Cobra Continuation Coverage
COBRA, a federal law, allows you and your eligible dependents to continue health care coverage for a limited period at your own expense under certain circumstances when health care coverage would otherwise end under the terms of the Plan.
You do not have to prove that you are in good health to choose COBRA Continuation Coverage, but you do have to meet the Plan’s COBRA eligibility requirements and you must apply and pay for such coverage. Your COBRA rights are subject to change.
Coverage will be provided only as required by law. If the law changes, your rights will change accordingly. In addition, the Fund reserves the right to end your COBRA Continuation Coverage retroactively if you are determined to be ineligible for such coverage.
Under COBRA, you and your covered dependents may continue the same coverage that you had before the COBRA-qualifying event, including:
- Medical coverage (including PPO coverage).
- Hospital coverage.
- Prescription drug coverage.
- Dental coverage.
- Vision coverage.
Notwithstanding the above, COBRA Continuation Coverage does not include “Loss of Time”, "Accidental Death & Dismemberment" or “Death Benefits.”
COBRA Continuation Coverage is available to you, as a Member, if coverage would otherwise end if:
- Your regularly scheduled hours are reduced so that you are no longer eligible to participate in the Fund’s welfare benefits program, or
- Your Covered Employment ends for any reason other than gross misconduct.
For Your Dependents
COBRA Continuation Coverage is available to your Eligible Dependents if coverage would otherwise end if:
- Your (as the Member) regularly scheduled hours with your Contributing Employer are reduced so that you are no longer eligible to participate in the Fund’s welfare benefits program.
- You (as the Member) end Covered Employment with your Contributing Employer for any reason other than gross misconduct.
- You (as the Member) die, get divorced (or your marriage is civilly annulled), or you become entitled to Medicare (Part A or B, or both) and drop Fund coverage.
- Your dependent child ceases to be eligible for Fund coverage.
How COBRA Continuation Coverage Works
Under COBRA, in order to have a right to elect COBRA Continuation Coverage after your divorce, a child ceasing to be a “dependent child” under the Plan, or if you become disabled (or are no longer disabled) as determined by the Social Security Administration, you (or your family member) are responsible for notifying the Fund Office of these qualifying events.
To this end, you (or your family member) must notify the Fund Office in writing of any of these qualifying events no later than 60 days after the event occurs or 60 days after the date coverage would have been lost under the Plan because of that event, whichever is later (“60-Day Qualifying Event Notice”). That notice should be sent to:
Health and Benefit Trust Fund
Local 94-94A-94B, AFL-CIO
337 West 44th Street
New York, NY 10036
The Fund Office will then send you information about COBRA Continuation Coverage.
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What if I get injured on the job?
Benefits are not payable for occupational accidents, injuries or sickness covered by any Workers’ Compensation statute or similar legislation. All claims in relation to an injury or a condition that is directly or indirectly job-related are not covered by the Fund. For more information, please visit the Health and Safety section.