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Health Fund
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Other Extensions Of Coverage

After you or your dependents lose eligibility for the Fund's health plans, there may be other options for extending coverage. For example, when your adult dependent child turns age 26, the Fund will send your dependent a notification of termination of coverage that will contain information about their individual right to elect:

Total Disability

If, at the time coverage ends, you or a dependent - excluding Same-Sex Spouses and Same-Sex Domestic PartnersAn individual who has submitted to the Fund an Affidavit of Domestic Partnership on a form provided by the Fund, along with supporting documentation, and who meets the criteria set forth in such Affidavit. Generally, for a partner to qualify, both the participant and his/her same-sex partner must acknowledge being in a committed relationship which has been in existence for at least six months. For more information, contact the Administrative Office. - are totally disabled, that person may receive extended benefits through the total disability extension offered by the Fund or through COBRA.

The Total Disability Application and Attending Physician Statement must be submitted within 30 days before coverage would otherwise end.


A Disabled Participant:

  • After being deemed eligible for a disability extension of coverage, the totally disabled participant and his/her covered dependents are entitled to full medical and dental benefits for 6 months from the date coverage would otherwise end.
  • If, at the end of the 6 month extension of coverage, the participant remains disabled, he/she will be entitled to elect an additional 12 months of "comprehensive medical coverage" (out-patient mental health and chemical dependency, medical, vision and prescription benefits only), or COBRA. If the participant elects the 12 months of comprehensive medical coverage, their dependents will not be eligible for coverage. The dependents will be offered COBRA. Their COBRA entitlement will be offset by the 6 months of disability extension previously received.
  • If, after the first 6 month extension of coverage, the participant elects COBRA, the COBRA entitlement will be offset by the 6 month extension previously received. If the 12 month comprehensive medical coverage extension is elected, COBRA will not be offered at the termination of this extension.

A Disabled Spouse:

  • If, at the time coverage would otherwise end (participant's coverage ends), and the covered spouse (opposite sex) is deemed eligible for a disability extension of coverage, the spouse (opposite sex) will be entitled to elect 12 months of comprehensive medical coverage or COBRA. If the 12 month extension is elected, COBRA will not be offered at the termination of the 12 month extension.

A Disabled Child:

  • If, at the time coverage would otherwise end (earlier if participant's coverage ends or the dependent child turns 26), and the child is deemed eligible for a disability extension of coverage, the child will be entitled to elect 12 months of comprehensive medical coverage or COBRA. If the 12 month extension is elected, COBRA will not be offered at the termination of the 12-month extension.
  • If a dependent child reaches age 26 and qualifies as “permanently disabled” by the Fund (as defined in Your Eligible Dependents section*), the dependent child will be entitled to coverage as long as the participant is covered under the Fund. If the participant loses eligibility for Fund coverage, the disabled child's coverage would also end. Should the participant regain earned coverage at a later date, the "permanently disabled" child's coverage would resume. Recertification of your dependent's permanent disability is required every two years.

*Eligible dependent is defined on page 21, under the "Who's Eligible" section, sub-section "Your Eligible Dependents," starting with the bullet titled: "Children age 26 or older who are incapable of self-sustaining employment because of mental retardation or physical handicap as long as:"

Note: The Total Disability Application and Attending Physician Statement form is available on our website or contact the Eligibility Department at the Administrative Office. If these forms are not received within 30 days before coverage would otherwise end, coverage under this extension of coverage may not be granted.

Active Survivor Coverage

If you die while covered under the Fund, your covered surviving dependent(s) will be entitled to Extended Coverage with the Health Fund, if at the time of your death:

  • You were an active participant under age 60;
  • Accumulated at least 68 quarters of Health Fund coverage; and
  • You were married (to an opposite or same-sex spouse) or in a Same-Sex Domestic Partnership for at least two years.

Your surviving dependent(s) can elect either of the following options:

  • Five years of full medical and dental coverage; or
  • Subject to the applicable rules under the Fund, lifetime full medical and dental coverage starting on the date you would have turned age 60.

Note: If the five-year coverage is elected, coverage will end if your Surviving Spouse (opposite or same-sex) remarries, your Same-Sex Domestic Partner enters into a new domestic partnership or any of your dependents becomes eligible for Medicare or any other group health plan. If the lifetime coverage is elected and your Surviving Spouse (opposite or same-sex) remarries or your Same-Sex Domestic Partner enters into a new domestic partnership, his/her coverage will end. If your Surviving Spouse (opposite or same-sex) or Same-Sex Domestic Partner becomes Medicare-eligible, the Plan's coverage will be secondary to Medicare. (See "Understanding Coordination of Benefits (COB)").

Your Surviving Spouse (opposite or same-sex) or Same-Sex Domestic Partner is required to immediately notify the Administrative Office if he/she remarries or enters into a new domestic partnership. Alternatively, your Surviving Spouse (opposite sex) can enroll for COBRA Continuation Coverage. This option for COBRA Continuation Coverage is not available to Same-Sex Spouses or Same-Sex Domestic Partners. (For information about COBRA, see "COBRA Continuation Coverage".)

Certified Retiree Survivor Coverage

If you're at least 60 years old when you die and you had accumulated at least 68 quarters of Health coverage; and

  • You had been married (to an opposite or same-sex spouse) or in a Same-Sex Domestic Partnership for at least two years at the time of your death, your survivor will receive the same Certified Retiree A participant who satisfies certain requirements is designated as a Certified Retiree. Health benefits he/she would have received had you retired and died immediately thereafter; or
  • You had been married (opposite or same-sex) or in the Same-Sex Domestic Partnership for less than two years at the time of your death, your survivor will be entitled to receive this coverage for six months.