Maintaining Coverage

Your insurance continues automatically provided at least one (1) monthly deduction remains in your account.

Continuation of Coverage for Functionally Impaired Children

Extended Health Care and Dental Care coverage will continue beyond the date an unmarried Child attains the limiting age for coverage, provided proof is submitted to the Insurance Company within 31 days that such Child:

 Conditions for Coverage:  
  • is incapable of self-sustaining employment by reason of functional impairment;
  • became so incapacitated prior to attainment of the limiting age; and
  • is wholly Dependent upon you for support and maintenance.

Thereafter, such proof must be submitted to the Insurance Company, as required.


Direct Payments

As mentioned above, your insurance continues automatically as long as you have a balance of at least one (1) monthly deduction in your account. However, if at the end of any month, you have less than one (1) deduction, you may continue your coverage for all benefits, by making a payment directly to the Trust Fund. You are allowed to make these direct payments for twelve (12) months. An extension beyond the twelve (12) month limit may be granted providing you are in good standing with the Union, and have not refused work at the trade within the territorial jurisdiction of the Union.You may make direct payments until you retire or reach age sixty-five (65).

You may be eligible for financial assistance to maintain direct payments, however such assistance only applies to Life Insurance, Health Care and Dental Care Benefits. The assisted coverage will not include Vision Care, Weekly Wage Replacement, Long Term Disability, Members & Family Assistance Plan (MFAP), Labour Accident Money Program (LAMP), or Emergency Out of Country benefits.

Should you elect to Retire and your coverage is in effect at time of Retirement, the benefits provided under the Insulators Local 95 Benefit Plan, except Weekly Wage Replacement and Long Term Disability benefits, may be continued. Note; the Life Insurance benefit reduces at the earlier of retirement or age 65. At first, the balance in your hour bank account will be used to provide your benefits and when that is depleted you may elect to continue the benefits on a Self-Pay basis until you attain age sixty-five (65).

Should you decide to return to work you may continue to make Self-Pays beyond age 65, but only for so long as you continue working. There can be no break in coverage; your benefits must be continuous, and you must begin your self payments within 30 days of the depletion of your Hour Bank. Retirees do not accumulate contributions in an hour bank after retirement.

NOTE: Retirees who return to work after receiving their RETIREE LIFE CERTIFICATE and elect to make Self-Pays will be entitled to no other Life Insurance benefit above their Life Certificate.

Disability Fund Assistance

Should you become disabled and be unable to work, your Trustees have arranged for the Trust Fund to assist you by maintaining coverage for benefits, for you and your eligible Dependents. All benefits may be continued by the Trust Fund, provided you are: in receipt of Weekly Wage Replacement benefits; Long Term Disability Income; Workplace Safety and Insurance (WSIB); E.I. Disability Income benefits; or salary continuance benefits from a Motor Vehicle Accident insurance. Proof of your disability will be required on a monthly basis. (Contact the Administrative Agent for further details.)

The Trust will continue to maintain benefit coverage for up to a continuous period of 24 months, provided you are totally disabled from your “own occupation, thereafter Disability Fund Assistance continues provided you are prevented from performing “any” occupation. To be considered disabled from any occupation you will be in receipt of CPP Disability Benefits or, approved for a Waiver of Life Insurance premiums by the insurance carrier. In no event will Disability Fund Assistance continue beyond your attainment of age sixty-five (65).

Termination of Insurance:

Your benefit coverage, and that of your eligible Dependents, will cease under this Plan:

 Termination of Insurance:  
  • The first day of any month in which you have less than one deduction in your account, or
  • The last day of any month in which you have made the maximum number of contributions under the Direct Payments option, or
  • The last day of any month in which you cease to qualify under the Disability Fund Assistance provisions, but not beyond your attainment of age 65, or
  • The first of the month following the month in which you attain the benefit age limit, or
  • The date you cease to be in a class of persons who may be insured under this policy, or
  • The date the Group Master Policy is cancelled or terminated.

 

On termination of your coverage you may have the option to convert a portion of your Life Insurance coverage to an individual Life Insurance Policy. For more details contact your Administrative Agent.

In the event that you are disabled, or if you die, some benefits may be extended to you or your Dependents. Please contact your Administrative Agent.

Coverage for your Dependents will terminate on the date such Dependent ceases to meet the Dependent eligibility requirements.

 Note:  

Should you elect to work beyond age sixty-five (65), you may continue coverage until December in the year you turn seventy-one (71) with the following exceptions:

  • Long Term Disability Benefit terminate at age 60
  • Life Insurance Benefit reduces at age 65
  • Weekly Income Replacement Benefit terminates at age 70
  • Labour Accident Money Program (LAMP) terminates at age 70.



Reinstatement of Coverage

If your coverage under this Plan ceases because you have insufficient credits, and you have not Retired, your coverage will be reinstated when you have accumulated one monthly deduction in your account. Your coverage is effective on the first day of the second month following that accumulation.

If you have been out of benefit coverage for six consecutive months, you will be treated as a new Member and the Member Eligibility provisions will apply.

Insulators Local 95 Benefit Trust Fund c/o Benefit Plan Administrators 
90 Burnhamthorpe Road West, Suite 300 Mississauga, Ontario L5B 3C3