Active Employees

Family Health Benefits

Active Participants & H Plan Employees

Prior to the start of your eligibility, you will be sent notification from the Fund Office as well as more detailed information regarding the benefits summarized below. These benefits are available for you and your family when medically necessary and not the result of a work related accident.

This chart contains information on the benefits available for your work classification. If you are self-paying for your coverage due to disability or unemployment or are on COBRA, refer to the Summary Plan Description (SPD) for the benefits available to you and your eligible family members. Certain restrictions, limits, pre-authorizations, deductibles and co-pays apply. Refer to the SPD for details. If there is a discrepancy between the SPD and the Plan Document, the Plan Document governs.

Active Electrical Worker H Plan Employees
Requirements 135 hours/payroll month  

135 hours/payroll month

 

Medical (office visits, doctor charges, etc.)

Through UnitedHealthcare Choice Plus Network Only

Well Woman

Through UnitedHealthcare Choice Plus Network Only

Routine Physicals

Through UnitedHealthcare Choice Plus Network Only

Lab & X-rays

Through UnitedHealthcare Choice Plus Network Only

Chiropractic care, physical therapy, occupational therapy, & speech therapy

Contact UnitedHealthcare for Pre-Notification

1-800-850-1418

Through UnitedHealthcare Choice Plus Network Only

Contact OneNet for Pre-Notification

1-800-850-1418

Hospitalization & Surgery
Contact UnitedHealthcare for Pre-Notification1-800-850-1418

Through UnitedHealthcare Choice Plus Network Only
Contact UnitedHealthcare for Pre-Notification

1-800-850-1418

Maternity & Gynecological Care

Maternity benefits not available to dependent children

Maternity benefits not available to dependent children

Through UnitedHealthcare Choice Plus Network Only

Emergency Room
Employee Assistance Plan (Business Health Services)
Substance Abuse & Mental Health

Contact Business Health Services for Benefit Navigation

1-800-765-EAPS

Through EAP Only

1-800-765-3277

Prescription Drugs N/A
Dental Effective 1/1/04
Vision N/A
Hearing
Death N/A
Accidental Dismemberment & Loss of Sight N/A
Weekly Accident & Sickness N/A
Supplemental Occupational Benefit N/A

Office Workers

You are considered an Active Non-Bargaining Unit Employee eligible for benefits under this Plan if you work in a job category that is not subject to a collective bargaining agreement, and work for an employer who has a collective bargaining unit agreement with IBEW Local 26 as well as a special written participation agreement with the Board of Trustees for Active Non-Bargaining Unit Employees.

If you are an Active Non-Bargaining Unit Employee, your employer must make contributions to the Plan on your behalf for two consecutive months. The agreement with your employer require that contributions on your behalf begin for the payroll month following the first month in which you work 60 or more hours.

You are NOT considered an Active Non-Bargaining Unit Employee and are not eligible to participate if:

  • you are a part-time or temporary employee who has never worked more than 60 hours in a payroll month;
  • you are hired and work only during the months of May through September of any year regardless the number of hours worked;
  • you are not actively employed for wages; or
  • your employer does not employ at least as many Active Electrical Workers as it does Active Non-Bargaining Unit Employees.

Eligibility

If you worked hours in (Qualifying Month) and your employer pays the premium you will be eligible for benefits in (Coverage Month) If you worked hours in (Qualifying Month) and your employer pays the premium you will be eligible for benefits in (Coverage Month)
January March July September
February April August October
March May September November
April June October December
May July November January
June August December February

Disabled Children

Disabled children are covered under the Plan if the child is totally disabled (that is, completely unable to perform the normal activities of a person of the same age and gender). You are required to provide proof of the disability before your child reaches age 19 and show that he or she is dependent upon you for support. From time to time, the Board of Trustees may require proof that your child remains disabled and financially dependent upon you.

Dependents

Generally, coverage for your dependent begins on the date you become eligible (either as an Active Electrical Worker, Active Non-Bargaining Unit Employee or Retired Employee), or if later:

  • the date of birth for natural children;
  • the date of marriage for spouses and stepchildren;
  • the date of placement for adopted children or foster children; or
  • the date that you began supporting the child(ren)

If you wish to add dependents to your coverage, refer to the Forms page for EWTF to download the necessary documents. You may be asked to provide additional information (i.e., including but not limited to copies of marriage licenses and birth certificates).

It is the participant’s responsibility to notify the Fund Office of a change in marital or dependent status. If the Fund Office is not notified timely and claims or prescriptions are paid when not eligible, the participant will be responsible for refunding the overpayment made by EWTF.

Click here if you would like to see the benefits available to spouses and dependent children of active employees.

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