Over Age Dependent—Special Enrollment Form (Patient Protection and Affordable Care Act)

The Membership Services Department is beginning the process to enroll overage dependents (Age 19 through the end of the calendar month in which a child attains age 26). The coverage will be effective July 1, 2011.

The Southern California IBEW-NECA Health Trust Fund is a multiemployer Taft-Hartley/ ERISA group plan. As such, the Southern California IBEW-NECA Health Plan was afforded an option by the Federal government to elect grandfather status and therefore maintain the current plan benefits through the expiration of the Inside Wireman collective bargaining agreement: June 30, 2011. The recent mandatory changes that you may have heard about in the media are scheduled to begin on the first day of the Plan year following the expiration of the longest running collective bargaining agreement that was in effect on March 23, 2010 (in this instance, the Inside Wireman Agreement referenced above).

Attached is the Special Enrollment Form for Over-age dependent. Please complete this form and attach a copy of your dependent child's certificate of live birth or adoption papers. The Administrative Trust Funds Office will only be able to process completed forms with the required documentation. Coverage will commence on July 1, 2011 for enrolled dependents age 19 through the end of the calendar month in which the child attains age 26.

You may contact the Administrative Trust Funds Office Monday through Friday from 9AM to 5PM at the toll free number 1-800-824-6935 or (323) 221-5861. You may also visit the Trust Funds' website at www.scibew-neca.org to review the Summary Plan Description, obtain forms, or sign up to access personalized information.

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