Medical Information
BASIC ELIGIBILITY RULES
Initial Eligibility Rules
- 375 hours during a period of 3 consecutive months, eligible for benefits the 1st day of the 2nd calendar month following that 3‐month period; or
- Total of at least 500 hours are contributed during a period of 6 consecutive months, eligible 1st day of the 2nd calendar month following that 6‐month period.
- You and your eligible dependents will become initially eligible on the 1st day of the 2nd month following any 3 consecutive calendar months in which you have worked at least 375 hours for Contributing Employers.
- You must enroll your dependents, or they will lose their eligibility to participate in the health plan.
Newly Eligible Enrollments
- You will need Social Security Number and Date of Birth for all covered family members.
- You should confirm your health care providers participate in the insurance plan before making an appointment
- You will receive a detailed benefit booklet and ID card at your home after you have enrolled.
- If you have become eligible for the first time and are enrolling in the medical plan, you may be asked to send a HIPAA Certificate of Creditable Coverage to the Fund Office.
Reinstatement Rules
Member must post 140 hours within a 4‐month period immediately following such termination. Reinstatement will take place on the 1st day of the month following the month requirement is met. If Reserve Account does not show 140 hours within such 4‐month period all hours will be forfeited unless coverage is continued through self‐ payment. Once a Reserve Account has been forfeited for this reason Active Member will have to meet the Initial Eligibility requirements again. Once reinstated, there will be no requirement to add dependents or select your plan again. Everything will we return to your previous status prior to termination.
EXTENDED COVERAGES
Hour Bank
Members can bank up to 560 hours which equates to 4 months of extended coverage after you terminate employment. Once you gain your initial eligibility, any hours you work over the 140 hours needed to maintain eligibility will be deposited into your hour bank.
Labor Purchase
If a member terminates employment with more than 70 hours remaining in their hour bank, they may buy the needed hours to gain another month of active coverage. The charged rate will depend on the plan election of the given participant.
COBRA Continuation Coverage
If a member terminates coverage with less than 70 hours remaining in their hour bank they may purchase COBRA continuation coverage for 18 months, some exceptions apply. COBRA Rates are posted below in the Useful Forms Section.
CURRENT EMT PLAN OPTIONS
Kelsey Care – HMO
Base plan option that comes with no payroll deduction. See summary of benefits for detail of benefits and coverages.
Memorial Hermann – ACO
Middle Tier Option with $1.00 per hour payroll deduction. See summary of benefits for detail of benefits and coverages.
Aetna POS Choice II
Premium Plan that comes with $4.00 payroll deduction. See summary of benefits for detail of benefits and coverages.
National Vison Administrators, L.L.C (NVA)
Vision Benefits Summary effective July 1, 2023.
Electrical-Medical-Trust-Benefit-Summary-Vision—Copy
ELECTRICAL MEDICAL TRUST WEBSITE
Electrical Medical Trust The goal is to provide a convenient one stop destination for all plan participants of the Electrical Medical Trust. A single repository for all of the plan information a participant would need with easy access to important disclosures, plan documents, forms, and eligibility information.
SHORT TERM DISABILITY
Short Term Disability is for eligible participants who are unable to work due to injury or illness. The EMT will pay $300 per week for up to 26 weeks, along with extending your medical benefits up to 3 months. Some exceptions apply.