Enrollment Documentation
When you and your dependents satisfy the eligibility
requirements described above, you and
your dependents are eligible under this plan.
However, before any claims can be processed,
an Enrollment Form and the required documents
must be on file at the Trust Office.
If you need to add or remove a dependent
from the plan, the following documentation is
required.
Marriage
To enroll a spouse, you must provide the following
documentation within 60 days of the
marriage:
- A new Enrollment Form.
- A copy of the certified marriage certificate.
Coverage for your spouse will begin after enrollment
is completed, retroactive to the date
of marriage.
Domestic Partner
To enroll a domestic partner, you must provide
the following documentation within 60 days
of establishing the domestic partnership:
- A new Enrollment Form.
- A copy of the Affidavit of Domestic Partnership.
Coverage for your domestic partner will begin
after enrollment is completed, retroactive to
the date the domestic partnership was established
with the plan (please see "Eligible
Dependents" on pages 5-7).
Newborn, Adopted, Legally Placed, or Stepchildren
To enroll a newborn or other dependent child,
you must provide the following documentation
within 60 days of the birth, marriage,
establishment of the domestic partnership,
adoption, or the date the child was legally
placed in your care:
- For a newborn, a new Enrollment Form and a copy of the birth certificate
that was certified by the Department of Vital Statistics. For natural children
born out of wedlock, a Child Enrollee Questionnaire, a copy of the
birth certificate that was certified by the Department of Vital Statistics,
and the paternity affidavit or a copy of the judgment or decree establishing
paternity are also required. Other documents may be required to determine
the effective date of coverage for a child born out of wedlock (please see
the definition of "children" on page 149).
- For stepchildren, a new Enrollment Form, a copy of the certified
marriage certificate, a Child Enrollee Questionnaire, and a complete
copy of the appropriate divorce decree, parenting plan, and child support
order.
- For a child who is placed for adoption, a new Enrollment Form and
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.
- For legally placed children, a new Enrollment Form and a copy of
the court order specifying legal custody.
Your newborn child will be eligible for coverage
on the date of birth. If a child is placed
with you for adoption, he or she will be eligible
for coverage on the date of the placement
for adoption as long as the child satisfies the
eligibility requirements of this plan. If a child
is legally placed with you by virtue of a court
order, he or she will be eligible for coverage on
the date of the court order. Stepchildren who
live in your home are eligible for coverage on
the date the parent was enrolled in the plan.
Please see "Eligible Dependents" on pages 5-7
for additional details about eligibility.
Legal Separation or Divorce
If you are divorced or legally separated, you
must provide the following documentation:
- A new Enrollment Form.
- A complete copy of the divorce decree.
- If there are children, a complete copy of the parenting plan and child support
order.
Eligibility for your former or legally separated
spouse and stepchildren ends on the last day
of the month in which the legal separation or
dissolution of marriage becomes final. However,
your former or legally separated spouse and
stepchildren may elect to continue coverage
under COBRA Continuation Coverage for up
to 36 months (please see "COBRA Continuation
Coverage" on pages 136-141).
If, following a divorce, you want your former
spouse to remain your life insurance beneficiary,
you must designate your former spouse
as your life insurance beneficiary on a new
Enrollment Form.
A Qualified Medical Child Support Order
(QMCSO) could have an effect on benefit
coverage. Please notify the Trust Office if
a QMCSO is part of a divorce proceeding
(please see "Eligible Dependents" on pages
5-7).
End of Domestic Partnership
If you no longer satisfy the requirements of a
domestic partnership, you must provide the
following documentation:
- A new Enrollment Form.
- A Domestic Partnership Termination Form.
Eligibility for your former domestic partner
and his or her children ends on the last day
of the month in which the termination of the
domestic partnership becomes final. COBRA
Continuation Coverage is not available to
your former domestic partner or the children
of a former domestic partner.
If, following the end of a domestic partnership,
you want your domestic partner to
remain your life insurance beneficiary, you
must designate your former domestic partner
as your life insurance beneficiary on the new
Enrollment Form.
Child's Loss of Eligibility
No documentation is required when a dependent
child loses eligibility because he or she
attained a limiting age. However, you should
contact the Trust Office if your child leaves
school or marries. Your dependent children's
eligibility also ends on the last day of the
month in which you, your spouse, your domestic
partner, or your dependent child no longer
satisfies the eligibility requirements of the plan
(please see "Eligible Dependents" on pages
5-7, "Suspension of Eligibility For Noncovered
Employment" on pages 11-12 and "Termination
of Coverage" on page 15).
Your dependent children may elect to continue
coverage under COBRA Continuation
Coverage for up to 36 months (please see
"COBRA Continuation Coverage" on pages
136-141). COBRA Continuation Coverage
is not available to the children of a domestic
partner.
Death of A Dependent
You should notify the Trust Office if a spouse,
domestic partner or a dependent child dies.
The Trust Office will provide you with the information
necessary to submit a life insurance
claim (please see "Life Insurance Benefits" on
pages 111-115).
Death of Participant
If you die, someone in your family should
notify the Trust Office. Your surviving dependents
are covered under this plan until your
earned eligibility is exhausted if they continue
to meet the eligibility requirements of this
plan. When your earned eligibility is exhausted,
COBRA Continuation Coverage may be
available to your dependents. Domestic partners
are not eligible for COBRA. In certain
circumstances, your dependents may qualify
for the Carpenters Health and Security Plan—For Retired Carpenters (please see "Carpenters
Health and Security Plan—For Retired
Carpenters" on pages 142-143). When the
Trust Office is notified of your death, your life
insurance beneficiary will receive the information
necessary to submit a life insurance claim
(please see "Life Insurance Benefits" on pages
111-115). A surviving spouse or domestic
partner who remains enrolled under this plan
must also complete a Life Insurance Beneficiary
Designation—Surviving Dependent form naming
a new life insurance beneficiary.
Documentation
The Board of Trustees reserves the right to
request documented proof of dependency
at any time. Whenever documented proof
of dependency or any other documentation
is requested by the Trust Office, it must be
received within 60 days of the request or eligibility
and the dependent's right to enroll will
be denied.
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