D.A. Townley  -  Plan Administrators Iron Workers Union Local 97 International Association of Bridge, Structural, Ornamental and Reinforcing Iron Workers 
 

health
benefits

        
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
   
 
 
 
 
 
   
 

General Information

 

 
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.

 

 
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. 

 

 
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”.

 

 
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.


 

 
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As a Member of Local 97, 110 hours will be withdrawn each month from the Hour Bank for coverage. 8 months’ coverage (880 hours) may be accumulated ahead, which will be drawn upon during a period of poor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.

 

 
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.

 

 
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.

 

 
When does coverage end?

Coverage is always provided on a whole-month basis only and will be terminated when:

  1. 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
  2. 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. 

 

 
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


 

 
DISABILITY CREDITS

When a Member is collecting under the Weekly Indemnity Plan/ E.I. Sick Benefits or under Workers’ 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 Workers’ 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 Workers' 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 Workers’ 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.

 

 
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’s 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.

 

 
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.

 

 
INTEGRATION OF BENEFITS

Claims payment will be reduced by any payment payable under a No-Fault Auto Insurance Plan or similar legislation.

 

 
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.


 
 

Form Links
Health & Welfare Enrolment Card and Beneficiary Designation
Common Law Spouse Declaration Form
MSP Application for Group Enrolment Form
MSP Group Change Form
Fair PharmaCare Registration Form
 

Related Links
Enrolment into the Plan and Making Changes to Member, Dependent or Beneficiary Information
Printable Version of the Health & Welfare Plan Booklet

 
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