Qualifying Events
You may experience a qualifying event that permits you to add or remove covered dependents from your Benefit Trust Fund medical plan. Examples of qualifying events recognized by the Fund include:
- Marriage
- Divorce or Legal Separation
- Birth of a Child
- Adoption
- Death
If a qualifying event permits you to make a dependent change, you must fill out a new Enrollment Form and any necessary certification forms and submit them to your Employer, along with any other documentation required by the plan.
When adding a new dependent, you must submit an Enrollment Form and necessary documentation to your employer in order for coverage to take effect. Your Employer must submit all documentation to the fund within 60 days of the qualifying event. Coverage for new dependents begins on the date in which they qualify as eligible dependents, which includes:
- With respect to a newborn child, the date of birth; or
- With respect to a step-child, the date of your marriage to your step-child’s parent; or
- With respect to a foster child, the date the child is placed with you for foster care; or
- With respect to a child named in a Qualified Medical Child Support Order (QMCSO), the date specified in the court order; or
- With respect to an adopted child, the date of adoption or placement for adoption.
Enrolling Dependents
Fill out an Enrollment Form. For any dependent child whose last name differs from yours, or who is not your biological child, you must also complete an Eligible Dependent Certification (EDC) Form and provide copies of legal documents that confirm dependency. Submit completed forms and any necessary documentation to your employer and they will forward them to the Fund Office.
If you are adding a disabled dependent to the Benefit Trust Fund medical plan, you must fill out the Disabled Dependent Certification Form and the Physician Certification of Disability Form. Submit the completed forms to your employer. Your employer should forward your completed forms to the Fund Office. The Fund reserves the right to periodically request proof of continued disability to verify eligibility for coverage for a dependent age 26 or older.
Other documentation is required when enrolling certain dependents. For example:
- Adoption documentation (or adoption placement documentation) are required for coverage of legally adopted children and children placed for adoption.
- Coverage of stepchildren requires submission of the child's birth certificate and proof of the employee's marriage to the child's biological or adoptive parent.
- Coverage of other dependents requires submission of guardianship documents or other documents confirming the legal relationship between the employee and child.
- The Fund Office may also ask you for other related information it needs to evaluate the terms of your relationship with the child.
- Adding coverage for a new spouse requires submission of a marriage certificate.