Enrolled employees can typically cover their eligible dependents under their health plans.
Dependents can include:
- Lawful spouse, including common-law spouse
- Child(ren), including your biological children, step-children, adopted children or legally appointed children.
For many medical plans, including Benefit Trust Fund medical plans, children are eligible dependents until they reach age 26 if they are not covered under another medical plan as their primary coverage.
When enrolling dependents, employees may need to submit documentation confirming dependent status. Documentation typically includes the following:
- Adoption papers
- Birth certificates
- Marriage licenses
- Death certificates
- Guardianship documents.
Special circumstances may allow a participant to change health care coverage during the plan year. Changing coverage could mean switching to a different plan option or dropping a dependent from coverage.
For many plans, coverage for enrolled employees and their dependents may be added or changed only once a year, during a plan's annual enrollment period. Participants may also change coverage during the plan year under certain circumstances defined by the IRS. Changing coverage may mean switching to a different medical plan option (if available) or adding or removing dependents.
Benefit Trust Fund plans do not have an annual enrollment period. Plans are negotiated into a collective bargaining agreement and then all IAM members covered under that agreement are eligible to enroll in the plans.
Certain circumstances called "qualifying events" allow participants to change coverage.
Qualifying events include:
- Birth of a child
If you or a dependent have a qualifying event, you may be allowed to change coverage and add or drop a dependent from coverage. In most cases, health plans require you to notify the Fund Office and make changes to the plan within a certain period after the qualifying event occurs. For the medical plans of the Benefit Trust Fund, the period is thirty days after the qualifying event occurs.
If an eligible participant loses medical coverage due to certain qualifying events, he or she may be eligible to continue coverage under the same medical plan by electing COBRA continuation coverage. COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act, lets individuals make personal payments to continue under their same health plan due to:
- Voluntary or involuntary employment termination
- Reduction in work hours
- Divorce or separation
- Death of a primary plan participant or dependent
- Dependent child exceeding the maximum age limit.
Eligible participants that elect COBRA continuation coverage must do so within sixty days after the date their prior coverage would otherwise end, or the date the participant receives a notice of the right to elect continuation coverage, whichever is later. Participants in COBRA continuation coverage must pay the full cost of the premiums, and an administrative fee.
For more information on COBRA continuation coverage, visit the Department of Labor website, or contact the Fund Office for specific information about how continuation of coverage rules apply to your plan.