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Retiree H&W - Rules for Electing Retiree Coverage

ELIGIBILITY RULES:

A retired employee who has attained age 48 and has had:

(1)   60 months of health & welfare eligibility with this Fund, for which retiree funding has been paid, in the 84 months immediately preceding retirement, or

(2)   10,400 hours of contributions reported to this Fund, for which retiree funding has been paid, in the 84 months immediately preceding retirement, or

(3)   25,000 hours of contributions reported to this Fund, for which retiree funding has been paid, prior to retirement,

(monthly eligibility will be valued at 173.33 hours a month for 2 and 3

above)

            -or-

A retired employee who is under age 48, has satisfied one of the conditions above, and

       (1)   is totally disabled and is receiving a Disability Retirement  Benefit

              from the Alaska Electrical Pension Fund, or

       (2)   is totally disabled as defined by the Alaska Electrical Pension Fund

              and worked under a Bargaining Unit represented by IBEW Local

              1547 or a Special Agreement for 5 years,

will be eligible on the first of the month coinciding with the date of retirement (or on the first of the month following the termination of eligibility as an active employee under this Plan, if later).

To be retired or in retirement status you must be receiving a monthly pension benefit from the Alaska Electrical Pension Fund or a similar plan provided by an employer contributing to the Alaska Electrical Health & Welfare Fund or you must provide proof of retirement acceptable to the Fund.

ENROLLMENT

While coverage is available, a retired employee must enroll with the Fund to be eligible for benefits. Enrollment forms are available at the Administrative Office and must be completed at the time of retirement. 

If you do not enroll while you meet the eligibility requirements for retiree coverage, you will not be eligible to enroll in the future. 

A monthly self-pay contribution by each retiree is currently required for retiree health and welfare coverage. The amount of the contribution depends upon the age and service of the retiree and whether or not a spouse is to be covered. 

 IF YOU OR YOUR SPOUSE ARE ELIGIBLE FOR MEDICARE

The Fund will automatically adjust the retiree contribution when the retiree or covered spouse becomes Medicare eligible (currently age 65 for most retirees)If you or your covered spouse become eligible for Medicare prior to age 65, please notify the Administrative Office. 

If you or your spouse are eligible for Medicare coverage YOU MUST ENROLL IN BOTH PARTS A and B OF MEDICARE.  Part A of Medicare covers general hospital expenses and Part B covers physicians and medical expenses. If you are eligible for Medicare and fail to enroll, BENEFITS UNDER THE RETIREE MEDICAL PLAN(S) WILL BE PROCESSED AS THOUGH YOU WERE ENROLLED IN BOTH PARTS A and B OF MEDICARE. This means benefits would be paid on the assumption that you are enrolled in both Parts A and B of Medicare; and if you have not enrolled, you could incur significant uncovered out-of-pocket expenses. We strongly encourage all retirees to contact Social Security to determine the procedures and timetables for enrollment in Medicare.

OTHER GROUP COVERAGE

If you have other group coverage you are eligible to enroll in the low option retiree plan through this Fund.  This plan will supplement your other group coverage by providing 20% reimbursement on allowable expenses.

CHANGES IN FAMILY STATUS

If your family status changes and you are eligible to add/delete a dependent and/or move from a married plan to a single plan or vice versa, you must notify the Fund within 60 days of the change in family status to make an election change.  If you  or your spouse gains (or loses) other health coverage you may be eligible to move in (or out) of the low option plan, provided you notify the Fund to make an election change within 60 days of the effective date of the gain (or loss) of other coverage.  

Moving from a Married Plan to a Single Plan

If notified within the required 60-day period, the Administrative Office will make the plan change retroactively to the first of the month following the event, refund any difference in premiums paid, and reprocess any claims accordingly.  A new enrollment form and the appropriate documentation of the change in family status is required.  Outside of the 60-day window, retirees can elect to change to a single plan prospectively (first of the month following written notification or receipt of a new enrollment form) and no refunds will be provided.  A new enrollment form is required in this case.  If coverage is waived on any dependent but maintained on the retiree, that dependent cannot be re-enrolled in the future unless they experience a qualified change in family status.

Moving from a Single Plan to a Married Plan

If notified of a qualified change in family status within the required 60-day period, the Administrative Office will make the plan change retroactively to the first of the month following the event and collect any difference in premiums due.  A new enrollment form and the appropriate documentation of the change in family status is required. Any claims will be reprocessed accordingly.  Outside of the 60-day window, retirees cannot add a new dependent.

Qualifying Changes in Family Status

Marriage                                                      

Birth or adoption of a child

Dependent child gains/loses eligibility            

Divorce or legal separation

Significant change in spouse’s coverage through employment                     

Death of a dependent

These provisions may be subject to change. Therefore, you should contact the Administrative Office to verify contribution requirements prior to your retirement.

FUTURE CHANGES TO THE RETIREE PLAN

Please note the Retiree Health & Welfare Plan is provided at the discretion of the Board of Trustees and cannot be guaranteed in the future.  Additionally, the benefits and the amount of the monthly premium may be modified at any time by the Trustees.

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