Operating Engineers Health & Welfare Fund

Eligibility
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Retiree Eligibility

Termination of Retiree Eligibility

Retiree Annual Open Enrollment

 

REQUIREMENTS FOR  
 RETIREE HEALTH & WELFARE ELIGIBILITY  

A participant will be eligible for Retiree Health & Welfare benefits at retirement ONLY IF HE:  
1.

Has had sufficient hours of contributions at the master rate made to the Fund on his behalf to make him eligible to receive a Regular Pension, an Early Pension or a Disability Pension from the Trust; AND
2.

has not had a Separation from Employment unless, after the Separation from Employment, he has worked at least 6,000 hours in covered employment for which contributions are paid to the Fund;* AND
  3.

has had at least 3,000 hours of contributions made to the Fund on his behalf as an Active employee at the then existing master rate; AND
4.

has refrained, at all times after retirement, from any employment for a non-contributory employer if that employer performs operating engineer work; AND
5.

has been eligible for Active Health & Welfare benefits for at least two (2) of the eight (8) consecutive eligibility quarters immediately preceding his Pension effective date.  However, if the participant has worked 30,000 or more hours in contributory employment, then he must have been eligible for at least three (3) of the twenty (20) consecutive quarters preceding his Pension effective date. (NOTE: The requirement for Pro-Rata or Reciprocal pensioners is different.  Please contact the Fund Office for details.); AND
6.

makes the required monthly payment for coverage in a timely manner; AND
7. is not engaged in any type of gainful employment and covered, or eligible to be covered, by group health insurance through that employment or continuation coverage under COBRA through that employment.

*A Separation from Employment in the Health & Welfare Fund means:
a.

The participant fails to work at least 500 hours in contributory employment during a period of three (3) consecutive Plan Years; OR
b.

the participant is employed as an operating engineer for a non-signatory employer who is not paying contributions to the Fund

 

 

 
RETIREE ELIGIBILITY

Retiree Health & Welfare eligibility is based upon the hours you worked for employers who made contributions to the Health & Welfare Fund on your behalf.  

 

You would qualify for one year of coverage for each 1,500 hours on which contributions were made to the Health & Welfare Fund, however, within the five-year-period prior to your retirement, you must have been eligible for at least three eligibility quarters under the Active Plan.  A minimum of 3,000 hours is required for minimum coverage.  3,000 hours provides two years of coverage.  

Retirees must pay a fee for coverage and several options are available.  The fees are set by the Trustees of the Health & Welfare Fund and are subject to change from time to time.

 


CONDITIONS UNDER WHICH YOUR ELIGIBILITY ENDS  

Your eligibility for Retiree Health and Welfare Coverage will end on the earliest of the following dates:
1.

The date your pension under Operating Engineers Pension Trust is terminated, except if one of the following applies:

  1. You have returned to active employment with contributing employers.  In this case, your Retiree eligibility will continue until the quarter in which contributions were made on your behalf for 200 or more hours during a qualifying work quarter.  However, you must make payments under the COBRA Plan during the time you are working.  The maximum length of COBRA coverage is 18 months.

  2. Your Disability pension is terminated.  In this case, your eligibility as a Retired Participant will continue for a maximum of 5 consecutive months or until you gain Active eligibility (whichever occurs first).  However, you must continue your self-payments under the Retiree Plan during this 5-month period.
2.

On the last day of the month during which your Retiree Health & Welfare coverage has equaled one year for each 1,500 hours of employment.  You may not change to the self-payment plan to maintain eligibility.
 3.

On the first day of any month for which a required self-payment has not been received by the Fund Office.
4.

If you engage in gainful employment and are covered, or eligible to be covered, by any other group health insurance through that employment, including continuation coverage under COBRA, whether or not you elect that coverage.
5.

On the first day of the month following a month in which you fail to provide the documents requested by the Fund Office to determine your annual earned income.
6.

On the first day of any month in which you work IN ANY CAPACITY for an employer not signatory to a Collective Bargaining Agreement requiring contributions to the Fund, if that employer performs operating engineer work.


ANNUAL OPEN ENROLLMENT 

During December of each year, the Health & Welfare Plan holds an open enrollment period. If you are eligible to enroll in the Plan but are not currently enrolled, you will automatically receive open enrollment information.  Health & Welfare coverage for Retired and Widow participants who elect to enroll in the Plan during this open enrollment period will not begin until April 1 but you must pay the required fees for January through March.  Any charges incurred between January 1 and March 31 will not be covered.  Open Enrollment Forms, click here.