Active Health Plan BenefitTabs™
This is a summary of benefits and not a substitute for the Southern California IBEW-NECA Health Plan Summary Plan Description, and to the extent it differs from the SPD, the terms of the SPD will govern.
Eligibility for coverage for Active Employees is based on your working a certain minimum number of hours with one or more Employers who actually make Contributions to the Fund on your hours of employment.
To establish initial eligibility, you must meet the minimum number of hours required by the IBEW Local 11 Inside Wiremen's Agreement on your behalf within four consecutive months. You will be eligible for benefits under the Southern California IBEW-NECA Health Trust Fund the first day of the third month, following receipt of 100 hours of contributions at the rate established from time to time by the IBEW Local 11 Inside Wiremen's Agreement. (For details, please refer to Working Local 11 Electricians.)
Even if an employee's Hours Bank Reserve contains enough hours for initial eligibility, the employee will have no actual coverage (EXCEPT life insurance) until the employee has completed all steps required for enrollment in benefits offered by the Plan. The employee's failure to take appropriate action in enrolling for benefits will cause a reduction in the employee's Hours Bank Reserve without providing the employee with benefits or coverage.
Pro-ration shall apply to provisions in CBAs calling for contributions lower than the standard rate. (For details, please refer to I.O. Health Reciporcal Agreement & Pro-ration Under Certain CBAs.)
Click here to see rules for marital partners.
Click here to see rules for Sound Unit 45%-50% Apprentices.
Dependent EligibilityA dependent of an Eligible Employee becomes eligible at the same time that the Employee becomes eligible, or the date the Dependent is acquired, if later. You must provide the required documentation to complete their enrollment. Dependents include legal spouses and children through the end of the month in which the child attains his or her 26th birthday. A child includes a natural child, a stepchild, an adopted child, an eligible foster child and a child for whom the Employee or Employee's Spouse is the Guardian of the person.
A dependent child who attains the maximum age shall remain an eligible dependent so long as the child is disabled, resides with the employee and is listed as a dependent on the Employee's tax return. See Eligible Dependents for more information.
Waiting PeriodYou will be eligible for benefits under the Southern California IBEW-NECA Health Trust Fund the first day of the third month, following receipt of 100 hours of contributions at the rate established from time to time by the IBEW Local 11 Inside Wiremen's Agreement.
Example 1 – You work 100 hours in January and the employer(s) reported and paid contributions in February. You will be eligible for benefits on May 1st.
- Any hours you work in excess of the required number are placed in an "hours reserve bank." You may accumulate up to 600 hours in this bank. After you establish initial eligibility, you must continue to work the required number of hours each month to continue being eligible. If you work less than the required number of hours but have enough hours in your bank, these hours will be "withdrawn" from your bank to meet the number of hours required for continued coverage.
Losing CoverageYour coverage will end when the combined sum of your worked hours and/or your hour bank is less than the number required for continued coverage.
Your coverage will also end if you are an owner or officer of an employer who is non-compliant with the contributions requirements (typically this means not paying the required contributions). This will take effect 45 days after the Employee has been notified, unless the employer becomes compliant within that 45 day period.
ReinstatementAfter losing coverage, you must once again meet the requirements for initial eligibility.
If you work outside the geographic area of Local 11, you will need to enroll in the Electronic Reciprocal Transfer System (ERTS) in order to maintain coverage in this Plan.
For details and information regarding eligibility for the reciprocity program, please refer to I.O. Health Reciporcal Agreement & Pro-ration Under Certain CBAs.
Additional InfoReview of Plan Eligibility — The Fund Office has prepared a video to understand how to gain and maintain eligibility in the SC IBEW-NECA Health Plan. Take a brief tour and review the video. The video is not a substitute for the Summary Plan Description. Prior to filing any application for benefits, you should thoroughly review the Summary Plan Description (SPD).