To enroll your dependent child for coverage under the Plan, submit a completed Dependent Child Enrollment Form or Information Verification Form along with a copy of the birth certificate or adoption papers to the Fund Office. If you are not married to your child’s birth mother/father, then you would also need to complete a Dependent Affidavit Form, have it notarized, and submit it to the Fund Office with any supporting documents. You must submit the completed enrollment form with the appropriate documentation to the Fund Office within 60 days of the event. If you do not enroll your dependent in 60 days, claims will be denied until you submit the required information.

Your birth child is eligible for coverage on the date of his or her birth. If you adopt a child, have a child placed with you for legal guardianship, or acquire a stepchild through marriage, he or she will be eligible for coverage on the date of placement or marriage, as long as you are responsible for healthcare coverage and your child meets the Plan’s definition of a dependent child.

• Pre-retirement surviving spouse pension; or
• Pre-retirement death benefit.

• received your pension in a lump sum payment, no further benefits are payable; or
• You were receiving your pension in the form of a:
  • Single life annuity and benefits are payable for your lifetime only. No further monthly benefits are payable after your death.
  • Ten Year Certain and you had not received 120 monthly payments before your death, your beneficiary will receive the remainder of the 120 monthly payments. If at least 120 monthly payments were made before your death, no further benefits are payable.
  • 50% (or 75% or 100%) spousal pension, your spouse will receive 50% (or 75% or 100%) of the amount you were receiving for the rest of his or her lifetime.

• Attaining Normal Retirement Age (age 62).
• Attaining Early Retirement Age (age 55-61) and withdraw from all employment with a covered employer or Disqualifying Employment.
• Disability. Receipt of a Social Security disability award or with 2 independent doctors reports stating that you are totally and permanently disabled.
• Small Account Balance – if your Participant Account Balance is less than $5,000.00 and you have not and contributions to the Plan for 2 fiscal years
• Special Rollover Distribution – if your Participant Account Balance is greater than $5,000.00 and you have not worked in Disqualifying Employment for 5 consecutive Plan Years and are withdrawn from all employment with a covered Employer.