Make it bigger:

Eligibility

For every hour you work, your employer contributes a designated amount to cover the cost of  your health benefits. The Local 478 Fund Office credits your hours toward your health coverage as soon as it receives your employer's contributions.

Once you have established a bank of hours, and you continue to work on a regular basis, you should have few problems with eligibility. However, new members are often confused about when their eligibility begins. If you need more information, you can check our eligibility chart.

If you want to keep track of your individual hours and eligibility, visit the Member's Only section of our Web site. There you will find information on your employer's most recent contributions to all of your funds, including your 401K deferrals. You will find a graphical display to indicate your current and future health eligibility.

Gaps in employment
Construction is a seasonal industry, and many of our members are accustomed to gaps in employment. As much as possible, our Plan's eligibility rules are designed to minimize breaks in your health coverage, even when you are not working.

When you have a gap in employment and stop building up hours, your eligibility is determined by the hours paid on your behalf for the preceding three-month, six-month and 12-month periods. If you are an Active Member, you are eligible for health benefits in a given month if you pass any one of the following tests.
  • The 200-hour test: You must have at least 200 hours contributed on your behalf in the three-month period preceding the current month.
  • The 400-hour test: You must have at least 400 hours contributed on your behalf in the six-month period preceding the current month.
  • The 800-hour test: You must have at least 800 hours contributed on your behalf in the twelve-month period preceding the current month
Example
200-hour test
400-hour test
800-hour test
Month
of July
Eligibility is determined based on hours worked the previous March through May.
Eligibility is determined based on hours worked the previous December through May.
Eligibility is determined based on hours worked the previous June through May.


Initial Eligibility
You will become eligible for health benefits on the first of the month that follows the month after the three-month period during which the Fund Office receives at least 200 hours in employer contributions on your behalf. Here are a few examples:

 
 
Employer contributions
Skip month
Initial eligibility
Example 1
April: 205 hours
May
June 1
Example 2
April: 105 hours
June
July 1
 
May:103 hours
 
 
 

As time passes, eligibility time periods move forward as well. In August, we would consider the hours paid on your behalf for the period from April through June. As your gap in employment increases over time, and we contribute fewer hours on your behalf, you will have a more difficult time passing the 200- and 400- hour tests. Eventually the only test you will pass will be the 800-hour test. 

If you have a significant bank of hours, your eligibility is likely to extend for as much as eight or nine months without employer contributions. When your regular eligibility expires, you have the option of paying for your coverage through our COBRA program.

Spouses and Dependents:
If you are an Active Member, you may cover your spouse or eligible dependent children through the end of the month they turn 26 at no additional cost.

Effective January 1, 2011 Dependents are covered up to age 26 regardless of student status, unless they are covered through an employer or spouse.

Family status changes:
It is important to notify the Fund Office if there are any changes in your family, including birth, death, divorce, primary insurance coverage or change of address.

Transition from Active to Retiree Benefits:
Click Here to view the eligibility rules of the Fund's Retiree Programs

Retirees:
As a Retired Member, you have a one-time option to continue to receive health coverage. You must be 60 years old (or younger if you qualify for a disability pension benefit) and have had active health benefits within 12 months of your retirement date.  If your spouse has health coverage through employment, you may defer electing coverage for your spouse until that coverage is no longer available.

Once you elect to continue coverage, your eligibility is based on your timely payment of the monthly retiree premium, which is usually deducted from your Local 478 pension benefit. Your total monthly amount is based on a charge for each eligible covered individual, including yourself, your spouse and any dependents.

If you are covered by Medicare, your monthly premium will be less than the amount charged to retirees who are not covered by Medicare. The current individual premiums for the Pre-Medicare and Medicare Supplement Retiree Plans are $200 and $125 respectively.