MICHIGAN BAC HEALTH CARE FUND

COMMON QUESTIONS ASKED

 

 

How are my benefits Funded?

 

The primary source of financing for the benefits provided under the Health Care Fund and for the expenses of Fund operations is employer contributions.

 

What are the Fund’s eligibility requirements?

 

Initial eligibility requires 275 hours of contributions within three (3) months or less.  There is a one (1) month bookkeeping period in which you are not eligible.

 

Continuing eligibility requires 275 hours of employer contributions within three (3) months or less.  There is a one (1) month bookkeeping period in which you are not eligible.

 

What do I do if my employer does not remit my fringes?

 

First call your employer.  There may be a very good reason that the fringes have not been remitted.  If your employer cannot explain the reason to your satisfaction, you should contact the Local Union.

 

What do I do if I am injured and cannot work?

 

The Fund provides disability credit which may continue your coverage for health care benefits.  The Fund also provides a weekly disability benefit for non-occupational injuries.  You should complete a disability form and submit it directly to the Fund Office.

 

 

How can I add my dependents to the Plan?

 

Complete a “Membership and Record Change Form” and submit copies of marriage or birth certificates.

 

What do I do when I get divorced?

 

You must send a copy of your complete divorce decree otherwise coverage will be maintained for your ex-spouse.  If the Fund pays for benefits that should not be paid because your spouse no longer meet the definition of a dependent, you will be held responsible.

 

When does coverage stop for my dependent children?

 

Dependent children are covered through the end of the year in which they turn 19 unless they meet the requirements for maintaining coverage.  The Plan requires the following to maintain coverage beyond the age of 19; the child is dependent on the participant for more than half of their support, related to the participant by blood, marriage or legal adoption and is a full time student for at least five months of the year.

 

Self-Payments will be required to maintain coverage for dependents over the age of 19.

 

Can I continue coverage when I retire?

 

Yes, provided you meet the retiree requirements for maintaining coverage.

 

What is COBRA?

 

COBRA is the Consolidate Omnibus Budget Reconciliation Act of 1986.  COBRA requires that the Fund provide coverage for participants and their dependents that may not otherwise be offered.  COBRA is available for dependents who no longer meet the definition of a dependent as defined by the Plan.  The rates are 102% of the actual cost of providing benefits. 

 

What is Coordination of Benefits?

 

Coordination of Benefits or COB coordinates benefits with other health benefits you may have such as coverage through your spouses employer.

 

What Benefits are covered under the Plan?

 

The Plan provides for hospital, medical-surgical, laboratory, x-rays, office calls, physician services, prescription drugs, dental and vision care through Blue Cross Blue Shield of Michigan.