NNEBT

QUATERLY ELIGIBILITY, PARTICIPATION REQUIREMENTS AND ENROLLMENT
ALLIED TRADE

[A-1 & A-2 Plans]

Your eligibility for benefits under the Plan depends on the number of hours that you work and the contributions that the Trust receives on your behalf.

Important Terms

New Member: An individual who has never been covered under any Trust benefit program.
Regular Member: An individual who has coverage under the Trust based on quarterly eligibility.
Employment Period: A three-month (quarterly) period for which your employer contributes to the Trust to provide benefits for you.
Covered Period: A three-month (quarterly) period following an employment period during which you are eligible for benefits under the Plan.

Participation Requirements

A New Member must have at least 200 cumulative hours of employer contributions in a 6-month period to become eligible for benefits under the A-1 Plan. Coverage for a New Member will begin on the first of the month following the month in which the member has 200 hours of contributions. A New Member’s initial coverage will be for a two-month period and, thereafter, coverage for a New Member will continue on a month-to-month basis, until the New Member qualifies for quarterly eligibility, as long as a New Member has at least 100 hours of contributions in each succeeding month following the month in which he has 200 hours of contributions. To qualify for quarterly eligibility, a New Member must have hours of contributions during the first month of an Employment Period and be credited with at least 400 hours of contributions in that Employment Period.

A Regular Member, thereafter, must continue to be credited with at least 400 hours of contributions in each subsequent Employment Period to remain eligible for benefits under the A-1 Plan.

A Regular Member will become eligible for benefits under the A-2 Plan once he is credited with at least 450 hours of employer contributions in an Employment Period.

Eligibility Schedule

The following is the schedule that shows the Employment Periods and the corresponding Covered Periods:

1. Covered Period: January - February - March
Employment Period: August - September - October

2. Covered Period: April - May - June
Employment Period: November - December - January

3. Covered Period: July - August - September
Employment Period: February - March - April

4. Covered Period: October - November - December
Employment Period: May - June - July

Pay-in Option

A Regular Member, who has A-1 coverage and who has hours of employer contributions in an Employment Period, can maintain eligibility for A-1 coverage for the corresponding Covered Period, by paying to the Trust the difference between 400 hours and the number of hours for which his employer made contributions on his behalf during the Employment Period.

A Regular Member, who has A-1 coverage and who has no hours of employer contributions in an Employment Period, can maintain, on a one-time basis, A-1 coverage for the corresponding Covered Period, by paying to the Trust an amount equal to 400 contributory hours.

A Regular Member, who has A-2 coverage and who has hours of employer contributions in an Employment Period, can maintain eligibility for A-2 coverage for the corresponding Covered Period, by paying to the Trust the difference between 450 hours and the number of hours for which his employer made contributions on his behalf during the Employment Period or he can convert to coverage under the A-1 Plan by paying to the Trust the difference, if any, between 400 hours and the number of hours for which his employer made contributions on his behalf during the Employment Period.

A Regular Member, who has A-2 coverage and who has no hours of employer contributions in an Employment Period, can maintain, on a one-time basis, eligibility for A-2 coverage for the corresponding Covered Period, by paying to the Trust an amount equal to 450 contributory hours or he can convert to coverage under the A-1 Plan by paying to the Trust an amount equal to 400 contributory hours.

A Regular Member, who has hours of employer contributions in an Employment Period less than 450 but at least 400, will have elected to receive coverage under the A-1 Plan by not paying in for the hours necessary to reach the A-2 requirement of 450 hours.

A Regular Member who converts from A-2 coverage to coverage under the A-1 Plan will not become eligible again for A-2 coverage until he is credited with at least 450 hours of employer contributions in an Employment Period.

A New Member, who has hours of employer contributions in a month, can maintain eligibility for A-1 coverage for the corresponding month, by paying to the Trust the difference between 100 hours and the number of hours for which his employer made contributions on his behalf during the month. A New Member, who has no hours of employer contributions in a month, can maintain, on a one-time basis, eligibility for A-1 coverage for the corresponding month, by paying to the Trust an amount equal to 100 contributory hours.

Any periods of coverage provided through the pay-in or conversion options will be deducted from a member’s COBRA entitlement.

Disability Credits

A Regular Member, who has A-1 coverage and who becomes disabled, will receive a one-time credit for a maximum of 134 hours per month but not more than 400 hours for a period of three consecutive months. A Regular Member, who has A-2 coverage and who becomes disabled, will receive a one-time credit for a maximum of 150 hours per month but not more than 450 hours for a period of three consecutive months. In either case, the disability credits will be applied to the Employment Period for which the member lacks sufficient hours of contributions because of his disability.

A Regular Member, who has received the disability credits and, thereafter, has returned to work for two consecutive Employment Periods will be eligible for additional disability credits.
Any periods of coverage provided through the disability credits will be deducted from a member’s COBRA entitlement.

Enrollment

Members who meet the eligibility requirements may enroll in the Plan by submitting a completed enrollment application to the Trust. Members who meet the eligibility requirements but who do not enroll in the Plan are entitled to coverage only on an out-of-network basis.

Members must notify the Trust of any event that would change the scope of the coverage provided through the member, including a marriage, divorce, birth, adoption or death.

Termination of Coverage

A member’s coverage under the Plan will end -
1. At the conclusion of any Covered Period after the member’s employment ends;
2. At the conclusion of any Covered Period after the member’s employer ceases to be a contributor;
3. If the member’s employer or the member fails to make any required contributions;
4. If the member becomes ineligible because of a lack of contribution hours; or
5. If the Trust ends or modifies the Plan.

A spouse’s coverage under the Plan will end when the member’s coverage ends. A spouse’s coverage also will end upon divorce from the member; provided however, that a former spouse’s coverage will continue under the Plan, if the divorce decree requires coverage for the former spouse; and provided further, that the coverage will end when (a) either the former spouse or the member remarries; (b) the former spouse becomes eligible for Medicare; or (c) the former spouse becomes eligible for coverage under another group plan.

A dependent child’s coverage under the Plan will end when the member’s coverage ends. A dependent child’s coverage also will end when he marries or at the conclusion of the calendar year in which he attains age 19. Provided however, that coverage will not end for a dependent, unmarried child who is between the ages of 19 and 23 so long as the child is a full-time student in regular attendance at an accredited post-secondary school or college and the Trust is provided, by the member, with annual verification from the post-secondary school or college of the enrollment of the dependent child for the spring semester; and provided further, that if a dependent child is handicapped and incapable of earning his own living as of the time his dependent coverage would otherwise end, the Trust will continue to consider him a covered dependent so long as he remains in such condition, provided that the member has submitted proof of the child’s incapacity to the Trust within 31 days of the date on which the child attained the age of 19.

Notwithstanding anything stated above, if a member dies, his spouse and dependents, if otherwise eligible, will remain covered, at no cost, for a maximum period of one year. Any such periods of coverage will be deducted from the COBRA entitlement of the spouse and/or dependents.