Summary Plan Description
Six months of Self-Contribution Coverage is available if you are a qualified temporarily disabled or unemployed participant. You must satisfy the following conditions to qualify for this coverage:
- You must be unemployed and actively maintained on the out-of-work list at the Pacific Northwest Regional Council of Carpenters or the regional council in the jurisdiction in which you are working, and not doing any work for gain or profit, even if on a temporary basis. Or, you must be employed and recently dispatched to a contributing employer and working to reestablish dollar bank eligibility; or
- You must be temporarily disabled with the attending physician (MD, DO or DPM only) continually certifying the disability; and
- You must have been eligible for benefits based on dollar bank eligibility for at least three months during each twelve-month period of the thirty-six months immediately preceding loss of eligibility due to unemployment or temporary disability.
Special Eligibility Rights
- If you are an apprentice, you must have been eligible for benefits based on dollar bank eligibility for at least three months during each twelve-month period you participated in the Apprenticeship Program. You must also be in good standing with the Joint Apprenticeship Training Committee (JATC).
- If you are absent from employment because of active duty in the uniformed services in accordance with the Uniform Services Employment and Reemployment Rights Act (USERRA) and you suspend or terminate coverage, you are eligible to participate in Self-Contribution Coverage for up to 24 months.
Participation in Self-Contribution Coverage cannot be used to help establish eligibility for Retiree Coverage.
If you meet the above requirements and are eligible to participate in Self-Contribution Coverage, Carpenters Trusts mails an application to you the month before your coverage would otherwise terminate. If you wish to purchase continuation coverage, complete the application and return it with your first month's payment to Carpenters Trusts. Please make your check payable to "Carpenters Trusts of Western Washington." Your application and payment must be received by Carpenters Trusts before your dollar bank eligibility terminates. Carpenters Trusts will notify you, in writing, of acceptance or denial of your application.
Cost and Payment
Once your application has been approved, coverage is on a month-to-month basis as long as you continue to meet the necessary requirements. Dependents are included at no additional charge. Billings are mailed in the first week of the month for the following month's coverage. Payment is due upon receipt of the bill but not later than the 25th of the same month. There is no grace period. Failure to make the necessary payment terminates coverage. The monthly contribution rates are established by the Board of Trustees and are subject to change.
Duration of Coverage
Self-Contribution Coverage is available for a six-month period but can be renewed (subject to Board of Trustee approval) for an additional six-month period if you continue satisfying the requirements listed above. Once you return to work for a contributing employer, you can continue self contributions (within the stated limitations) until you reestablish dollar bank eligibility. You may elect COBRA once Self-Contribution Coverage terminates, but the total Self-Contribution Coverage and COBRA Coverage may not exceed 18 months, or 36 months in the case of a qualified beneficiary (spouse or dependent child) who has a second qualifying event.
Choice of Coverage
There are two options to choose from:
- Self-Contribution Coverage With Dental. This option is the same as dollar bank eligibility but does not provide time loss benefits.
- Self-Contribution Coverage Without Dental. This option is the same as dollar bank eligibility but does not provide time loss or dental benefits.
If you do not qualify for Self-Contribution Coverage, you may qualify for COBRA Coverage for a period of time not to exceed the total period of time allowed by federal law (please see COBRA Coverage below).
Related Health & Security Content
- 2017 Summary of Material Modifications (1/31/2017)
- 2017 Summary of Material Modifications (1/1/2017)
- 2016 Summary of Material Modifications
- 2014 Summary of Material Modifications
2017 Summary of Benefits and Coverage
Delta Dental of Washington
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