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Skip Navigation LinksHome » Health Benefit Info Active » Coverage  
 

General Information
When your coverage under the Active Plan of benefits ends due to a reduction in hours worked or a qualifying life event, you have options for continuing coverage in the Chicago Regional Council of Carpenters Welfare Fund.  By electing one of the continuation of coverage options described below and paying the premium payment on or before the due date you can be confident that you have coverage when you need it. You must chose and elect the coverage in writing and make all required monthly premium payments by the required deadlines. 

  •   Active Plan Coverage through the Self-Pay of Hours Option;
  •   Active Plan Coverage under COBRA; or
  •   Low Cost Medical Plan

Click here to download and print a copy of the Notice of Health Care Procedures.

Click here to download and print a copy of the Continuation of Coverage Options Brochure.

Continuation Coverage Under Self-Pay of Hours 

The Board of Trustees amended the Plan effective December 1, 2017 to provide for a self-payment of hours option for participants who have not worked sufficient hours to maintain eligibility.  If you are an Active Participant who loses coverage in the Active Plan of Benefits as a result of a reduction in contributory hours that causes you to fail to meet the Plan’s eligibility requirements, you are eligible to elect the self-pay option to continue your coverage if certain conditions are met:

  • You were eligible for benefits during the preceding coverage quarter, and
  • You are a member in good standing with your local union (e.g., your dues must be current, and not in arrears), and
  • You have not exhausted the maximum number of self-payment quarters allowed, and
  • You are not a retiree.

The self-pay option will be offered in addition to continuation of coverage options under COBRA and the Low Cost Plan. 

Premium Payments for the Self-Pay Option

The premium amount due for the self-pay option is calculated as the lesser of:

  •  the difference between 250 hours (200 hours for apprentice reduced benefits) and the number of hours contributed on your behalf in the calendar quarter, multiplied by the current Commercial Health & Welfare Contribution rate,* or 
  •  the difference between 1,000 (760 hours for apprentice reduced benefits) contribution hours in the current and three immediately preceding calendar quarters and the hours contributed on your behalf, multiplied by the current Commercial Health & Welfare Contribution rate.*

*The contribution rate is determined in accordance with the terms of the Commercial Area Agreement for Cook, Lake and DuPage Counties between the Mid-America Regional Bargaining Association (“MARBA”) and the Chicago Regional Council of Carpenters.

 

Example:  Bob worked 210 hours last quarter.  He worked 770 hours during the previous three quarters.  That’s a total of 980 hours over the past four calendar quarters.  He’s short 40 hours for the quarter, and 20 hours for the current and 3 preceding quarters.  

If Bob decides to self-pay to maintain eligibility, he will pay $235.80 (40 hours x $11.79 = $471.60 vs. 20 hours x $11.79 = $235.80).

  Other Important Information about the Self-Pay Option

  • You may self-pay for a maximum of 250 hours per quarter; however, you may only self-pay for a maximum of 4 quarters in a rolling 12 quarter (3 year) period. 
  •  Self-payment of hours do not count toward meeting future eligibility requirements.  Only employer contributions for the hours you worked and hours credited for a short term disability claim count toward calculating future eligibility. 
  • Coverage provided through self-pay runs concurrently with the maximum amount of coverage months provided under COBRA; this means that your total months of potential COBRA eligibility are reduced by the number of months of coverage you receive by making self-payments.
  • The self-pay option cannot be used to establish initial eligibility.
  • The self-pay option may only be elected by Active Participants.  It is not available to retirees and cannot be independently elected by a dependent. 
  •  Apprentices that qualify for the self-payment option will be offered the opportunity to continue coverage under the same level of benefits they lost; either full Active coverage or reduced Apprentice coverage.  

Payment Information:

The self-pay option requires that you make one premium payment to cover the entire insurance quarter.  The full payment is due on the first day of the coverage quarter.  The Plan allows for a 30 day grace period, or last day of the first month in the coverage quarter, whichever is greater (postmark date).  Payments made after the grace period will not be accepted and coverage will not be reinstated. 
 

Coverage Quarter

Last day payment will be accepted (postmark date)

Dec. 1st thru Feb. 28th

Dec. 31st

Mar. 1st thru May 31st

Mar. 31st

June 1st thru Aug. 31st

June 30th

Sept. 1st thru Nov. 30th

Sept. 30th

 Mail Premium Payments to:

Payments should be made by check or money order payable to Chicago Regional Council of Carpenters Welfare Fund. Please include your identification number (as found on the front of your BCBS ID card) or your social security number on each check or money order payment.

Mail your election form and all payments to: Chicago Regional Council of Carpenters Welfare Fund, Attn:  Continuation Coverage, 12 E. Erie Street, Chicago, IL 60611. You are responsible for remitting payment on a timely basis. You will not receive monthly invoices. Call the Fund Office at 312-787-9455, menu option 3, if you have questions relating to eligibility or payments.

Continuation Coverage Under COBRA

The right to continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). Under COBRA you, your spouse and your dependents may continue the same health care coverage past the date coverage would normally end. Under certain circumstances, you may continue:
  • Hospital, Comprehensive Medical and Prescription Drug benefits, or
  • Hospital, Comprehensive Medical, Prescription Drug, Dental and Vision benefits.

You will not be eligible to continue coverage for life insurance, accidental death and dismemberment, short term disability, or the life insurance for dependent.
 
If you have a newborn child, adopt a child, or have a child placed with you for adoption while COBRA continuation coverage is in effect, you may add the child to your coverage. You must notify the Health Benefits Dept., in writing, and provide the required documentation.  It may also be necessary to pay an additional premium.
 

Qualifying Events
Continuation Coverage under COBRA is offered to a covered individual if he/she loses coverage as a result of a qualifying event. Within 14 days of a qualifying event, the Fund Office will send an election notice. Qualifying events include:

  • Termination of your employment (for causes other than gross misconduct);
  • Reduction in your hours;
  • Your death;
  • You becoming entitled to coverage under Medicare;
  • You and your spouse becoming legally separated or divorced; or
  • Your child loses dependent status under the Plan.

Your eligible dependents may elect coverage independently from the employee.

Notifying the Fund Office
You must inform the Health Benefits Department of a legal separation, divorce or a child losing dependent status under the Plan within 60 days of the qualifying event. If you do not notify us within 60 days of such an event, you and/or your dependent will forfeit the right to continuation coverage under COBRA.
 
Monthly Premiums
Your first payment for continuation coverage under COBRA must include payments for any months retroactive to the day your coverage under the Active Plan ended. This payment is due no later than 45 days after the date you or your dependent signed the election form and returned it to the Fund Office.
 
All subsequent payments are due on the first day of each month for which coverage is provided.  If a monthly payment is paid later than the first day of the month but before the end of the 30-day grace period, COBRA coverage will be suspended as of the first day of the monthly coverage period and then retroactively reinstated to the first day of the month when the monthly payment is received.  Any claims submitted for benefits when coverage is suspended will be denied by the Plan and must be resubmitted for payment once coverage is no longer suspended.
 
If payment is received later than 30 days after the due date, all benefits will end immediately. Once your continuation coverage under COBRA is terminated, it cannot be reinstated.

Electronic Payments
In addition to check and money order payment options, we also accept on-line electronic payments from your checking, savings or credit card account.  Please note that for on-line electronic payments an additional convenience service fee applies ($1.50 for checking and savings account transactions and 2.5% for credit card transactions).  Before you can use the on-line electronic payment system, the Fund Office must establish an account for you on the electronic payment website.  To establish an electronic payment account, you will be required to return your continuation of coverage application with the first month’s premium payment in the form of a check or money order.  Separate payments must be made for each UID account.  Payments for multiple UID accounts cannot be combined. Once your account has been established, you may click here and enter your COBRA/Low Cost UID# (without the dashes) to access the electronic payment system.   Follow and complete each step with the requested information.  To assist the Fund Office in processing your electronic payment, you must specify the month(s) you are paying for in the applicable section on the electronic website.  Once you have made your payment, you will receive a confirmation number and a confirmation e-mail will be sent to the e-mail address that you provide on the electronic payment website.   It is recommended that you save the confirmation for your records. Regardless of the method of payment you select, failure to submit timely payment for the premium amount due will result in cancellation of coverage.

Period of Coverage
Coverage Continues for 18 Months – You may elect to purchase continued coverage for you and your eligible dependents for up to 18 months if coverage ends due to your termination of employment or you experience a reduction in hours.
 
Coverage Continues for 29 Months – if your employment ends due to your termination of employment or reduction in hours, and at that time, or within 60 days of the event, a covered individual is totally disabled (as determined by Social Security), coverage for each eligible dependent may continue for an additional 11 months, for a total of 29 months. To continue coverage for an additional 11 months, you must notify the Fund Office of your determination of disability by the Social Security Administration, before the end of the initial 18-month coverage period.
 
Coverage Continues for 36 Months – Your eligible dependents may elect to continue coverage for up to 36 months if coverage ends due to:

  • Your Death;
  • Your entitlement to health care coverage under Medicare;
  • Legal separation or divorce; or
  • Dependent child no longer qualifies for dependent coverage under the terms of the Plan.

Certificate of Creditable Coverage
Within 60 days after coverage first ends and then again after continuation coverage ends, you will be provided with a Certificate of Creditable Coverage (Certificate). The Certificate will specify the period of time an individual was covered under the Plan and additional information required by law. This may help reduce or eliminate any pre-existing limitation under a new group medical plan.
 
In addition, a Certificate will be provided within 45 days after receipt of a request for such Certificate if that request is received by the Fund within two years after the later of the date coverage under this Plan ended or the date continuation coverage ended.

Low Cost Medical Plan

Eligibility for Low Cost Medical Plan
As an alternative to continuation coverage under COBRA if you lose eligibility for medical benefits because you did not have the required hours to meet the eligibility requirements, you are eligible to elect the Low Cost Medical Plan for yourself or for your entire family. Enrollment in the Low Cost Medical Plan constitutes a waiver of continuation coverage under COBRA. Click here for the Low Cost Medical Plan brochure.
 
Your spouse and dependent children are not eligible for the Low Cost Medical Plan unless you, the participant, elect coverage for the entire family.

The Low Cost Medical Plan is not available for Retirees or their dependents.
 
Period of Coverage
Coverage is limited to 18 consecutive months, payable on a month-to-month basis.
 
Monthly Premiums
You must elect and make payment for this option by the last day of the month immediately following the last day of your eligibility.
 
Mail Premium Payments to:
Payments should be made by check or money order payable to Chicago Regional Council of Carpenters Welfare Fund. Please include your identification number (as found on the front of your BCBS ID card) or your social security number on each check or money order payment.

Mail your election form and all payments to: Chicago Regional Council of Carpenters Welfare Fund, Attn:  Continuation Coverage, 12 E. Erie Street, Chicago, IL 60611. You are responsible for remitting payment on a timely basis. You will not receive monthly invoices. Call the Fund Office at 312-787-9455, menu option 3, if you have questions relating to eligibility or payments.

Electronic Payments
In addition to check and money order payment options, we also accept on-line electronic payments from your checking, savings or credit card account.  Please note that for on-line electronic payments  an additional convenience service fee applies ($1.50 for checking and savings account transactions and 2.5% for credit card transactions).  Before you can use the on-line electronic payment system, the Fund Office must establish an account for you on the electronic payment website.  To establish an electronic payment account, you will be required to return your continuation of coverage application with the first month’s premium payment in the form of a check or money order.  Separate payments must be made for each UID account.  Payments for multiple UID accounts cannot be combined. Once your account has been established, you may click here and enter your COBRA/Low Cost UID# (without the dashes) to access the electronic payment system.   Follow and complete each step with the requested information.  To assist the Fund Office in processing your electronic payment, you must specify the month(s) you are paying for in the applicable section on the electronic website.  Once you have made your payment, you will receive a confirmation number and a confirmation e-mail will be sent to the e-mail address that you provide on the electronic payment website.   It is recommended that you save the confirmation for your records. Regardless of the method of payment you select, failure to submit timely payment for the premium amount due will result in cancellation of coverage.

Termination of Eligibility for Low Cost Medical Plan
Your eligibility for coverage under the Low Cost Medical Plan will terminate either: 

  1. When required monthly self-payments are not received by the last day of each month; or
  2. After 18 consecutive months of coverage under the Low Cost Medical Plan.

If eligibility ends for either of these reasons, you cannot enroll in the Low Cost Medical Plan again until you have reinstated (and lost) your eligibility for regular benefits. In addition, after exhausting 18 consecutive months of coverage under the Low Cost Medical Option, you cannot apply for COBRA continuation coverage.

Transferring from Continuation Coverage Under COBRA to the Low Cost Medical Plan  
If you are a COBRA qualified beneficiary (including dependents), and you elected continuation coverage under COBRA for the Active Plan following a qualifying event due to loss of coverage related to the reduction of hours or termination of employment, you may subsequently elect coverage, on a prospective basis, under the Low Cost Medical Plan, at any time during the 18-month coverage period so long as the participant (employee) who lost coverage elects and is covered under the Low Cost Plan.   
 
The option to convert is only available once per COBRA qualifying event. By converting from continuation coverage under COBRA to alternative coverage under the Low Cost Medical Plan, all former qualified beneficiaries effectively waive all existing and future continuation coverage under COBRA under the Active Plan for that qualifying event and, further, waive all COBRA rights under the Low Cost Medical Plan for that qualifying event. You and any other qualified beneficiaries must also follow all election procedures for the Low Cost Medical Plan. 

Combined coverage consisting of continuation coverage under COBRA in the Active Plan and alternative coverage under the Low Cost Medical Plan may not exceed the maximum period of 18 months from the date of the original qualifying event under the Active Plan for each qualified beneficiary electing alternative coverage under the Low Cost Medical Plan.

Conversion Policy
A covered individual also has the option of converting his/her medical coverage to an individual policy. A covered individual may apply for conversion of his/her medical coverage upon termination of medical coverage, COBRA Continuation Coverage or the Low Cost Medical Plan coverage. The conversion policy is provided by BlueCross BlueShield.
 
Continued coverage under COBRA or the Low Cost Medical Plan is not the same as conversion coverage. A Covered Individual can convert to an individual policy after continuation coverage ends by contacting BlueCross BlueShield at 1-800-313-4153, provided he/she does so within its time limits.
 
Unlike continuation coverage, the conversion coverage does not guarantee identical coverage and the covered individual must pay for conversion coverage at individual rates, which may be higher than the COBRA or the Low Cost Medical Plan rate.

 

 

 
 

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