Eligibility

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Plans 5, 6, 6A

The Bay Area Delivery Drivers Security Fund sponsors three different health plans for active (i.e., not retired) employees. Which plan is your plan is determined by the collective bargaining agreement (or subscriber agreement) between your union and employer. If you are unsure of which Plan is yours, call your local union, your employer, or the Fund Administrator.

You are eligible to participate in the Bay Area Delivery Drivers Security Fund if:

You are employed by an employer who has a collective bargaining agreement or an approved subscription agreement with a participating local union which provides for participation in a plan sponsored by the Fund,
You work (or are compensated for) at least as many hours as required under the collective bargaining agreement for your employer to be obligated to contribute on your behalf,
Your employer contributes to the Fund on your behalf on time and in the full amount required by the Fund, and
You have completed and submitted an enrollment form to the Fund.

Minimum Hours of Service Requirement

You are eligible to begin coverage under the Plan once you have met the Minimum Hours of Service Requirement as provided in the collective bargaining agreement (and/or approved subscription agreement) between your union and your employer.

You can begin coverage on the first day of the calendar month that follows the month in which you completed the service requirement. For most Plan participants, this will be the first day of the month that follows the month in which you complete your 80th hour of service. For example, if your first day of work is in May and your collective bargaining agreement requires you to work 80 hours before you begin participating in the Plan and you complete 80 hours of work by May 15, your coverage would begin on June 1st (provided that your employer makes the required contribution, and your contract does not exempt probationary employees from the contribution obligation).

Keeping Your Eligibility

After you have met the initial eligibility requirements, you will maintain your eligibility from one month to the next if:

You have worked the number of hours required under the collective bargaining agreement between your union and employer (typically 80 or more hours in a month), and
Your employer makes the required contribution to the Fund on time and in full on your behalf, as required in its collective bargaining agreement, or
You are not working, but the collective bargaining agreement still requires your employer to make payments on your behalf (because you are on leave, disability, etc.), or
You have continued coverage by self-payment (see “Continuation Coverage” beginning on page 11 of the SPD, or
You qualify for continuation of health plan coverage if totally disabled (see page 11 of the SPD).

Contributions paid for hours worked in one month pay for coverage for the following month. For example, when your employer makes contributions on your behalf for the hours you worked in March, this contribution pays for your coverage for April.

Paid time off, such as vacations, sick leave, and holidays, are counted as ‘work hours’ for eligibility purposes, and your employer is still obliged to contribute to the Fund on your behalf during such periods (unless the collective bargaining agreement specifically states otherwise).

Dependent Eligibility Rules

Your dependents will be covered by the Plan when you establish eligibility or, if you are already enrolled in the Plan, when the dependent becomes an eligible dependent through birth, marriage, or adoption. You must make sure to enroll your eligible dependents in the Plan by contacting the Fund Office: they will not be entitled to benefits until they are enrolled. Different eligibility requirements apply for domestic partners.

Plan 7

Employee Eligibility

You are eligible to participate in the Bay Area Delivery Drivers Security Fund if:

You are employed by an Employer who has a Collective Bargaining Agreement or an approved subscription agreement with a participating local union which provides for participation in a plan sponsored by the Fund,
You work (or are compensated for) the minimum number of hours as required under the Collective Bargaining Agreement for your Employer to be obligated to contribute on your behalf,
Your Employer contributes to the Fund on your behalf on time and in the full amount required by the Fund, and
You have completed and submitted an enrollment form to the Fund.

Minimum Hours of Service Requirement

You are eligible to begin coverage under the Plan once you have met the Minimum Hours of Service Requirement as provided in the Collective Bargaining Agreement (and/or approved subscription agreement) between your union and your Employer.

You can begin coverage on the first day of the Calendar Month that follows the month in which you completed the service requirement. For most Plan Participants, this will be the first day of the month that follows the month in which you complete your 80th hour of service.

For example: if your first day of work is in May and your Collective Bargaining Agreement requires you to work 80 hours before you begin participating in the Plan and you complete 80 hours of work by May 15, your coverage would begin on June 1st (provided that your Employer makes the required Contribution, and your contract does not exempt probationary Employees from the Contribution obligation).

Dependents Eligibility

Your Dependents will be covered by the Plan when you establish eligibility or, if you are already enrolled in the Plan, when the Dependent becomes an eligible Dependent through birth, marriage, adoption, or forming a Domestic Partnership. You must make sure to enroll your eligible Dependents in the Plan within 31 days of becoming eligible by contacting the Fund Office. They will not be entitled to benefits until they are enrolled.

An eligible Dependent is:

Your legal Spouse or your Domestic Partner.
Children up to age 26 including:
1. your natural children.
2. your stepchildren (including children of your Domestic Partner) who live in your household.
3. legally adopted children on the date they are placed with you in your home in anticipation of final adoption.
4. children for whom you have been appointed Legal Guardianship.
5. foster children.
6. children designated as your Dependents in a valid
Adult Disabled Child: Unmarried mentally or physically disabled children aged 26 and older who are unable to support themselves and are primarily dependent on you for their support provided, (1) they were eligible and totally and permanently disabled before age 26; and (2) you furnished proof of the ongoing total and permanent disability within 31 days of your child reaching age 26 (and as may also be periodically required by the Fund after age 26).

Domestic Partners

Domestic partners are defined as same-sex and opposite-sex couples registered with any state or local government agency authorized to perform such registrations. There are no requirements for proof of relationship or waiting periods that are not also applied to married couples. For your Domestic Partner to receive benefits, you must enroll in the Plan by submitting to the Fund Administrator:

An application of enrollment, and
A copy of the the Certificate of Domestic Partnership (or equivalent form) issued to you and your Domestic Partner by a state or local government agency.

More on Domestic Partners

When Your Dependents’ Eligibility Begins

If you have Dependents on the date you first become eligible to participate in the Plan, your Dependents also become eligible on that date (but you must still enroll them). If you are already enrolled when you acquire a new Dependent, please see the Special Enrollment section on page 9 of the SPD for information on when your newly acquired Dependent becomes eligible.

When Coverage Ends

Employee coverage ends on the earliest of the following:

The date the Plan terminates,
The end of the month for which the last Employer Contribution is made on your behalf,
The 32nd day after you enter the U.S. armed services on a full-time basis (if you fail elect to self-pay)
The date your eligibility for coverage ends as described under “Continuation Coverage”,
The date your Employer ceases to be a Participating Employer, or
The date you retire, are pensioned, leave voluntarily, or are dismissed from employment, or the date you otherwise stop active work for your Employer.

Dependent Coverage ends on the earliest of the following:

The date your Dependent ceases to be an eligible Dependent under the Plan (for example, for your Spouse upon divorce),
The last day of the month in which your children reach the Plan’s maximum age allowed for Dependent Children,
The date your coverage terminates,
The date your Spouse or Domestic Partner enters the U.S. armed services on a full-time basis, or

The date the Plan terminates, or the date the Plan terminates coverage for Dependents.

Surviving Dependents

If you are an Active Employee and you die leaving only your Spouse or Domestic Partner, he/she will remain eligible for up to twenty-four (24) months after your death (starting with the first day of the month immediately following the date of your death) or until he or she remarries or enters into another Domestic Partnership. If you die leaving only Dependent Children, they will remain eligible for up to two years or until he or she no longer qualifies as a Dependent child, whichever occurs first.

If you die leaving both a Spouse (or Domestic Partner) and Dependent child(ren), your children’s eligibility will be based on your surviving Spouses or Domestic Partner’s participation. For example, if you die and your Spouse remarries one year later, your Dependent Children will also lose their coverage on the date of marriage.

Please contact the Fund Administrator for information regarding the cost of this coverage.

Note that these extensions of coverage for a Spouse and children run concurrently with any COBRA rights that may exist, not in addition to such rights. At the end of the two-year extension described here, your Spouse, Domestic Partner or child may remain eligible to continue coverage through COBRA.

Options When Your Coverage under This Plan Ends

When coverage under this Plan terminates, you may have the option to self-pay for temporary continuation of this group health plan coverage by electing COBRA Continuation Coverage. You can also look into your options to buy an individual insurance policy for health care coverage from the Health Insurance Marketplace.

If you purchase coverage in the Marketplace, you could be eligible for a premium tax credit that would lower your monthly premium for Marketplace-purchased coverage. Being eligible for COBRA does not limit your eligibility for coverage for a premium tax credit.

For more information about the Health Insurance Marketplace, visit www.healthcare.gov or www.coveredcalifornia.com (for California residents). You may also qualify for a special enrollment opportunity for another group health plan for which you are eligible (such as a Spouse’s plan), if you request enrollment in that plan within 30 days of losing coverage under this Plan.

When the Plan Can End Your Coverage for Cause

In accordance with the requirements in the Affordable Care Act, the Plan will not retroactively cancel coverage (a rescission) except when Contributions and self-payments are not timely paid, or in cases when an individual performs an act, practice or omission that constitutes fraud, or makes an intentional misrepresentation of material fact that is prohibited by the terms of the Plan, or as otherwise allowed by federal law.

Plans 11A, 11B

To be eligible for the Retiree plan(s), you must satisfy all of the following rules: First, you are eligible to participate in the Retiree plan if you are receiving:

A pension from the Western Conference of Teamsters Pension Fund (or another Plan recognized for this purpose by the Board of Trustees), or
Social Security old age benefits, or
A pension from a plan sponsored by an employer that has participated in the Fund for at least ten consecutive years and has a current collective bargaining agreement and approved subscription agreement with a participating local union, or
Federal Social Security disability benefits for which you qualified while working in employment covered by the Fund as an active employee; and

Second, while an active employee you must have been eligible for benefits under a Bay Area Delivery Drivers Security Fund Plan for active employees for at least 60 months, including at least 48 out of the last 60 months immediately preceding the effective date of your pension or disability; and

Third, you make the required monthly copayment, which is due on the first day of each calendar month. If you fail to make the payment within thirty days of the date it is due, your coverage will be terminated and cannot be reinstated: and

Fourth, the Employer from which you retired remains a contributing employer in one or more of the Fund’s Plans for active employees: IF YOUR FORMER EMPLOYER LEAVES THE FUND, ITS RETIREES LOSE ELIGIBILITY IN THE RETIREE PLAN EFFECTIVE AT THE END OF THE MONTH IN WHICH THE EMPLOYER STOPS CONTRIBUTING TO THE FUND.

Why does a retiree lose eligibility in the Retiree Plan if his former Employer leaves the Trust Fund? Because the Retiree Plan is primarily funded through the contributions for active employees. Note, however, that if your former Employer files for bankruptcy and/or goes out of business, your retiree coverage will still continue.

Dependent Eligibility Rules