ACTIVE MEMBER ELIGIBILITY

Who May Be Covered

This Plan is for Members in good standing as per the Uniform Local Constitution (Article III – Membership), who are residents in Canada and:

  • work for Contributing Employers; or are
  • Unemployed Members* who have insufficient funds in their Dollar Bank Account to maintain coverage.

*Note: Unemployed Members have Member Life Insurance only in the amount of $10,000. There is no cost to the Member for this benefit as it is being paid by the Trust Fund. To be entitled to this benefit the Member must meet the following requirements:

  • Immediately prior to unemployment, you must have been previously covered as an Active Member;
  • be unemployed due to layoff;
  • be, and remain, a Member in good standing as per the Uniform Local Constitution (article III – membership), and actively seeking work through LIUNA Local 493 by being registered on the out-of-work list of the Union.
  • Have completed, signed and returned an enrollment form to the Health &Welfare Trust Benefit Office

When You Become Covered Initially

You and your eligible dependents will become covered on the first day of the month following the accumulation of 1 month of coverage costs in your Eligibility Bank Account (currently $250). The plan administrator will keep you covered by the Welfare Plan during periods of unemployment or underemployment, as long as you have at least one month of coverage costs in your Eligibility Bank Account and you remain a member in good standing.

A completed and signed Enrollment form must be received by the Health and Welfare Trust Administrator.

The above Eligibility Bank rules are those that were in effect when this booklet was printed. These rules are subject to change in the future, and in that event, you will be notified. Frequently, changes will occur because there has been a change in the contribution rate to fund the cost of enhanced benefits, in which case it is likely that any amounts previously mentioned will increase to reflect the cost of a new and improved Welfare Plan.

If your dependent is confined, the effective date of coverage is the first date the dependent is no longer confined.

Confinement shall include both home and hospital confinement. If the dependent is confined at home, confinement shall mean the dependent is unable to carry on any substantial part of the regular and customary duties or activities of a person in good health and of the same age and sex. This shall not postpone the effective date for a child born while the employee’s dependents are covered under this policy.

Eligibility Continuance

If your Eligibility Bank is exhausting, you may elect to continue your eligibility by contributing to the Local 493 Welfare Trust Fund the dollar amount equal to the monthly amount required to maintain your eligibility bank ($250.00 plus taxes at the time of print).

  • You must be active in benefits at the time of contribution and the payment must be received by the Welfare Trust Fund by the 20th of the month prior to the month in which benefits are to remain active
  • There is a 3-month maximum on eligibility continuance per calendar year.

It is the MEMBER’S RESPONSIBILITY to be aware of your eligibility status.

You can contact our office at any time to check on your eligibility bank and it is strongly advised at the time of layoff.

Reinstatement

If your coverage has previously terminated because of insufficient funds in your Eligibility Bank Account, or due to administrative suspension for not meeting the requirements of a member in good standing as per the Uniform Local Constitution (article III- membership), you will again become covered on the first day of the month following the accumulation of 1 month of coverage costs in your Eligibility Bank Account or reinstatement as a member in good standing.

Termination of Coverage for Active Members

The coverage for you and your eligible dependents will terminate on the earliest of the following dates:

  • the last day of the month in which you have less than one month of coverage cost in your Dollar Bank Account.
  • on the day you cease to be a member in good standing as per the Uniform Local Constitution (article III – membership), including suspension for non-payment of dues.
  • if you transfer to another LiUNA Local, your group benefits will cease on the day of transfer. Any funds in your eligibility bank may be transferred to your new local by signing a reciprocal agreement, and will otherwise be held for a period of up to one year, at which time any funds will be credited to the general reserves of the fund.
  • if you enter Military Service.
  • if the Group Policy terminates.
  • if you discontinue any required contributions.
  • upon Retirement – if you continue to work, contributions go to the general assets of the plan to help support the Retired Member’s plan
  • the date outlined in the Summary of Benefits.
  • a dependent’s coverage will also terminate when he/she is no longer an eligible dependent.

Termination of Coverage for Unemployed Members who have insufficient funds in their Dollar Bank Account to maintain coverage.

Your coverage will terminate on the earliest of the following dates:

  • the date you are no longer actively seeking work through LIUNA Local 493 by being registered on the out-of-work list of the Union.
  • If you cease to be a member in good standing as per the Uniform Local Constitution (article III – membership).
  • If you enter Military Service.
  • If the Group Policy terminates.
  • If we do not receive any contributions for a period of one year.
  • The date outlined in the Summary of Benefits.

Extension of Coverage

If you are absent from work due to injury and are receiving Workers’ Compensation benefits, or upon approval of Long-Term Disability benefits, your Welfare Plan dollars bank account will be frozen, and you and your eligible dependents will remain covered while you are in receipt of Workers’ Compensation, up to a maximum of 12 months. Coverage ceases on the earlier of (i) one year following the date of injury, or (ii) the date you are no longer receiving Workers’ Compensation or Long-Term Disability Benefits. It is the responsibility of the member to notify the plan administrator directly within 30 days, and supply evidence that you are in receipt of WSIB or LTD benefits, the date of disability, and if known, the expected date of your recovery, to avoid being overlooked.

Eligible Dependents

Eligible dependents under this plan shall include:

  • Unmarried children from live birth who are under age 22. Dependent children must be dependent on you for support and not employed at a regular full-time job.
  • Coverage is continued while the child is under age 25 and attending an accredited college or university on a full-time basis. You must provide annual confirmation that the child is a full-time student and remains dependent on you for support and maintenance; and
  • Functionally impaired children who are totally dependent upon you for support. For the purposes of this plan, functionally impaired shall mean an unmarried person who was covered as a dependent prior to becoming functionally impaired and who is wholly dependent upon you for support and maintenance within the terms of the Income Tax Act; who is a resident in Canada.
  • A child of your spouse provided,
    • he/she is also your biological child; or
    • your spouse is living with you and has custody of the child.
  • Your spouse as the result of a valid civil or religious ceremony, or a person whose common-law relationship with you has existed for a minimum of 24 consecutive months immediately prior to the date on which a claim arose and provided the existence of such continuous common-law relationship can be established by public representation and ceases on the date the cohabitation ends.

Separated spouses shall be removed only with written permission from the spouse or by court order. Divorced spouses are not eligible for coverage.

No one will be eligible as a dependent while in military service.