EXTENDED COVERAGE

Unemployment

If you are temporarily unemployed but currently available for work (signed on the out-of-work list at Local 447), you may pay a subsidized rate to continue your coverage for up to twelve months after you otherwise would lose eligibility. You must have been covered under the active Plan for at least twelve continuous months immediately prior to being eligible for this subsidized coverage. Contact the Administrative Office for more information about this extended coverage.

Extended Coverage under Family and Medical Leave Act ("FMLA")

Under the federal Family and Medical Leave Act (FMLA), your employer must continue to pay for your health coverage during any approved leave. In general, you may qualify for up to 12 weeks of unpaid FMLA leave each year if:

1. Your employer has at least 50 employees;
2. You worked for the employer for at least 12 months and for a total of at least 1,250 hours during the most recent 12 months; and
3. You require leave for one of the following reasons:
1. birth or placement of a child for adoption or foster care,
2. to care for your child, spouse or parent with a serious medical condition, or
3. your own serious health condition.

Details concerning FMLA leave are available from your employer.

Requests for FMLA leave must be directed to your employer; the Administrative Office cannot determine whether or not you qualify. If a dispute arises between you and your employer concerning your eligibility for FMLA leave, you may continue your health coverage by making COBRA self-payments.

If your employer continues your coverage during an FMLA leave and you fail to return to work, you may be required to repay the employer for all contributions paid to the health plan for your coverage during the leave.

Military Service

You will be eligible to continue coverage in accordance with federal law. If your military leave begins on or after December 10, 2004, you will be eligible to continue coverage for up to 24 months from the date your military leave begins, provided you make monthly payments equal to 102% of the cost of coverage. If you are on military leave for less than 31 days, your employer is required to pay for your medical coverage.

The Plan will continue to cover your dependents if you are deployed for military duty for the length of your deployment, even if your primary medical coverage is provided by the military.

Coverage During Disability

If you cannot work because of disability, full coverage for you and your dependents will continue during your disability, up to a maximum of four months after the last day of the month in which your disability began. Maintaining your coverage under the first four months of a disability will not draw against any hours accumulated in your reserve bank. You must have been covered as an active for at least twelve continuous months immediately prior to being eligible for this subsidized coverage. If you are unable to return to work, eligible for State Disability benefits or in the process of obtaining your Social Security Disability benefits, you are eligible for up to twelve additional months of subsidized self-pay coverage.

COBRA Continuation Rights

In accordance with federal law, you and/or your spouse or dependent children are entitled to self-pay for a temporary extension of health coverage under certain circumstances.

A newborn or adopted child added by the former employee on COBRA is considered a qualified beneficiary. The newborn or adopted child must be added within 30 days of the birth or adoption.

COBRA premium is 102% of the cost for employees who are employed under the labor contract. The Board of Trustees may increase the premium on an annual basis if costs increase to the Plan. You should check with the Administrative Office as to the proper self-payment rate.

For an additional charge and subject to certain notice requirements, the 18-month continuation period shown in the table above may be extended for up to 29 months for any individual (and his or her eligible family members) with a Social Security disability award issued prior to or within a period of up to 60 days following the time of the reduction or termination of employment. Notice of the disability award must be provided to the Administrative Office within 60 days after the latest of the disability determination date, the date of the qualifying event, the date on which the qualified beneficiary loses coverage, or the date on which the qualified beneficiary is informed of the obligation to provide the disability notice, and within the initial 18-month period of COBRA eligibility. The cost for the 11-month extension will be 150% of the cost to the Plan. The 11-month disability extension period will end if the disabled individual recovers before the end of the disability extension period. Contact the Administrative Office for further details about this disability extension.

If your family experiences another qualifying event while receiving 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if notice of the second qualifying event is properly given to the Administrative Office. This extension may be available to the spouse and any dependent children receiving continuation coverage if the employee or former employee dies, or gets divorced, of if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.

The maximum continuation period is 36 months, even if more than one event occurs giving rise to COBRA continuation rights. The 18, 29, or 36 month period of COBRA eligibility is reduced by months of free or subsidized coverage provided in the event of unemployment, disability or death.

COBRA continuation coverage will end before the 18, 29, or 36 month continuation coverage period expires if: (1) you or your dependents fail to pay the required premium on time; (2) you or your dependents become covered, after the date of election, by another group health plan (except a plan that excludes or limits benefits for a preexisting condition affecting you or your dependent, and such exclusion or limitation is enforceable under the Health Insurance Portability and Accountability Act); (3) you or your dependents become entitled, after the date of election, to Medicare; (4) your employer ceases to maintain any health plan for active employees; or (5) you or your dependents qualified for the 29- month maximum continuation period based on disability, but are no longer disabled.

Continuation coverage will no longer be available under this Plan if this Plan terminates.

You or your dependents are responsible for notifying the Administrative Office when divorce occurs or when a child loses dependent status. Notice must be given within six months after the later of: (1) the divorce or loss of dependent status, or (2) the actual loss of coverage. If the required notice is not provided within the time allowed, COBRA self-payment will not be permitted.

Within 60 days after the Administrative Office is informed in writing of an event entitling you and/or your spouse or dependent children to COBRA coverage, the office will provide detailed information concerning the coverage available and its cost. You or your dependents must send the election form to the Administrative Office within 60 days of your loss of coverage or the date of receipt of the notice from the Administrative Office, whichever is later. If you do not send the election form within this 60 days you will lose all rights under COBRA, which may affect your ability to obtain coverage without any pre-existing condition limitation.

Anyone electing COBRA coverage must pay for it retroactive to the date he or she lost coverage under the Plan. Payment for this retroactive coverage is due within 60 days after the date COBRA coverage is elected. Subsequent payments are due on the first day of the coverage month. You are responsible for paying the premium on a timely basis. No bill or notice will be sent. If the premium is not paid within 30 days of the due date, your coverage will be terminated without notice. COBRA, once terminated, cannot be reinstated. No benefit claim will be honored unless the required payment has been received for the period in which the claim was incurred.

If you elect to purchase continuation coverage, coverage for your eligible family members will continue automatically unless your spouse independently declines coverage. Even if you elect not to continue your coverage, your spouse and eligible dependent children may elect continuation coverage. Anyone electing continuation coverage must pay for it.

If your dependents are covered by a regional plan (like a health maintenance organization servicing a limited area) and relocate to another area where your former employer has an active workforce, your dependents may be eligible to elect COBRA coverage under the plan provided for the active employees working in that area. Under no circumstances would such a transfer prolong the 36-month continuation period. Call your former employer for more information.

If your employer ceases contributions to the Fund or withdraws participation in the Fund, employees or dependents will not be offered COBRA. However, if you or your dependents are covered under COBRA when the cessation of contribution or withdrawal occurs, you and your dependents will be able to continue COBRA to the end of the continuation period, i.e., 18, 29 or 36 months. This COBRA continuation will also be terminated if your former employer through which the COBRA was elected has or establishes a plan to cover a class of employees formerly covered under the Plan. Your former employer is required to provide COBRA coverage from that point to the end of your continuation period.

For any questions about your rights under COBRA call the Administrative Office.

Conversion of Medical Coverage for Kaiser Participants Only

When group medical insurance coverage ends you and/or your dependents may be entitled to enroll in an individual conversion plan offered by Kaiser. This coverage may cost more and/or provide fewer benefits than your group health coverage. You only have a limited time to apply for this conversion after your coverage through the group plan or COBRA terminates, so you should call Kaiser as soon as possible. Your right to conversion is discussed in the Kaiser brochure available from the Administrative Office.

Certificate of Former Coverage

The certificate of former group health plan coverage provides evidence of your health coverage under the Plan. If you become covered under a new group health plan that excludes coverage for certain medical conditions, you may need to furnish the certificate to the new plan administrator. You may also need this certificate to buy, for yourself or your family, an insurance policy that does not exclude coverage for medical conditions that are present before you enroll.

If you or your dependent lose coverage under the Plan, you will be furnished with a certificate of former plan coverage. You may need the certificate if your new plan excludes coverage for pre-existing conditions. If you are entitled to COBRA coverage, the certificate will be mailed when a notice for a qualifying event under COBRA is required and after COBRA coverage stops. You may also request a certificate within 24 months after losing coverage.

Inform Administrative Office Of Address Changes

In order to protect your family's rights, you should keep the Administrative Office informed of any changes in the addresses of family members. You should keep a copy, for you records, of any notices you send to the Administrative Office.