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General Information |
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Who is eligible for benefits?
Any person working under the Collective Agreement of Local Union
97 of the International Association of Bridge, Structural and
Ornamental Ironworkers.
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Does a Member have to complete any forms?
Yes. The Member must complete the following forms:
It is most
important that EACH Member complete the required forms whether
or not he is eligible. These forms should be sent to the
Administration Office without delay.
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How does a Member qualify for benefits?
A person qualifies for benefits when 220 hours or more are
reported by the employer within a 5 month period or less. The
hours reported are put to the credit of each person's HOUR
BANK.
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When will coverage commence?
Coverage will commence on the 1st day of the month following the
month (lag) in which sufficient hours are reported and paid to
the Plan by the employer(s). An example is provided on page 4
of the Health
& Welfare Plan Booklet.
A Member is eligible for all benefits except Weekly Indemnity
after satisfying the normal qualifying conditions of the Plan.
A Member does not become eligible for Weekly Indemnity
coverage until the first day of the second month after the
Member has worked, and the Plan has received contributions,
for 1,000 hours of work with a participating employer.
ATTENTION:
Any Member of Local 97 found to be working for a non-signatory
Ironworker Contractor may have their coverage terminated and
will forfeit any accumulation to their hourbank.
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How does the Hour Bank build for future coverage?
Once a person is qualified, additional hours reported
will be added to the Hour Bank.
As a Member of Local 97, 110 hours will be withdrawn
each month from the Hour Bank for coverage. 8 months
coverage (880 hours) may be accumulated ahead,
which will be drawn upon during a period of poor
employment, lengthy illness or extended vacation.
A person who is not a Member of Local 97 but who is
working under the Local 97 Collective Agreement will
have a charge of 130 hours made against his/her Hour
Bank. A maximum of up to four months coverage
(520 hours) can be accumulated in the Hour Bank.
It should be noted that Local 97 Ironworkers Health &
Welfare Plan has Reciprocal Agreements with the
plans of other Locals of the International Association of
Bridge, Structural and Ornamental Ironworkers and
Members of a Local with a Reciprocal Agreement, will
not receive coverage from the Local 97 Ironworkers
Health & Welfare Plan. Contributions made on their
behalf are remitted to their home Local's welfare plan.
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What happens if the Hour Bank falls short for coverage?
If the Hour Bank drops below 110 hours, the
Administrator will send out a notice as to the balance
in the Hour Bank and the amount required to maintain
coverage. If payment of the amount requested is
received by the deadline specified on the notice,
coverage will be continuous.
Those Members who have a balance of employer
hours in their Hour Bank and, although working
regularly, do not have sufficient work to maintain the
Hour Bank charge, will qualify under "Shortage Hours"
and will receive a billing showing the balance of hours
required to make up the 110 hours needed each
month to provide coverage. Shortage notices do not
reduce the maximum months under self-payment.
Please note that non-Members will not be notified
when their Hour Bank drops below 130 hours.
Self-payment is only available to a Member who was
covered under the Local 97 Ironworkers Health &
Welfare Plan. The Fund is subsidizing the rate and a
self-pay notice will be sent to each Member showing
the amount to be paid.
The first month a Member falls below the110 hours, but
has 90 or more employer hours in his/her Hour Bank,
a self-pay notice will not be sent out and the Fund will
absorb the difference out of general revenue.
For any Member who must self-pay 20 hours or less,
the Plan will pay their MSP premium for that month.
Limitations of Self-Payments
When there are no hours left in the Hour Bank due to
unemployment*, extended holidays, etc., self-payments
may be continued for110 hours X the applicable rate per
month for a maximum of 6 months, with respect to all
benefits except MSP, Long Term Disability and
Weekly Indemnity. Thereafter, this privilege will
only be
available if the Member is totally disabled and unable to
work subject to medical evidence, or a regular or
disabled Pensioner drawing from the Ironworkers
Pension Plan, Local 97. The maximum duration of selfpay
for Pensioners will be set at one year for every 3,000
hours recorded to this Plan. Pensioners retiring on or after September 01, 2010
with 25 years or more of contributions to the Ironworkers Local 97 Pension Plan
may self pay indefinitely.
Members, on self-pay, must obtain their own Medical
Services Plan (MSP) coverage. MSP is not available
through self-payment. For any Member who must selfpay
20 hours or less, the Plan will pay the MSP
premium for that month. To apply for individual MSP
coverage contact:
MEDICAL SERVICES PLAN OF B.C.
P.O. BOX 9035 STN PROV GOVT
VICTORIA, B.C.
V8W 9E3
www.healthservices.gov.bc.ca/msp
Self-pay coverage must be continuous from the date of
termination of coverage through the Hour Bank. If a
Member, whose coverage has lapsed, does not elect
to self-pay, he/she must work and report 220 new
hours to the Plan (the same commencement as for a
new Member).
*Please note: Only Members who are not gainfully
employed (other than through Local 97) will be entitled
to self-pay. A declaration must be signed by all
Members, including early Pensioners, to this effect.
Additional information such as a tax return, may be
requested by the Trustees.
Pensioners can have their self-payments for benefits
directly withdrawn from their bank account. Please see
the Administrator for more details.
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How do reports come in?
The Collective Agreement requires that
employers report, prior to the
15th day of each month, all hours for
which wages are paid to the Member up to the close
of the employer's payroll ending closest to the last
day of the preceding month. It is advisable that Members
keep their own pay slips, as errors may occur
in reporting and tabulating.
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When does coverage end?
Coverage is always provided on a whole-month basis only and will
be terminated when:
- The Hour Bank falls below 110 hours and the Member fails to make a payment by the date specified on the self-pay
notice (Members ONLY) to bring his/her Hour Bank up to the required
hours; or
- 6 consecutive self-payments have already been made to the Fund.
Any Member of Local 97 found to be working for a
non-signatory Ironworker Contractor may have their
coverage terminated and will forfeit any accumulation to their
Hour Bank.
Do not ignore the self-pay notice.
The only sure way
to guarantee continuous coverage is to pay by the date specified
on the notice. If self-payments are not received for two
consecutive months or more coverage will be terminated. In order to recommence self-payments
the Member is required to return to work and accumulate
sufficient hours in his/her Hour Bank once again.
ONLY ONE NOTICE WILL BE SENT OUT... ACT ACCORDINGLY
If a self-pay notice is received and it is thought to be
incorrect, contact the Administration Office immediately. Use the back of
the self-pay notice to explain any errors which are believed
to exist.
In the event that late hours are reported or other
adjustments are found later, the hours will be credited to the Hour Bank for future use.
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If coverage terminates, when will coverage recommence?
When 220 hours have been worked and reported to the Plan, the
same as commencement for a new person. A Member may not re-qualify by
self-payment. If coverage terminates, individual medical coverage
should be applied for through:
MEDICAL SERVICES PLAN OF B.C.
P.O. BOX 9035 STN PROV GOVT
VICTORIA, B.C.
V8W 9E3
www.healthservices.gov.bc.ca/msp
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DISABILITY CREDITS
When a Member is collecting under the Weekly Indemnity Plan/
E.I. Sick Benefits or under Worker's Compensation, will he/she
receive assistance with his/her Hour Bank?
Yes. For each day that they are disabled and, provided
the claim for the Weekly Indemnity Plan/E.I. Sick
Benefits or Worker's Compensation has been
accepted for payment, the Hour Bank will be credited
with contributions of 8 hours per day, subject to a
maximum of 110 hours per month for up to 12 months, for an accident or sickness a member receiving Worker's Compensation will continue to
have hours credited to their Hourbank,
and for a maximum of 6 months if the person is not a
Member of Local 97 at the rate of 130 hours per
month. If the claim is for Weekly Indemnity this will be
done automatically, but for Worker's Compensation or
E.I. Sick Benefits, a special form should be requested
from the Administration office. To qualify for these
Disability Credits the Member must be eligible for
benefits when the disability commences.
If the Member is disabled longer than the maximum
Weekly Indemnity claim of 26 weeks, he/she should
apply to the Administration Office for a form so that
further Disability Credits may be applied to the Hour
Bank.
Please note:
Social Insurance Numbers should be included on
all correspondence to the Plan.
Social Insurance Numbers are used for identification
purposes. Please notify the Administration Office if a
dependent is to be added or deleted from the Plan.
Self-pay notices or any other material mailed by or
under authority of the Administration Office to the
person's last known address is deemed to have been
duly received by the addressee.
Notification of a change of address is the duty and
responsibility of the Member.
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APPRENTICES/B.C.I.T. INSTRUCTORS
Upon graduation from the 1st year course, apprentices
will be entitled to receive Health & Welfare coverage
for
the calendar month following graduation and then will
be entitled to self-pay until hours of work are sufficient
to provide coverage or the maximum self-pay has been
attained. It is understood that Weekly Indemnity will not
be covered until the apprentice is at work.
(Effective June 1, 2006) Individuals who preapprentice
through Local 97 and then begin the Entry
Level Trades Training Program (ELTT), will be entitled
to full coverage under the Plan, excluding all disability
benefits, for up to 6 months, once their Hour Bank runs
out, provided they are in school attending the ELTT
program.
Registered Apprentices (RA), who attend Ironworking
upgrade classes, years 2&3, provided they have less
than 4 months of banked hours in their Hour Bank, will
be credited with 110 hours (one month of coverage) by
the Trade Improvement Committee. These RA's will be
permitted to self-pay for a maximum of 6 months if no
work is forthcoming.
(Effective January 1, 2007) Apprentices will be given 2
months' coverage upon successful completion of the ELTT
program.
B.C.I.T. Instructors will be given one month coverage when they are finished
teaching. When the instructors return to teach at
B.C.I.T., their Hour Bank will be frozen (if they had one)
and will remain frozen until they are finished teaching.
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CO-ORDINATION OF BENEFITS
If an individual is entitled, as a
result of sickness or bodily
injury, to receive similar benefits simultaneously under
the health insurance benefits of any other group insurance
plan (including any service organization or pre-payment
plan), to prevent overpayment, benefits payable
under this Plan will be co-ordinated with any benefits
payable for the same disability under such other
plan, in accordance with the Order of Benefit Determination
provision indicated in the group policy, to
the extent that the total amount paid does not exceed
100% of the incurred covered charges.
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INTEGRATION OF BENEFITS
Claims payment will be reduced by any payment payable under a
No-Fault Auto Insurance Plan or similar legislation.
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What if a Member owes the Plan money?
If a Member owes the Plan any money, then any money due to
such Member in the form of benefits will be paid to the Plan
rather than the Member, until such debt is repaid in full.
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