Benefit Guidelines

We’ve put together these guidelines to help you determine eligibility

Eligibility for Contractual and Non-Contractual Employees

This Plan is intended to benefit employees of employers that have collective bargaining agreements with Local 40, 81 and/or 95 of the United Union of Roofers, Waterproofers and Allied Workers AFL-CIO. Each of these Local Unions, and any other Local Union of the United Union of Roofers, Waterproofers and Allied Workers AFL-CIO which is allowed to cover employees represented by it under this Plan. 

Those employees covered by collective bargaining agreements with the Participating Union are in general referred to as “contractual employees.” Other employees of signatory employers who are not covered by a collective bargaining agreement requiring contributions to this or any other health plan are in general referred to as “non-contractual employees.” 

  • Contractual Employees Subject to the rules set forth in the Summary Plan Description, contractual employee working in employment covered by a collective bargaining agreement with a Participating Union is eligible on the first day of the second calendar month following the month for which the individual has accrued 480 units. Units are only accrued for hours for which contributions are required and actually paid under a collective bargaining agreement with a Participating Union.
  • Non-Contractual Employees Qualified Non-Contractual Employees of Participating Employers may be eligible for Plan benefits if they meet the proper conditions.

Eligibility for Contractual and Non-Contractual Retirees

This retiree medical plan is designed to provide benefits to individuals who retire from the roofing industry and remain retired and their Eligible Dependents.

  • Contractual RetireesA “contractual retiree” is any person who is eligible for and actually is receiving pension benefits from the Pacific Coast Roofers Pension Plan for work covered by a collective bargaining agreement or as an employee of the Union. Retirees’ spouses are also eligible as dependents, but no person is eligible both as a retiree and a spouse. 
  • Non-Contractual Retirees A Non-Contractual retiree is any person (a) who is not gainfully employed for 40 or more hours per month, and (b) meets the Plan’s eligibility rules for Non-Contractual retiree coverage. 

Eligibility Dependents

For the purpose of this Plan, Eligible Dependents are defined as:

  1. Your lawful spouse, or if you have no lawful spouse, your Registered Domestic Partner. For this purpose, Registered Domestic Partner shall mean any person who has registered a domestic partnership with a governmental body pursuant to state or local law authorizing such registration.
  2. Your natural born children and other children defined as follows:
    1. (a) Adopted Children. Adopted children beginning on the date of placement for the purpose of adoption;
    2. (b) Stepchildren. Stepchildren (including children of spouses and Registered Domestic Partners) who are domiciled with the Participant in a parent-child relationship and are chiefly dependent upon the Participant for support and maintenance.
    3. (c) Guardianship. Other children who are (i) domiciled with the Participant in a regular parent-child relationship, (ii) are chiefly dependent upon the Participant for support and maintenance, and (iii) either the Participant or the spouse is the dependent’s legal guardian.