Other Eligibility Provisions

Eligibility During Disability

You are not entitled to Eligibility During Disability for a disability that begins while you are maintaining your eligibility by making short-hours or COBRA self-payments.

Disability Hours

If you become totally disabled and satisfy the requirements described below, you will be credited with disability hours during your period of disability at the rate of 8 hours per day, Monday through Friday. Disability hours will be granted until the end of your disability, however, the maximum period of time your eligibility can be continued using disability hours is 12 consecutive months.

Three-Rule Requirement

You will be eligible for disability hours only if you meet all 3 of the following rules. Hours for which you made a short hours self-payment do not count toward satisfaction of these rules.

  1. You must be eligible (from working) on the date your disability starts; AND
  2. You must be eligible (from working) for the benefit month which next follows the benefit month in which you became disabled; AND
  3. You must have worked enough hours and have been credited with sufficient disability hours in the eligibility month in which you became disabled to satisfy the Plan's Continuing Eligibility rules.

Example 1 - You become disabled on September 10 after working the following hours:

Eligibility Month Hours Worked in
Eligibility Month		 Benefit Month
July 150 September
August 125 October
September 50 November

Example 2 - In this example, your disability date remains September 10, but you worked the following hours prior to becoming disabled

Eligibility Month Hours Worked in
Eligibility Month		 Benefit Month
July 150 September
August 25 October
September 50 November

Example 3 - Again, you become disabled on September 10, but in this example your hours are as follows:

Eligibility Month Hours Worked in
Eligibility Month		 Benefit Month
July 150 September
August 100 October
September 10 November

Additional Rules Governing Eligibility During Disability

  1. These provisions apply to non-work-related disabilities. They also apply to work-related disabilities if you become disabled on the job while you are working for an employer who is making contributions to the Fund under a collective bargaining agreement or participation agreement, or if you are an employee of the Fund and become disabled on the job. If you become disabled on the job while working for an employer who is not signatory to a collective bargaining agreement or participation agreement, or other than while on the job for the Fund, you will not be eligible for disability hours.
  2. The maximum period that your eligibility will be continued under these rules is 12benefit months. However, if your eligibility is continued under this provision and you return to employment for a contributing employer before the expiration of 12 benefit months, your eligibility will be continued for the rest of the benefit month in which you return to work on a continuous full-time basis and for the next two succeeding benefit months. This permits your eligibility to be continued without interruption while you are earning future eligibility because of your return to work.
  3. If you qualify for disability hours and if you recover in the same month in which your total disability began, you will be eligible in the benefit month related to the eligibility month in which you were totally disabled, provided you would have been eligible under the Plan if you had worked full-time for a contributing employer during your period of total disability.
  4. If you are covered under this provision for the allowed 12 months and are still disabled and unable to go back to work, or if you recover from your total disability but there is no work available in your jurisdiction, you may be entitled to continue coverage by making COBRA self-payments (see COBRA Coverage starting on page 26).
  5. If you recover after receiving disability hours and you do not go to work for an employer contributing to Lineco, your coverage will terminate on the date you are no longer disabled or the date your coverage terminates under the Continuing Eligibility rules of the Plan, unless you elect and make correct and on-time COBRA self-payments.
  6. If you die while you are covered under these provisions and you have not accumulated any further eligibility, your dependents will be covered for 3 more months starting with the first day of the month following the month in which you die. After the 3-month period, your dependents may be entitled to continue coverage by making COBRA self-payments.

Eligibility During Military Service

If you leave employment with a contributing employer to enter active duty in the uniformed services of the United States, any credited hours you have accumulated will be frozen during your period of active duty. After your release from active duty under circumstances entitling you to re-employment under federal law, your eligibility and accumulated credited hours will be reinstated on the date you return to work with a contributing employer, provided your return to work is within the time prescribed by federal law.

Self-Payments - You and your eligible family members are also entitled to make self-payments for continued coverage for up to 24 months, regardless of any coverage provided by the military or government. The payment amounts, rules and provisions for continued coverage during military leave are very similar to COBRA coverage. This Plan will pay primary benefits before the military/government pays except for service-related disabilities.

Credited Hours During Short-Term Service - The following provision applies if you perform active duty in the military service for 30 days or less, provided you meet ONE of the following requirements:

If you meet one of the above requirements, you will be credited with up to a maximum of 8 credited hours per business day while you are performing the active military duty. These credited hours may be used for the purpose of satisfying the Continuing Eligibility requirements as though the hours had been earned from working.

For More Information - More information about the re-employment rights of persons returning to work from the uniformed services of the United States is available from the Veterans' Employment and Training Administration of the United States Department of Labor. For more information about your self-payment rights during military service, contact the Fund Office.

Family Medical Leave Act (FMLA)

If you are entitled to leave under the Family and Medical Leave Act, your eligibility will be continued for up to the maximum period required by federal law (usually 12 weeks) upon receipt of a copy of appropriate certification from your employer and a record of the approved leave time.

JATC School Eligibility

If you attend a Joint Apprenticeship Training Committee-sponsored school, you will receive credit at the rate of 8 hours per day, up to a maximum of 120 credited hours during your lifetime. You will only receive credit for JATC school if you would otherwise have been working in covered employment. If your JATC class does not prevent you from working in covered employment, you will not receive credit for those hours.

Eligibility for Weekly Income Benefits

The eligibility rules governing the Weekly Income Benefits are explained on pages 38-39.

Reciprocity

Lineco is signatory to the International Brotherhood of Electrical Workers Reciprocal Agreement. The purpose of the reciprocity agreement is to permit you to retain eligibility when contributions are made for you to another IBEW welfare fund.

The Electronic Reciprocal Transfer System (ERTS) has replaced the paper IBEW reciprocity system. If you want Lineco to be your home fund when you travel outside of Lineco's jurisdiction, you should register with ERTS at any IBEW Local Union office, and advise the fund office in whose jurisdiction you are working to send your contributions to Lineco.

Surviving Dependent Eligibility

If you die while making COBRA self-payments for yourself and your dependents, your surviving dependent spouse may be entitled to make COBRA self-payments according to the COBRA coverage rules and subject to the following additional rules:

  1. COBRA self-payments may only be made for up to a maximum of 36 months, minus the number of self-payments you had made before your death; and
  2. If your surviving spouse dies while she is making COBRA self-payments for herself and any dependent children, the children (or their guardian) can make COBRA self-payments for up to 36 months, minus the number of self-payments made by you and by your spouse prior to your respective deaths, unless coverage terminates earlier according to the termination rules on page 24.

If you die while you are an eligible employee (who is not making COBRA self-payments), coverage under the Plan for your surviving dependents may be continued according to the rules explained below.

  1. Your surviving dependents may be entitled to an automatic continuation of coverage as follows:
    1. If you were covered under the Eligibility During Disability provisions at the time of your death, your dependents will continue to be covered for 3 months starting with the first day of the month following the month in which you die; or
    2. If you were not covered under the Eligibility During Disability provisions at the time of your death, your dependents will continue to be covered through the end of the benefit month for which you had earned eligibility before your death.
  2. After that, your spouse can continue coverage for herself and your children by one of the two following methods:
    • Making COBRA self-payments; or
    • Making Surviving Dependent self-payments.
    If your spouse chooses to make COBRA self-payments, she will not be entitled to make Surviving Dependent self-payments at any future date. Similarly, if she chooses the Surviving Dependent self-payment option, she will lose the right to elect COBRA coverage at any future date. If you are not survived by your spouse, your children's coverage can be continued under COBRA coverage.

COBRA Coverage for Surviving Dependents - If your surviving spouse chooses this option, the rules governing COBRA coverage (pages 26-28) will apply.

Surviving Dependent Self-Payments - If your surviving spouse is under age 62, she can make self-payments to continue coverage for herself and any of your surviving dependent children in accordance with the following rules:

  1. Your spouse will have a choice of the following coverage options:
    1. Medical benefits only, which includes the Routine Physical Exam Benefit, the Diagnostic X-Ray and Lab (DXL) Benefit, the Comprehensive Benefit, the Mental Health and Substance Abuse Benefit, and the Prescription Drug Programs. (No Routine Physical Exam or DXL Benefits are payable for children.); or
    2. Medical benefits plus the Dental Benefit and the Vision Care Benefit.
  2. The amount of the monthly self-payment is determined by the Trustees and may be changed at any time.
  3. Your spouse must make her first self-payment on or before the date on which a self-payment to maintain continuous coverage is due. There must be no lapse in coverage.
  4. Each subsequent payment must be postmarked no later than the 15th day of the month preceding the benefit month for which she is paying. Payments postmarked after the 15th will not be accepted.
  5. If your spouse fails to make a self-payment on or before the date it is due, her eligibility and the eligibility of any of your surviving dependent children will terminate at the end of the benefit month for which she had already paid. She will not be allowed to make any future self-payments.
  6. Once a self-payment has been accepted by the Fund Office, it will not be returned.
  7. When your spouse becomes age 62, her coverage under the active employee Plan will terminate and she will then be able to make self-payments for the Plan's Retiree Benefits.
  8. Your spouse can continue to make self-payments until she remarries, becomes covered under another group health care plan, or until one of the other events specified in No. 9-c on page 24 occurs.
  9. If your spouse doesn't elect to make Surviving Dependent self-payments when she is first entitled to do so, she will not be permitted to make self-payments at any future date.

Coverage for your surviving dependent children will terminate if your surviving spouse's coverage under this provision terminates for any reason—for example, if she remarries, becomes covered under another group health care plan, fails to make a timely self-payment, or dies. However, if she continues to make self-payments for Retiree Benefits when she becomes age 62, your dependent children will remain covered as long as she does, provided they continue to meet the Plan's definition of a dependent.