Active Health Summary Plan Description
As of September 1, 2017
En Español (PDF)

4.6 Initial Eligibility for Certain Employees of Certain New Contributing Employers

The following describes the conditions under which an Employee may be granted initial eligibility if working in Covered Employment for a new contributing Employer.

  1. For purposes of this rule, a "new contributing Employer" is an Employer who has been providing medical coverage to its Employees from a source other than the Plan and who entered into a Collective Bargaining Agreement requiring Contributions to the Plan.
  2. For purposes of this rule, an "eligible Employee" is an Employee who meets all of the following requirements:
    1. The Employee was employed by the Employer immediately prior to the effective date of the Collective Bargaining Agreement.
    2. The Employee was receiving medical coverage from the Employer immediately prior to the effective date of the Collective Bargaining Agreement.
    3. The Employee following the effective date of the Collective Bargaining Agreement remains in the employ of the Employer and performs work for which Contributions are payable to the Plan pursuant to the Collective Bargaining Agreement.
    4. The Employee has no pre-existing Hour Bank Reserve under this Plan as of the effective date of the Collective Bargaining Agreement.
  3. An eligible Employee of a new contributing Employer shall be granted an initial Hours Bank Reserve equivalent to four (4) months of coverage. In order to off-set this initial Hours Bank Reserve, an equivalent amount of hours of the first Hours Worked per month in excess of the hours required for monthly eligibility will not be credited to the eligible Employee's Hours Bank Reserve. If the initial eligibility is granted after the close of the first workweek of a particular month, the initial Hours Bank Reserve granted shall be equivalent to five (5) months of coverage, and an equivalent amount of the first Hours Worked per month in excess of the hours required for monthly eligibility will not be credited to the eligible Employee's Hours Bank Reserve in order to off-set the initial hour bank granted.
  4. Only collective bargaining unit Employees may be granted initial eligibility under this rule.
  5. In the event an eligible Employee granted an initial Hours Bank Reserve pursuant to sub-section (C) terminates employment, whether voluntary or involuntary, prior to working in Covered Employment at least the number of hours credited pursuant to sub-section (C), all benefits of that Employee and their Dependents under this Plan shall terminate as of the first day of the month following the month in which the employment terminated. An Employee granted an initial Hours Bank Reserve pursuant to sub-section (C) and their Employer must give prompt written notice of termination of employment to the Administrative Office. Employees and their Dependents losing eligibility pursuant this Section shall be offered non-subsidized COBRA coverage and conversion rights to the extent required by applicable law. Should the Employee return to Covered Employment or sign the out-of-work book of IBEW Local 11 within five (5) business days of the termination of employment, no loss of eligibility shall occur under this sub-section.
  6. Should the termination be for reasons of injury or illness for which Workers' Compensation temporary disability benefits or California State Disability benefits are payable, no loss of eligibility shall occur under this sub-section unless and until the Employee recovers and then only if the Participant then fails within five (5) business days to return to Covered Employment or sign the out-of-work book of IBEW Local 11.
  7. Should the termination be due to Participant taking a leave of absence in accord with applicable Family Medical Leave Act ("FMLA") laws, no loss of eligibility shall occur under this sub-section unless and until the Employee completes the authorized leave and then only if the Participant then fails within five (5) business days to return to Covered Employment or sign the out-of-work book of IBEW Local 11.
  8. Should the termination be due to the Participant being called into active military service, no loss of eligibility shall occur under this sub-section, and coverage shall be continued to the extent otherwise provided for under this Plan.