Northwest Carpenters Health and Security Plan

Enrollment 

If your dependents satisfy the eligibility requirements described above, your dependents are eligible under this plan. Coverage may be provided retroactively as described below, provided that your dependents’ eligibility shall not begin prior to the first date you are eligible, and claims received more than 12 months after the incurred date will not be processed. To include an eligible dependent under your coverage, the following enrollment documents are required:

Spouse/domestic Partner

To enroll a spouse, you must provide the following documentation:

To enroll a domestic partner, you must provide the following documentation:

Coverage for your spouse/domestic partner begins after enrollment is completed, retroactive to the date of marriage or domestic partnership.

Natural Child

To enroll a natural child, you must provide the following documentation:

  • A Dependent Enrollment Application.
  • A Certificate of Birth issued by an appropriate state agency. The participant or retiree must be named on the Certificate of Birth.

The newborn child of a participant or retiree, or the newborn child of a participant’s or retiree’s spouse, is temporarily enrolled for the first 60 days of life if Carpenters Trusts receives the Dependent Enrollment Application within the first 60 days of the date of birth. The newborn child of an unmarried or legally separated male participant or retiree is temporarily enrolled for the first 60 days of life if Carpenters Trusts receives a Dependent Enrollment Application and a paternity affidavit. A Certificate of Birth is required for coverage to extend beyond 60 days. The participant or retiree must be named on the Certificate of Birth. After 60 days of life, no claims will be processed until the appropriate documentation is received. Following receipt of the appropriate documentation, coverage for the newborn child will be effective from the date of birth, subject to the 12-months claim filing deadline.

Stepchild

To enroll a stepchild, you must provide the following documentation:

  • A Dependent Enrollment Application.
  • A copy of your marriage certificate to the child’s mother or father.
  • A Certificate of Birth issued by an appropriate state agency. Your spouse must be named as the child’s mother or father on the Certificate of Birth.

Coverage for your stepchild begins after enrollment is completed, retroactive to the date your spouse was covered in the plan.

Adopted Child or Child Placed for Adoption

To enroll an adopted child or a child placed for adoption, you must provide the following documentation:

  • A Dependent Enrollment Application.
  • A certified copy of the placement report and petition for adoption that were filed with the court, or other documents confirming that the child was legally placed for adoption.
  • A Certificate of Birth issued by an appropriate state agency.

Coverage for your child placed for adoption begins after enrollment is completed, retroactive to the date of the placement.

Legally Placed Child

To enroll an unmarried legally placed child, you must provide the following documentation:

Coverage for your legally placed child begins after enrollment is completed, retroactive to the date of the court order.

Last Updated: 04/25/2023