Coverage Eligibility

Quick Reference

Call the Fund Office: 800-922-3240 or 203-934-7991
Fax the Fund Office: 203-680-3847

Highlights

Initial Eligibility and Reinstatement

You and your eligible dependents will be initially eligible for coverage, or reinstated for coverage, on the first day of the second month after you work 300 hours in the previous three-month period and the Fund receives employer contributions for the hours you’ve worked. Coverage will be continued for three consecutive months.

Example 1: New Member
Jeff begins working in October and works 102 hours that month. He also works 152 hours in November and 80 in December, for a total of 334 hours over three months. The contributions for his hours worked are received by the Fund Office.

When Jeff’s coverage begins: February 1
Jeff’s coverage begins after one “skip” month, based on the 300-hour rule. And, because he’s just starting his eligibility, he and his eligible dependents are covered for three full months: February, March and April.

Example 2: Reinstating Coverage
Tim had been out of work and is not eligible for health coverage in October. But, he recently went back to work for 300 hours the preceding July, August and September. The contributions for his hours worked are received by the Fund Office.

When Tim’s coverage begins: November 1
Tim’s coverage begins after one “skip” month, based on the 300-hour rule. And, because he’s reinstating his eligibility, he and his eligible dependents are covered for three full months: November, December and January.

Continued Eligibility

You will continue to be eligible for coverage on the first day of the second month after you work in Covered Employment for 300 hours during the preceding 3 months, 1,000 hours during the preceding 10 months, or 1,200 hours during the preceding 12 months (effective May 1, 2024) and provided the required contributions for that work activity are paid to the Health Fund by the Contributing Employer.

Example 3: Continuing Eligibility
Roberto is eligible for health coverage in January. To be eligible for coverage in February, Roberto must have:

1. worked at least 1,200 hours for the prior 12 months—January through December—and the contributions for his hours worked must be received by the Fund Office. 
   OR
2. worked at least 1,000 hours for the prior 10 months—March through December—and the contributions for his hours worked must be received by the Fund Office.
   OR
3. worked at least 300 hours for the prior three months—October through December—and the contributions for his hours worked must be received by the Fund Office.

Details

Health Fund Overview 2024
Health Fund Overview 2024 – Spanish
Schedule of Benefits January 2023
Schedule of Benefits January 2023 – Spanish
Schedule of Benefits May 2024
Schedule of Benefits May 2024 – Spanish