Dependent Premium
Dependents Who Are Eligible for Coverage from This Fund Include:
- Your lawful spouse
- Lawful child up to age 26, including adopted children, step-children, foster children and children in your legal guardianship
- Children over the age of 26 who are incapable of self-sustaining employment.
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Dependent Premium
If you have dependents, you may add your eligible dependents to your plan. The Fund requires that you pay a dependent premium of $150 per quarter ($50 per month) to cover all of your eligible dependents. Your dependents must be added to your plan within 30 days of your coverage effective date (except in the instance of a life eventLife events are certain occurrences that will allow you to enroll your dependent(s) without waiting until the Fund's next Open Enrollment.).
Effective as of January 1, 2011 and as required by the Patient Protection and Affordable Care Act of 2010 (the "Affordable Care Act"), the Fund will extend coverage to a participant's eligible children up to the end of the month in which the child attains age 26. Coverage is available whether the child is married or unmarried, regardless of student status, employment status, financial dependency on the participant (except noted below), or any other factor other than the relationship between the child and the participant.
Please note: If the dependent child is married, coverage will not be extended to the child's spouse or children.
As a result of this change, as of January 1, 2011, full-time student verification will no longer be required by the Fund, however, you will be required to verify the eligibility of your dependent children (e.g., by providing a birth certificate), just as you're required to verify the eligibility of any dependent you enroll for coverage. If you remain eligible under the Fund, coverage for the eligible dependent child will generally be provided until the last day of the calendar month in which the child attains age 26.
Your eligible unmarried children over age 26 who are incapable of self-sustaining employment because of mental retardation or physical handicap remain eligible under the same conditions as set forth in the SPD, provided that the disability and the child's coverage began before he or she reached the age of 26.
Please note, dependent coverage is not effective until the premium payment is received. After your initial payment is received you will be invoiced for all subsequent premiums due. Invoices are mailed out approximately 30 days prior to the due date; premium due dates are December 20th, March 20th, June 20th and September 20th.
| Dependents Eligible for Coverage | Required Documentation |
|---|---|
| Legal Spouse | A completed Dependent Enrollment Form  and a certified copy of your marriage certificate. |
| Dependent Children up to age 26 | A completed Dependent Enrollment Form and a copy of their birth certificate (if newborn a copy of the hospital birth record will suffice until you receive the official birth certificate).
|
| Adoption/Guardianship | A completed Dependent Enrollment Form and a copy of the adoption/release papers, guardianship or placement papers issued by a court of law. |
| Mental and Physical Handicapped Dependents age 26 and older |
A completed Dependent Enrollment Form and a completed Disability Application along with any other proof of incapacity including medical records and a statement of financial support. |
When Will You Receive A Bill?
You will receive an invoice about 30 days prior to the due date. Please review your invoice carefully, only the dependents listed on the invoice will be covered. If your dependent information is incorrect, please contact the Fund immediately. If, in the future, you gain or lose a dependent through birth, adoption, marriage, divorce, age ineligibility, or death, please notify the Fund within 30 days of the event. Please refer to the chart below for an example of dependent premium due dates for.
Premium Due Date
| Eligibility Quarter | Due Date |
|---|---|
| January 1 through March 30 | December 20 |
| April 1 through June 30 | March 20 |
| July 1 through September 30 | June 20 |
| October 1 through December 31 | September 20 |
You may pay premiums for more than one quarter at a time, if you wish. If payments are not received by the due date indicated on your invoice, dependent coverage will be terminated.
If You Are A Certified Retiree
With Dependents If you have been deemed a Certified Retiree A participant who satisfies certain requirements is designated as a Certified Retiree. by the Fund and are between the ages of 60 and 64, you are required to pay the dependent premium regardless of the type of coverage you have (retiree or earned). Once you turn 65 the following rules apply: If you are on earned coverage - you will be required to pay the dependent premium. If you are on Certified Retiree coverage - you will be exempt from the dependent premium.
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If You Choose Not To Cover Your Dependents
Should you decide not to continue coverage for your dependents, please let us know by completing and returning the declination form included with your premium invoice. Please note: By declining dependent coverage you will not be able to reinstate your dependent(s) coverage until the Fund's annual open enrollment period in the fall for coverage changes effective January 1st of the following year. Important: The declination of dependent coverage is not considered a qualifying event for COBRA Continuation Coverage for your dependents.
Special Enrollment
If you decline enrollment for your dependents (including your spouse) because of other insurance coverage, you may in the future be able to enroll your dependents in the Health Fund, without waiting until the next Open Enrollment, provided that you request enrollment within 30 days after the other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, placement for adoption, or guardianship, you may be able to enroll your dependents provided that you request enrollment within 30 days after the marriage, birth, adoption, placement for adoption or guardianship.
Please contact the Health Fund with questions regarding the dependent premium.
To enroll dependents please provide the following documentation:
| Relation/Event | Documentation Required |
|---|---|
| Spouse | A certified copy of your marriage certificate. |
| Divorce or Legal Separation | A copy of the final divorce decree or legal separation documents. |
| Child | A copy of the birth certificate. |
| Step-Child | A copy of the birth certificate and the divorce decree, custody information or statement of financial responsibility. |
| Adoption/Guardianship | A copy of the adoption/release or guardianship or placement documents. |
| Mental Retardation and Physically Handicapped* Dependents | Completed attending physicians statement along with any other proof of incapacity including medical records and a statement of financial support. |
| *Having a bodily defect, disability or characteristic that restricts, limits or prevents an individual's participation in normal physical activities or interferes with standard achievements, and/or limits or prohibits an individual's capacity to work or be gainfully employed and requires dependency on parents or other care providers for lifetime care and supervision. | |