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

16.1 Eligibility

IF YOU WISH TO PROTECT YOUR POTENTIAL ELIGIBILITY FOR RETIREE HEALTH COVERAGE, NEVER COMMENCE YOUR PENSION UNTIL RETIREE HEALTH PLAN ELIGIBILITY IS CONFIRMED IN WRITING BY THE ADMINISTRATIVE OFFICE BASED UPON YOUR PROPOSED PENSION EFFECTIVE DATE. RETIREMENT PRIOR TO AGE 56 WILL AFFECT YOUR ELIGIBILITY FOR RETIREE HEALTH PLAN BENEFITS

A full explanation of the Retiree Health Plan eligibility requirements is set forth in a separate Retiree Health Plan Summary Plan Description which the Administrative Office will provide you upon request. Certain collective bargaining agreements do not include contributions for Retiree Health Plan coverage. The Administrative Office can provide, upon request, a listing of those collective bargaining agreements which do not provide contributions for Retiree Health Plan coverage.

Before commencing the receipt of your Retiree Pension Plan benefits, you should contact the Administrative Office and receive written confirmation of your eligibility to enroll in the Retiree Health Plan. Also, note that participation in the Retiree Health Plan is not automatic; you must apply for and enroll in the Retiree Health Plan. If you will be maintaining eligibility for Active coverage by using the accumulated hours in your Hours Bank Reserve, you should monitor those hours carefully after you retire to make sure you apply for and enroll in the Retiree Health Plan before your Hours Bank Reserve is exhausted. If you exhaust your Hours Bank Reserve you should continue Active coverage by electing COBRA continuation coverage, and, upon the termination of your COBRA continuation coverage, apply for and enroll in the Retiree Health Plan.

An eligible spouse enrolled in the Retiree Health Plan may continue his/her coverage under the Retiree Health Plan upon the Retiree's death. An individual who has retired under the Southern California IBEW-NECA Pension Plan and meets all of the eligibility requirements under this Retiree Health Plan may delay enrollment in this Retiree Health Plan until the later of exhaustion of Hours Bank Coverage and/or COBRA coverage under the Active Plan. If during this permitted delay in enrollment such an individual shall die, his or her otherwise eligible spouse may enroll in the Retiree Health Plan no later than the exhaustion of Hours Bank Coverage and/or COBRA coverage under the Active Plan.

Benefits under the Southern California IBEW-NECA Retiree Health Plan are partially financed through Employer contributions that are specifically designated to provide health benefits for retired Participants. The HRA balance in a participant's account may be used to make Retiree Health Plan self-payments if the participant is eligible for Retiree Health Plan coverage, had contributions paid into the Plan for the participant's HRA and funds are currently available for premium payments commencing after September 1, 2017. You have no vested right to receive Retiree Health Plan benefits. The Trustees may change, modify, reduce or terminate the Retiree Health Plan's benefits and required self-payment at any time as a result of conditions or events requiring such action.
Effective with Retiree Health Plan initial enrollment for pensions commencing on or after April 1, 2017, the requirements are as follows:

A. Age/Pension and Service Requirements:

Early Retirees are eligible if they have attained age 56 at their Annuity Starting Date, are awarded an unreduced early retirement benefit from the Southern California IBEW-NECA Pension Trust Fund, and have had at least 44,500 hours worked under a collective bargaining agreement requiring Retiree Health Plan contributions to this Plan (includes Health hours credited through reciprocity), and of those hours 10,500 hours must have been worked in seven (7) of the 10 years prior to retirement.

Normal Retirees are eligible if they retire and have their Annuity Starting Date on or after age 62 under the Southern California IBEW-NECA Pension Trust Fund. Retiree Health Plan eligibility is limited to such individuals who have at least 10 years of credited service under the Pension Plan and have had 10,500 health hours under a Collective Bargaining Agreement requiring Retiree Health Plan contributions (includes Health hours credited through reciprocity) in seven (7) of the 10 years immediately preceding the date of retirement.

B. Timely Application and Payments:

In addition to each of the requirements stated above, you must request and complete an application, enroll by no later than the later of the date your first pension check was issued or your loss of eligibility under the Active Health Plan, and pay the monthly medical premium. The monthly medical premium may be deducted from your monthly Southern California IBEW-NECA Pension Trust Fund benefit OR monthly self-payments may be made to the Southern California IBEW-NECA Health Trust Fund. The HRA balance in a Participant's account may be used to make Retiree Health Plan self-payments if the participant is eligible for Retiree Health Plan coverage, had contributions paid into the Plan for the Participant's HRA and funds are currently available for premium payments commencing after September 1, 2017.

C. Delayed Enrollment:

An individual who has retired under the Southern California IBEW-NECA Pension Trust Fund and meets all of the eligibility requirements under the Retiree Health Plan may delay enrollment in the Retiree Health Plan until the later of the exhaustion of the Hours Bank Reserve and/or exhaustion of COBRA coverage under the Active Plan. If during this permitted delay in enrollment such an individual shall die, his or her spouse may enroll in the Retiree Health Plan no later than the exhaustion of the Hours Bank Reserve and/or the exhaustion of COBRA coverage under the Active Plan. See Article 16.2: HIPAA Special Enrollment Rights (Exception to the Deadline for Retiree Health Plan Enrollment) for more information.

D. Total Disability and/or Partial Disability Benefits and Crediting of Disability Hours:

Total Disability and/or Partial Disability Benefits and Crediting of Disability Hours for Retiree Health Plan eligibility are not available to individuals retiring on or after April 1, 2017. Initial Retiree Health Plan benefits through the Maintenance Agreement after retirement will no longer be available effective April 1, 2017.

NOTE: Nothing in the eligibility requirements set forth above impacts those individuals who met the Retiree Health Plan's eligibility rules and commenced to receive a benefit from the Southern California IBEW-NECA Pension Plan on or before March 31, 2017.