Eligibility

HOW DO I BECOME ELIGIBLE?

To be eligible for benefits under the Laborers’ National Health & Welfare Fund (Plan 1), you, your spouse, and your children must earn eligibility and enroll with the Plan. Eligibility is not automatic and depends primarily on your employer being accepted into the Fund and making timely contributions on your behalf.

There are different rules for eligibility based on whether contributions are made on an hourly rate or monthly rate basis:

Single Coverage (Employee Only):

Initial Eligibility: You generally become eligible on the first day of the second calendar month after your employer contributes for at least 210 hours across three consecutive calendar months. Continuation of Eligibility: To maintain single coverage, contributions for at least 210 hours must be made on your behalf for each preceding three-consecutive-calendar-month period. Banked Hours: If you fall short of the required 210 hours, your eligibility may be continued if you have enough "excess hours" from the preceding six calendar months to cover the shortfall.
Family Coverage:

Initial Eligibility: You generally become eligible on the first day of the second calendar month after your employer contributes for at least 360 hours across three consecutive calendar months. Your spouse and children must also enroll. Continuation of Eligibility: To maintain family coverage, contributions for at least 360 hours must be made on your behalf for each preceding three-consecutive-calendar-month period. Banked Hours: Similar to single coverage, excess hours from the preceding six months can help continue eligibility if there's a shortfall in hours.
Self-Paying A Shortfall:

If your employer contributes for at least 320 hours but less than 360, you may self-pay up to 40 hours of contributions to meet the 360-hour requirement and maintain Family Coverage.
Initial Eligibility:

You become eligible for Family Coverage the third month after you start work for a participating employer who pays monthly contributions on your behalf. You must complete an enrollment form to include yourself, spouse and children. Example: Start work in January, you become eligible for family coverage March 1st.
Continuation of Eligibility:

Eligibility remains as long as your employer continues to make the required monthly contributions.

Important Information

Enrollment is a necessary condition for coverage for you and your eligible family members. You must complete and submit an Enrollment Form, along with required documentation for spouses and children (e.g., marriage certificates, birth certificates). It is important to notify the Fund Administrator of any changes in your enrollment information, such as address changes, birth or adoption of a child, divorce, or death of a spouse or child.

Loss of Coverage can occur if:

Your employer fails to make contributions for the minimum required hours or months.

Your employer's participation in the Fund terminates.

Your spouse ceases to be your spouse, or your child attains age 26.

If you lose coverage, you may be entitled to temporary continuation of coverage on a self-pay basis under COBRA.

See 'Resources' Page for the full Plan Description