

If You Move from One Contributing Employer to Another

Your benefits under this Plan will continue provided you have maintained the necessary reserve as of the first of each month. Should you transfer from one contributing employer to another, your Reserve Account will be maintained, and you will not lose any benefits. You should make sure your new employer is contributing to the Trust for you.

If You Change Employment from a Category 1 to a Category 2 Employee

If you are a Category 1 (bargaining-unit) employee and you change employment classification to a Category 2 (non bargaining) employee and have a Reserve Account balance, your accumulated reserve account will be frozen for a period of twelve (12) months. If no contributions are received on your behalf as a Category 1 (bargaining-unit) employee during the twelve (12) months your Reserve Account has been frozen, any dollars remaining in your Reserve Account will be forfeited and revert to the unallocated reserves of the Trust.

Death of Employee

Upon the death of any employee who has eligible dependents covered under the Plan, such dependents shall continue to be eligible for benefits until the deceased employee’s reserve dollar bank account is exhausted. Your dependents are eligible for continuation coverage under COBRA as defined within the COBRA – Continuation of Coverage section of this benefit booklet.

The Maximum Accumulation in Your Reserve Account

The maximum amount you are allowed to accumulate in your Reserve Account is $10,350 (9 months) after your monthly deduction as set by the Board of Trustees.

To check on your Reserve Account each month, contact the Fund Administrator:

United Administrative Services
6800 Santa Teresa Blvd, Ste 100
San Jose, CA 95119
Telephone: (408) 288-4452
Toll Free : (800)541-8059

Reciprocal Agreements

The I.B.E.W./NECA Sound and Communications Health and Welfare Plan is a party to the Electrical Industry Health and Welfare Reciprocal Agreement. If you would like to have your health and welfare contributions sent from the I.B.E.W./NECA Sound & Communications Health & Welfare Plan to your home fund or from the health fund where you are working to the I.B.E.W/NECA Sound & Communications Health & Welfare Plan, contact the Fund Administrator for instructions.

Effective January 1, 2003, all participants must utilize the “Electrical Reciprocal Transfer System (ERTS)” to change reciprocity. You must register on ERTS to participate in reciprocity. For assistance, contact your home I.B.E.W. Local Union or the Fund Administrator.

An election to transfer your contributions to another health fund will act as a release and waiver of any and all claims against the I.B.E.W./ NECA Sound and Communications Health and Welfare Plan once contributions have been transferred and receipted by the health fund of your designation.

If the contribution rate of the funds to which your contributions are transferred is less than the contribution rate of the I.B.E.W./ NECA Sound and Communications Health and Welfare Plan, the smaller amount will be transferred, and the contributions over and above that hourly rate (excess contributions) will be retained by the I.B.E.W./ NECA Sound and Communications Health and Welfare Plan. By electing transfer, you waive any claims that might otherwise be made based on the retention by the I.B.E.W./ NECA Sound and Communications Health and Welfare Plan of these excess contributions.

Eligibility to reciprocate funds shall be governed by the terms and conditions of the Electrical Industry Health and Welfare Reciprocal Agreement.

Notification of Change of Address

From time to time the Fund Administrator may wish to communicate with you in writing in order to inform you of any changes in the Plan adopted by the Board of Trustees, or to obtain information related to your benefits under the Plan or concerning administration of the Plan.

It is your responsibility to notify the Fund Administrator in writing on any change of address. The Plan and Board of Trustees cannot be held liable for failing to provide written notification if you change your address and do not notify the Fund Administrator in a timely manner.

Documents

Summary Plan Description
Enrollment Card

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