Amendment No. 2
to the NECA-IBEW
Welfare Trust Fund
Restated Plan Rules and Regulations
2003 Edition
For Amendment #1 - Click Here
I. Effective June 1, 2003, Section 2A., Section 4., Section 6., and Section 7. in Article II are deleted and replaced with the following:
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2A. |
Waiver of Initial Eligibility Requirement for New Employer Groups. Newly Indentured Apprentices, and Newly Organized Employees (Stripped). |
For Employees of newly organized Employer groups, Newly Indentured First-Year Apprentices and Newly Organized Employees (Stripped) first participating in the Plan, the initial 420 hours eligibility requirement may be waived subject to acceptance and approval by the Trustees. Such employees who have never before been eligible under the Plan shall become initially eligibile on the first day of the second calendar month in which at least 150 Employer contribution hours are paid by a Contributing Employer.
Thereafter, Eligibility shall continue month to month based on 150 contribution hours in accordance with Section 4 of this Article II except that no accumulated Hour Bank hours in excess of 150 can be used for continued Eligibility until at least a total of 420 contribution hours has been credited to the new Employees’ Hour Bank. Also, eligibility during a disability period as set forth in Section 7 of this Article II shall not be provided until at least 420 contribution hours have been credited to the new Employee.
In order to qualify for this waiver of the Initial Eligibility requirement, an application must be completed and submitted in an appropriate form to the Trust and approved.
All other conditions for Eligibility as set forth in this Article II shall apply to Employees of Employer groups.
Section 4. Continued Eligibility.
An Employee who meets the Initial Eligibility requirements shall continue to be Eligible from month to month as long as he has at least 150 hours in his Hour Bank account. Each month that an Employee’s bank balance is 150 or more hours enables that Employee to be Eligible during the second calendar month after the month that the minimum balance was maintained. If he has less than 150 hours, he may continue Eligibility through COBRA Continuation coverage in accordance with Article V.
Section 6. Reinstatement of Eligibility.
If an Employee’s Eligibility terminates he may again qualify for Health and Welfare Benefits by returning to work with a Contributing Employer and having Employer contributions credited to his Hour Bank equal to at least 150 hours. An Employee reinstates Eligibility on the first day of the second calendar month following the month when his Hour Bank has been credited with at least 150 hours in not more than twelve (12) consecutive months.
If, after twelve (12) consecutive months, an Employee’s bank hours are less than 150 hours and there have been no hours credited through Employer contributions, the Hour Bank balance will be reduced to zero and the Employee must satisfy the Initial Eligibility requirements of Section 3 of this Article II to again become Eligible.
Section 7. Eligibility During Disability Periods.
If an Employee becomes Disabled while Eligible under the Plan, Eligibility may be continued for a maximum of 21 months from the date of the accident or illness while Disabled. Continued Eligibility due to a Disability is not contingent upon bank hours. However, if an Employee has accrued bank hours, such hours shall be used to continue Eligibility. Hour Bank balances less than 150 hours will be canceled.
However, disabled Employees eligible for coverage in accordance with this Article may not begin self-paying for Supplemental Retiree Benefits following the completion of the 21 months disability self-payment period available to Bargaining and Non-Bargaining/Non-Construction Group Employees. Coverage under this article must begin on the effective date of his first retirement. Refer to Article IV for further Retiree Plan rules.
Disability months will be counted from the first day of the month following the month in which the Disability began. To maintain disability Eligibility, bank hours will first be drawn down at a rate of 150 hours per month. When bank hours are reduced to zero, coverage will continue with no further contribution requirement for the remainder of the 21 month maximum provided the Employee remains Disabled.
If an Eligible Employee was Disabled for less than 21 months, he will be Eligible to continue his Eligibility in accordance with Article V, COBRA Continuation Coverage. Payments may be made for a maximum of 36 months.
If an Employee has exhausted the allowed 21-month maximum, he may continue Eligibility for a maximum of 36 months in accordance with Article V. Thereafter, he must have at least three (3) consecutive months of eligibility, based on employer contributions for purposes of requalifying for the “21 month” extension of welfare benefits and/or for requalifying for the “26 week” weekly income benefits.
II. Effective June 1, 2003, Section 3. and Section 5., in Article III, are deleted and replaced with the following:
Section 3. Continued Eligibility.
An Employee who meets the Initial Eligibility requirements shall continue to be Eligible from month to month as long as a monthly contribution is made on his behalf by a Participating Employer. Each month that an Employee has the sufficient contributions made on his behalf enables that Employee to be Eligible during the second calendar month after the month that the contributions were made. If no monthly contribution is paid, he may continue Eligibility through COBRA Continuation Coverage in accordance with Article V.
With respect to Non-Bargaining Construction Employees only, each month a monthly employer contribution is received by the Fund on behalf of the Employee, the Employee shall be credited with 10 contribution hours in an individual Hour Bank Account for use in earning future eligibility in accordance with Section 2 of Article II. The Hour Bank Account shall not be applicable to Non-Construction Bargaining Group Employees.
Section 5. Eligibility During Disability Periods.
If an Employee becomes Disabled while Eligible under the Plan, coverage may be continued for a maximum of 21 months while he remains totally disabled.
However, disabled Employees eligible for coverage in accordance with this Article may not begin self-paying for Supplemental Retiree Benefits following the completion of the 21-month disability self-payment period available to Bargaining and Non-Bargaining/Non-Construction Group Employees. Coverage under this Article must begin on the effective date of his first retirement. Refer to Article IV for further Retiree Plan rules.
Disability months will be counted from the first day of the month following the month in which the Disability began. To maintain Disability Eligibility, bank hours, if any were accrued under special circumstances, will be first drawn down at a rate of 150 hours per month. When bank hours are reduced to zero, coverage will continue with no further contribution requirement for the remainder of the 21 month maximum, provided the Employee remains Disabled.
If an Eligible Employee was Disabled for less than 21 months he will be Eligible to continue his Eligibility in accordance with COBRA Continuation Coverage in Article V.
If an Employee has exhausted the allowed 21-month maximum, he may continue Eligibility for a Maximum of 36 months in accordance with COBRA Continuation Coverage in Article V. Thereafter, he must have returned to active, actual, full-time work (40 hours per week) (as opposed to merely having hours imputed and/or reported on his or her behalf) and must have earned eligibility for at least three (3) consecutive months of eligibility, based on employer contributions for purposes of requalifying for the “21 month” extension of welfare benefits and/or for requalifying for the “26 week” weekly income benefits.
III. Effective June 1, 2003, Schedule D – COMPREHENSIVE MAJOR MEDICAL BENEFIT in Article VI is changed as follows for the “Deductible per Calendar Year.”
Deductible per Calendar Year*
Individual Maximum..........................................................$
Family Maximum.............................................................$1,500
* If the Calendar Year Deductible was met prior to June 1, 2003, the additional Deductible amount must be met for claims incurred on or after June 1, 2003.
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IV. Effective June 1, 2003, the following co-payment amount is added to Schedule D - COMPREHENSIVE MAJOR MEDICAL BENEFIT in Article VI.
Physician Office Visit...........................................$10 co-payment
V. Effective June 1, 2003, Schedule D – COMPREHENSIVE MAJOR MEDICAL BENEFIT in Article VI is changed as follows for the Deductible under the “Organ Transplants (Centers of Excellence)*:”
Deductible...........................The Plan’s $500.00 individual Deductible.
VI. Effective June 1, 2003, SCHEDULE OF MEDICAL BENEFITS RECEIVED IN ALABAMA Section 1 “Deductibles.” in Article VI is deleted and replaced with the following:
Deductibles.
Out-of-network expenses are subject to a $500.00 per Person, $1,500.00 per family Calendar Year Deductible.* In-network expenses are subject to a hospital In-Patient Deductible of $500.00 per confinement, up to a maximum of three Deductibles ($1,500) per Eligible Person per Calendar Year.
* If the Calendar Year Deductible was met prior to June 1, 2003, the additional Deductible amount must be met for claims incurred on or after June 1, 2003.
VII. Effective June 1, 2003, SCHEDULE OF MEDICAL BENEFITS RECEIVED IN ALABAMA Section 1 “Alabama Schedule of Benefits.” for Out-of-Network Physician Office Visits (including specialists) in Article VI is deleted and replaced with the following:
Out-of-Network
Physician Office Visit
(including specialists)...................................................Plan pays 75% after
VIII. Effective June 1, 2003, Section 4. Covered Medical Expenses in Article XII, the first paragraph of Number 23 is deleted and replaced with the following:
23. charges for organ transplants which are defined as non-experimental by the Centers for Medicare and Medicaid Services (CMS) for the condition being treated including, but not limited to: kidney, cornea, bone marrow, liver, heart, lung, heart/lung, pancreases, pancreases/kidney. The Plan’s $500 individual Deductible applies. Benefits are provided in accordance with Schedule D of Article VI. The following services are included:
A quorum of the Trustees in attendance at a Board of Trustees’ meeting held in New Orleans, Louisiana, on October 16, 2003 approved by majority vote the above-stated changes.
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