Plan Participation

Plans Available by Work Categories

Your Work Category determines when you are eligible to participate in this Plan, how you maintain coverage and when your coverage may end. If you qualify in more than one category, the category that provides the higher level of benefits will apply. You will not be entitled to receive benefits under more than one category.

You and your Eligible Dependents are eligible to participate in this Plan if you meet the requirements under one of the following Work Categories:

The chart below shows the Work Categories and the benefits available to employees, and their Eligible Dependents, that meet the Plan’s eligibility requirements for each category. 

 Active
Electrical Worker
Standard Plan
Active Electrical Worker
“H” Plan
Active Non-
Bargaining Unit Employee (Office Worke
Retired Employee NOT Eligible for MedicareRetired
Employee Eligible for Medicare
Requirements135 hours/
payroll month
135 hours/
payroll month
You work 80 or more hours in a month Must make self-payments for coverageMust make self-payments for coverage
Medical (office visits, lab and x-ray, physicals, chiropractic care)Benefits Supplement Medicare Coverage Only (reimbursement of Medicare annual deductible and Medicare coinsurance)
Hospitalization and Surgery
Maternity and Gynecological Care
Emergency Room
Employee Assistance Plan
Substance Misuse and Mental HealthNo Coverage
Prescription DrugsNo Coverage
DentalNo Coverage
VisionNo Coverage
HearingNo Coverage
Death BenefitNo Coverage
Accidental Dismemberment and Loss of SightNo CoverageNo CoverageNo Coverage
Weekly Accident and SicknessNo CoverageNo CoverageNo Coverage

Termination of Coverage for Participants in All Categories 

Generally, once your coverage terminates, benefits will not be paid for expenses you incur after your coverage terminates. However, if you are totally disabled when your coverage terminates, you will continue to be eligible for benefits for Covered Medical Expenses relating to the illness or injury causing the disability for a period of one year or, if sooner, until you recover from the disability. There are other circumstances when you may be allowed to continue Plan coverage for a specific amount of time. These circumstances are described in more detail in the section “Continuing Your Coverage”, on page 42.