Disability
Disability Extension Benefit
If you become temporarily Disabled while covered under Plan A you may qualify for up to 9 months of extended eligibility within a 24-month period.
Eligible Participants in Plan R and Plan B may qualify for up to 4 months of extended eligibility.
Flat Rate Participants and Stakeholders are not eligible for this extension of eligibility.
To qualify for a Disability Extension, you must file an application with the Trust Fund Office no later than 12 months from the First Day of Disability.
If your application is approved, a Disability Extension may then be given to extend existing eligibility (up to a maximum of 4 months for Plan R and Plan B or 9 months for Plan A) but not to establish eligibility.
The "lag month" applies. Therefore, in order to qualify for the disability extension, you must have eligibility for the month in which you become Disabled and for the following month.
For example, if you are eligible in April and disabled in April and you have at least 100 hours remaining in your Hour Bank to be deducted for May coverage, you may receive the Disability Extension to extend your Hour Bank for an additional month (for June coverage). However, if there are less than 100 hours in your Hour Bank and you would not be eligible for May, no Disability Extension would be granted.
Supplemental Monthly Disability Benefit
Participants who are covered under Plans A, B and R and qualify for the Health and Welfare Disability Extension are eligible for Supplemental Monthly Disability benefits during the months of extended coverage. This applies to both Kaiser HMO and Indemnity Medical Plan Participants. Participants in the Flat Rate Plan are not eligible for Supplemental Monthly Disability Benefits.
Requirements
Supplemental Monthly Disability Benefits are payable if you satisfy all of the following:
- You have met the qualifications for the Health and Welfare Disability Extension of health coverage and your extension of coverage has begun;
- You became temporarily Disabled due to Illness or Injury while eligible under the Plan;
- You were eligible under the Plan in 12 of 24 calendar months immediately preceding the First Day of Disability provided that your eligibility is through work hours or your Hour Bank, not as a result of a disability extension of eligibility;
- You worked for a Contributing Employer at least one day within the 30-day period preceding the First Day of Disability; and
- You are receiving either temporary Workers’ Compensation Benefits or State Disability Insurance benefits as a result of the Disability (or, if you live in a state that does not provide State Disability Insurance Benefits and you are not receiving Workers’ Compensation Benefits, you provide written certification from a Physician approved by the Plan that you are Disabled as defined by the Plan).
The Benefit
Benefits are payable only to you, the Participant, and may not be assigned. About the Benefit:
- The maximum benefit amount payable by the Plan is $365 per month.
- The maximum number of months payable for any one Period of Disability for Participants who have a qualifying Extension of Health Coverage is 9 months for Plan A Participants or 4 months for Plan B and Plan R Participants.