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FAQ

The answers to frequently asked questions below are general in nature and do not modify the terms of their respective Plans. You should refer to the related Summary Plan Description for more specific information regarding each Fund's Plan.

Top Frequently Asked Questions

What is the filing deadline for reimbursement of qualified previously unreimbursed medical expense claims?

12 months from the date of service.

Are my dependents also eligible for Plan A benefits?

Yes, your spouse and unmarried dependent children up to the age limit of the Plan, currently the end of the year in which they turn age 26, become eligible when you do. See the Health and Welfare Plan A Summary Plan Description for more information about eligible dependents.

What happens if I, or one of my dependents, has a loss of coverage?

If you lose coverage under Plan A, C1, C2, C3, C4 or Triple S, you, or our dependent, will be offered COBRA (self-pay continuation coverage). You have the right to purchase COBRA continuation coverage through the National Health & Welfare Fund until you re-qualify for coverage through employer contributions, qualify for another group health coverage plan or exhaust the time limit for continuation. Instead of electing and paying for COBRA coverage, you may wish to obtain coverage through the Health Insurance Marketplace. With either COBRA or Marketplace coverage, you may avoid a tax penalty for being uninsured. Check with your personal tax advisor to be certain.

How long does the Plan A coverage continue?

Plan A coverage is granted in six-month blocks. At the end of your six-months of coverage, the Fund Office will look back at the six-month eligibility period ending one month prior to the look back date. For example, if you earned eligibility for coverage January 1 to June 30, the Fund Office would look back at the six-months December 1 through May 31 to see if you worked at least 60 days in Covered Employment. If you meet the 60-day requirement, your coverage continues for another six months.

How long can I be without coverage before a tax penalty for being uninsured is imposed?

As long as your period of being uninsured is less than three (3) months and only occurs once in a calendar year then the IRS will not impose a penalty on you. Since the Health Fund’s coverage runs in quarters, a loss of coverage will be equal to, and in some cases greater than, three months. Therefore, to avoid a tax penalty you should exercise your right to obtain coverage through COBRA (by making a timely election and payment) or purchase coverage through the Health Insurance Marketplace.

What benefits are available under Plan A?

Plan A benefits available to eligible participants and their eligible dependents are hospital/medical, prescription drug, dental, vision, and hearing aid benefits. In addition, eligible participants, but not dependents, are covered for life insurance and weekly accident and sickness benefits.

What does minimum value mean?

In general, the ACA’s minimum value requirement means that your other employer or union sponsored group health coverage plan pays at least 60% of the total cost of medical services coverage by that plan.

Why did the Trustees develop another Plan C option?

Due to provisions of the Patient Protection and Affordable Care Act (ACA) that limited the ability of individuals to participate in Plan C’s stand-alone Medical Reimbursement Program (MRP) under certain circumstances, numerous participants and Local Unions sought a lower cost alternative to Plans C1, C2, and C3.

What does ‘affordable’ mean as per the ACA?

Affordable means that any payment you make for your individual coverage only (excluding any cost to cover your dependents) cannot exceed 9.5% of your total household income. Since the Fund does not maintain information about your total income or that of your entire household we would be unable to guide you as to whether or not coverage through one of our Plan options or that of another group fits the government’s definition of affordable.

How do I know if I am a Plan C participant?

Plan C participants usually work in the Motion Picture, Television, Commercial and Trade show industries under Collective Bargaining Agreements with I.A.T.S.E. or an affiliated Local that require employer contributions to Plan C.


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