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SECTION 3.0 - ELIGIBILITY RULES

  1. Employees: Employees are defined as persons working under the jurisdiction of the “Union”, persons employed by the Union on a full-time basis and any full-time employee, Official or Supervisory Employee of a Participating Employer (providing the Participating employer has executed an “Assent to Participate”) and who has agreed to make the required contributions on their behalf.

  2. Early Retirees: Defined as eligible employees between the ages of 55 but not yet 60 who have elected an early retirement benefit under the Plasterers Local 31 Pension Fund. Such persons shall be eligible to maintain their coverage hereunder by making the required COBRA payment for a maximum period of thirty-six months, commencing with the first month following their retirement date. Further, such participants shall be permitted to make COBRA payments for their dependents for a maximum period of thirty-six months, commencing with the first month following their retirement date.

  3. Retirees: Defined as eligible employees between ages of 60 - 65 who have elected to retire under the Plasterers Local 31 Pension Fund. Such persons shall be eligible to maintain their coverage hereunder by making the required COBRA payment for a maximum period of thirty-six months, commencing with the first month following their retirement date. Further, such participants shall be permitted to make COBRA payments for their dependents for a maximum period of thirty-six months, commencing with the first month following their retirement date.

  4. Qualifying Work Periods: Defined as the period in which a employee must work in order to qualify for benefits in the corresponding benefit period.

  5. Benefit Period: Defined as the period in which the employee is covered by the benefit.

    Qualifying Work Period Benefit Period
    June 1 – Aug. 31 Dec. 1 – Feb. 29
    Sept. 1 – Nov. 30 Mar. 1 – May 31
    Dec. 1 – Feb. 29 June 1 – Aug. 31
    Mar. 1 – May 31 Sept. 1 – Nov. 30
  6. Lag Period: Defined as the three-month period immediately following the Qualifying Work Period and preceding the Benefit Period.

  7. 350 Hour Initial Eligibility Rule: An Employee covered under the Collective Bargaining Agreement of the Union and working for a Participating Employer shall be eligible on the first day of the Benefit Period corresponding to the Work Period in which he has worked three-hundred and fifty (350) hours for a Participating Employer(s). In the event a new participants fails to work 350 hours in such work period, he may be permitted to make a self-payment for the difference between the actual hours worked and 350 hours, providing he has worked at least 100 hours for a contributing employer(s) in the Qualifying Work Period preceding the Benefit Period. New employees who have worked less than one hundred (100) hours for a contributing employer(s) will not be permitted to make a self-payment toward initial eligibility.

  8. Basic 300 Hour Rule: After meeting the initial eligibility rule, an Employee covered under the Collective Bargaining Agreement of the Union and working for a Participating Employer shall be eligible on the first day of the Benefit Period following the Qualifying Work Period in which he has worked three hundred (300) hours for a Participating Employer(s).

  9. 1000 Hour Special Exemption: After meeting initial eligibility, any employee covered under the Collective Bargaining Agreement of the Union and working for Participating Employers, who fails to work three hundred (300) hours in a Qualifying Work Period, but who has worked one thousand (1000) hours in the preceding four (4) consecutive Qualifying Work Periods shall remain eligible during that Benefit Period. Hours for which Voluntary Contributions have been made shall not be considered as hours worked for the purposes of determining eligibility under this provision.


    Shown below is a schedule of the four (4) consecutive Qualifying Work Periods for the 1000 hour Rollback Rule and the Benefit Periods to which they apply for eligibility purposes:

    Qualifying Work Period Insurance Period
    Dec 2003 - Nov 2004 Mar 2005 - May 2005
    Jan 2004 – Feb 2005 June 2005 – Aug 2005
    June 2004 – May 2005 Sept 2004 – Aug 2005
    Sept 2005 – Nov 2005 Dec 2005 - Feb 2006
  10. Self Payment Provision - Active Employees who Fail to Work the Required Number of Hours: Active eligible employees working at the trade for a participating employer, who worked less than three hundred (300) hours in the Work Period, shall be permitted to make a self-payment for the lesser of:

    1. The difference between the hours worked and the minimum of three hundred (300) hours required to maintain normal eligibility in the Plan provided the employee has worked at least 1 hour in the corresponding work period. or,
    2. Provided you have at least 700 hours reported in your Special Exemption Work Period, you may pay the difference between the hours reported in the Special Exemption Work Period and the 1,000 hours required by the Special Exemption Period.
  11. Termination and Payment Requirements: Coverage shall terminate for an eligible participant and his/her dependents on the first day of a Covered Benefit Quarter when requirements as described above have not been met. In order to re-gain coverage under the Plan, a participant must then re-qualify as outlined above in the 350 Hour Initial Eligibility Rule.

  12. COBRA Regulations For Eligible Participants And Dependents: An Eligible Participant or Eligible Dependent (as defined herein) whose group coverage is scheduled to be terminated will be permitted to make individual COBRA payments to maintain his or her Benefits. All such COBRA payments shall be subject to the regulations outlined in this Section 4.0.