Eligibility

Initial Eligibility (For New Employees)

You will become Eligible for benefits on the first day of the eligibility quarter after you accumulate 350 contribution hours within a nine-month period. Eligibility quarters are June through August, September through November, December through February and March through May. Contribution hours are the hours you work for which an Employer contributes to the Fund on your behalf. Hours from all contributing employers count toward Eligibility.

Continuing Eligibility

You continue eligibility based on the number of hours your work for which an Employer contributes to the Fund on your behalf. You need to have 350 hours in a benefit quarter, 700 in the last 2 benefit quarters, 1,050 in the last 3 benefit quarters or 1,400 hours in the last 4 benefit quarters to continue coverage in the corresponding eligibility quarter.

Benefit QuarterEligibility Quarter
January through March June through August
April through June September through November
July through September December through February
October through December March through May

Dependent Eligibility

Your dependents become eligible when you become eligible and they meet the Fund’s definition of a dependent. 

An “Eligible Child” under the Plan is any one of the following individuals:

  • Anyone who has not reached his/her 26th birthday, does not have access to
    health care coverage through his or her employer, and is the employee’s:
    • Natural child;
    • Adopted child or child placed for adoption;
    • Foster child;
    • Child who is named as an alternate recipient in a child support order, if the Plan determines the
      support order to be a Qualified Medical Child Support Order (QMCSO);
    • Step-child who was born to the spouse or who was legally adopted by the spouse before the
      marriage of the employee and that spouse;
  • Any child listed above, at any age, who is permanently and totally disabled and incapable of selfsustaining
    employment by reason of a medically determined physical or mental impairment that is
    expected to last for a continuous period of 12 or more months or result in death, and if:
    • Such incapacity began before the child reached age 26,
    • The child is dependent on the employee for at least 50% of his/her financial support and maintenance
      in each calendar year,
    • The child maintains a principal residence with the employee during each calendar year, and
    • The employee provides proof of such incapacity for the child when the Trustees request such proof.

See the  Summary Plan Description (SPD) more information about active eligibility.

When you retire, you may continue coverage under the Pre-Medicare Retiree Self-Pay Program if:

  • You are at least age 52;
  • You do not have enough hours left in your Reserve Accumulation Account to pay for a quarter of coverage (By electing the Retiree Plan of Benefits, you forfeit any excess Reserve Accumulation Account hours.);
  • You are receiving retirement benefits from the Iron Workers Mid-America Pension Plan or the Iron Workers Local 380 Retirement & Severance Plan;
  • Before retiring, you were eligible for benefits by virtue of Contribution Hours under this Plan for some part of each of the last ten (10) calendar years; and
  • For the quarter immediately prior to retiring, you were eligible for benefits under this Plan by virtue of any combination of the following: Contribution Hours, Reserve Accumulation Account hours, and Self-Pay Contributions.

Pre-Medicare Retirees

If you are covered under the Tri-State Welfare Fund benefits (either by your employment or by self-payment), you and your eligible spouse may self-pay for the Medical coverage available under the Iron Workers Tri-State Pre Medicare Retiree Welfare Plan. You must self-pay monthly for this coverage.

Medicare Eligible Retirees

If you are covered under the Tri-State Welfare Fund benefits (either by your employment or by self-payment), you and your eligible spouse may self-pay for the Medicare options available under the Iron Workers Tri-State Medicare Retiree Welfare Plan. You must be entitled to Medicare and self-pay monthly for this coverage.

Pre-Funded Allowance

If you are active on, and earned at least one Quarter of Service, after your effective date and retire, you may be eligible to continue Eligibility with the Retiree Pre-Funded Allowance. You must waive COBRA Continuation Coverage in order to receive the Allowance, which is used as a discount toward the quarterly self-pay rate for the Pre-Medicare Retiree Plan of Benefits, or the Medicare Advantage Plan. The allowance is applied toward the quarterly self-pay rate for your and your dependents’ coverage. 

Pre-Funded Allowance Effective Dates
Local 444 January 1, 2004
Local 465 January 1, 2005
All others January 1, 1999

To be eligible for the Retiree Pre-Funded Allowance, you must be:

  • At least age 62 and have 40 Quarters of Service; or
  • At least age 52 and have 60 Quarters of Service; or
  • Totally and permanently disabled with at least 60 Quarters of Service. 

See the brochure Ironworkers Tri-State Welfare Fund Pre-Funded Allowance Plan for more information.

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© Iron Workers Tri-State Welfare Fund. The information on this Web site presents selected highlights of the Iron Workers Tri-State Welfare Fund. The actual Plan provisions of the Plan are in the Plan’s legal document. In the event of a conflict between the wording on the site and the legal documents, the legal documents will govern. The Trustees reserve the right to amend, modify, or discontinue all or part of the Plan at any time.