Life Events

• Life Events that Affect Your Coverage

  Certain life events may impact your coverage, and failure to notify the Fund Office when they occur could prevent you from getting the most out of your Plan.

  NOTIFY THE FUND OFFICE AS SOON AS POSSIBLE IF YOU EXPERIENCE ONE OF THE FOLLOWING LIFE EVENTS:

  In this Section:

  • Move to a new address
  • A loss of eligibility (dependents)
  • Your marriage or divorce
  • You are terminated / laid-off or your hours or employment are reduced
  • You have a baby / adopt child
  • You become disabled
  • You retire
  • You take Family Medical Leave
  • You become eligible for Medicare
  • You or your eligible dependents enter active military service
  • Your death (your spouse or beneficiary should contact the Fund Office)

  • If You Get Married

    If you are covered under the Plan and you legally marry, your spouse is eligible for dependent benefits. Claims cannot be processed until a certified copy of your marriage certificate is on file at the Fund Office. Your spouse's effective date will be the date of your marriage. You must notify the Fund within 60 days of your marriage.

    NOTE: The below information may be updated electronically by logging into your myLINECO secure member portal located at www.lineco.org.

    Provide the Fund Office with:

    • Updated Family Enrollment Form; and
    • Certified Copy of Marriage Certificate
    • Spouse's Social Security Number
    • Information about any other insurance your spouse has.

  • If You Acquire a Stepchild Through Marriage

    Your stepchild may be eligible for LINECO benefits.

    Provide Fund Office with:

    • Updated Family Enrollment Form;
    • Copy of divorce decree / custody order for stepchild;
    • Stepchild's birth certificate and Social Security Number;
    • Certified copy of your marriage certificate; and
    • Information about your stepchild's other health plans.

    NOTE: The above information may be updated electronically by logging into your myLINECO secure member portal located at www.lineco.org.

  • If You Have a Baby

    Please contact the Fund Office within 48 hours.

    • Updated Family Enrollment Form;
    • Copy of your baby's birth certificate
    • Social Security Number (when it becomes available):
    • Copy of any other health plan information.

    NOTE: The above information may be updated electronically by logging into your myLINECO secure member portal located at www.lineco.org.

  • If You Adopt a Child

    Contact the Fund Office. The Plan will cover the child as of when they are placed in your home.

    Provide the Fund Office with:

    • Updated Family Enrollment Form;
    • Copy of the adoption certificate or documentation of the start of the adoption proceeding (must include dates when the child was placed in your custody); and
    • Information about your child's other health plans
    • Social Security Number

    NOTE: The above information may be updated electronically by logging into your myLINECO secure member portal located at www.lineco.org.

  • If You Take FMLA Leave

    If you have to take Family Medical Leave time from work, you may be entitled to continue your eligibility in the Plan for up to the maximum period required by Federal law (usually 12 weeks). Please contact your employer about FMLA and have your employer send the approved FMLA forms to LINECO.

    Provide the Fund Office with:

    • Employer-approved FMLA certification form(s).

  • When Your Child Turns 26

    Your dependent children are covered under this Plan until they turn 26. Generally, your child's eligibility under the Plan will stop on the last day of the month in which your child turns 26 (see No. 2 on page 87 for information on continued coverage for a totally disabled child). Your child's loss of eligibility at age 26 is a "qualifying event" (see page 31), and your child may elect COBRA at that time.

  • If Your Dependent's Eligibility for Benefits Changes for any Other Reason

    If for any reason your dependent no longer meets the Plan's dependent eligibility requirements, you must notify the Fund Office immediately. For example, dependents who enter the armed forces on a full-time basis become ineligible for LINECO coverage. Your failure to provide such notice, and the submission of claims while your dependent is no longer eligible for coverage, may be considered an intentional misstatement of material fact and/or fraud.

    If you do not notify the Fund Office when your dependent ceases to meet the eligibility requirements, you will be responsible for reimbursing the Plan for all charges that were paid by the Plan while the dependent was not eligible for coverage.

  • If You Divorce / Legally Separate

    Once you divorce or legally separate, your spouse is no longer eligible for benefits under this Plan, however, your ex-spouse may enroll in COBRA (see pages 31-34). If you do not notify the Fund Office upon divorce, you will be responsible for reimbursing the Plan for all charges that were paid by the Plan on behalf of your former spouse.

    • Updated Family Enrollment Form (update your life insurance beneficiary if you wish)
    • Copy of your divorce decree
    • Copy of any Qualified Domestic Relations Order (QDRO); and
    • If you have children, copy of any Qualified Medical Child Support Order (QMCSO), if applicable.

    If your ex-spouse wants to self-pay for COBRA, they must contact the Fund Office. Your ex-spouse may elect COBRA for up to a maximum of 36 months, provided the Fund Office is informed of the divorce within 60 days of the day the divorce/separation is legally finalized. For more information, see Continuing Your Coverage Under COBRA starting on page 31.

  • If You Become Disabled

    If you are an employee and become disabled, you may be eligible for certain Weekly Income Benefits and disability hours. It is important that you contact the Fund Office as soon as possible to ensure that you fully understand this benefit options (see the Weekly Income Benefit section beginning on page 73).

    To qualify for these benefits, you must visit a medical doctor and be disabled by that doctor within 15 days after your last day of work. In order to qualify for Weekly Income Benefits, your disability must be from a non-occupational accidental bodily injury or illness.

    The Weekly Income Benefit does not apply to retired members or utility / REA members.

    Contact the Fund Office as soon as possible after you suffer a disabling injury or sickness.

  • If You Retire

    Contact the Fund Office at least 3 months prior to your possible retirement from work in the electrical construction industry. ALL requirements must be met in order to qualify for LINECO Retiree Benefits.

    For Early or Normal Retirement, you must meet ALL of the following requirements:

    • At least age 55; and
    • Must be retired from any and all employment in the electrical construction industry; and
    • Must be receiving retirement benefits either from a plan negotiated or sponsored by the IBEW, from a qualified retirement plan, or from Social Security; and
    • Must be eligible for LINECO benefits on the day immediately preceding the effective date of your LINECO retiree benefits; and
    • Must have been eligible for coverage under LINECO due to work hours for 48 of the 60 months preceding the effective date of your LINECO retiree benefits

    For disability retirements, you must meet ALL of the following requirements:

    • Must be receiving disability retirement benefits either from a plan negotiated or sponsored by the IBEW, from a qualified retirement plan, or from Social Security; and
    • Must be eligible for coverage under LINECO on the day immediately preceding the day your disability plan benefits become effective.

  • If You Become Eligible for Medicare

    If you are Medicare-eligible (typically age 65), you are required to sign up for Medicare Part A and Part B. Failing to sign up for both may cause significant out of pocket expense when claims are processed, and you may also be penalized by Medicare for late enrollment.

    You should also notify the Fund immediately if you or your dependent (spouse or child) qualifies for Medicare due to End Stage Renal Disease (ESRD) or Social Security Disability (SSA).

    • Provide the Fund Office with a copy of yourMedicare card

    NOTE: there are changes to the major medical out of pocket maximum and prescription benefits once you, or your dependent, become eligible for Medicare. Refer to the Schedule of Benefits starting on page 7 and Prescription Drug Programs on Page 56 for more information.

  • If You Die

    If you are married and you die while you're covered by the Plan as an active employee or retiree, your surviving spouse may elect to continue coverage under the Plan if he/she is eligible for surviving spouse coverage. This coverage applies to your other eligible dependents covered by the Plan at the time of your death. Your spouse must contact the Fund Office and make timely payments to continue the insurance.

    Additionally, for eligible employees (not utility/REA/ retirees), your beneficiary / dependents may be eligible to collect your $20,000 life insurance benefit and an additional $20,000 if your death was due to an accident.

    Your surviving family members should do the following upon your death:

    • Notify the Fund Office;
    • Provide the Fund Office with a copy of your death certificate;
    • Apply for your life insurance benefit (and AD&D benefit, if applicable); and

    If your spouse is eligible for survivor benefits under the Plan, enroll in the Plan and make timely payments.