Eligibility & Enrollment

Learn more about changes to Participant Eligibility Levels and Monthly Co-Premium Payments

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Your Eligibility

 

Eligibility for enrollment in the Fund is based upon contributions the Fund receives on musicians’ behalf from Participating Employers. A Participating Employer is one that has entered into a Collective Bargaining Agreement which calls for contributions to come to the Fund.

 
 
 

A musician may qualify at one of three levels:

 

LEVEL A

ELIGIBILITY
CONTRIBUTION

$1,700 +

MEDICAL PLAN
COVERAGE OPTIONS

Blue Shield HD PPO – HSA
Blue Shield Access+ HMO
Blue Shield Trio HMO
Kaiser Traditional HMO
Kaiser Deductible HMO
Kaiser HD HMO – HSA

ADDITIONAL
COVERAGE

Chropractic / Acupuncture
Dental / Vision
Life and AD&D Insurance


LEVEL B

ELIGIBILITY
CONTRIBUTION

$1,400 to $1,699

MEDICAL PLAN
COVERAGE OPTIONS

Blue Shield HD PPO – HSA
Blue Shield Access+ HMO
Blue Shield Trio HMO
Kaiser Traditional HMO
Kaiser Deductible HMO
Kaiser HD HMO – HSA

ADDITIONAL
COVERAGE

Chropractic / Acupuncture
Dental / Vision
Life and AD&D Insurance


LEVEL C

ELIGIBILITY
CONTRIBUTION

$700 to $1,399

MEDICAL PLAN & ADDITIONAL COVERAGE

OPTION 1:
Kaiser HD HMO – HSA (without Dental / Vision)
Life and AD&D Insurance

OPTION 2:
No Medical Coverage - Dental / Vision Only
Life and AD&D Insurance


 
 
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What’s Your Level?

 

Employer contributions are accumulated for work performed during the 12-month period beginning October 3rd through October 2nd of the subsequent year. These contributions will determine a musician’s eligibility level for the coverage period January 1st through December 31st.

Eligible musicians will be notified, in November, of the level for which they have qualified. If you know your level or are just interested in finding out more about the benefits provided through the Fund, click through the various levels above.

 
 
 
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Carry-Forward
Contribution Bank

If a Participant fails to have sufficient Employer contributions during a Qualifying Period, a Participant may apply a maximum of $600 of Unused Employer Contributions from the prior Qualifying Period to make that Participant eligible for the next Coverage Year.

Unused Employer contributions are defined as either (a) the excess of the amount of $1,500 of employer contributions, that were actually contributed on the participant’s behalf and that were accepted by the Fund, or (b) the amount of employer contributions in the preceding qualifying period, that were actually contributed on the participant’s behalf and that were accepted by the Fund, when a participant did not qualify. In either event, the maximum look-back period is the prior 12-month contribution period (October 3rd though October 2nd of the following year), and no more than $600 in Employer contributions may carry-forward. The carry-forward contributions may qualify a musician for Level C eligibility.  Contributions that carry-forward may not be used to achieve Levels A or B.

 
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Combining Credits

Husband and wife musicians, who fail to achieve eligibility and who perform under one or more Agreements calling for contributions to the Fund, may elect to have their contributions combined within the Qualifying Period for the purpose of achieving eligibility at the lowest level; whoever has the higher contributions will be the eligible member. Your written request to combine contributions must be received by the Fund during the open enrollment period.


 

Eligible Dependents

Once a Member qualifies for Eligibility, eligible Dependents are also entitled to the benefits provided by the Plan under the self-pay premium option, as long as the Member remains eligible. Eligible Dependents, if paid for, will be covered under the same benefit program selected by the Eligible Member.

Father and son

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Reporting Engagements

It is each Employee’s responsibility to notify the Fund of engagements performed. Contributions not received timely, may not be applied to the prior qualifying period and therefore, may affect your eligibility in the Plan. Print and complete the Member Self-Reporting Form to advise the Union and Trust Fund of engagements you have performed. For more information on this subject, please refer to the Summary Plan Description (SPD).

 
 
 
 

ALERT!

Failing to report engagements in a timely manner could result in loss of eligibility.

You have the right to appeal the denial of eligibility for participation in the Fund’s benefits and coverages

 
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How to Enroll

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Annual Enrollment

 

To enroll in the Plan you must have qualified for benefits, through appropriate and sufficient employer contributions. Enrollment may only occur at the annual Open Enrollment (November 20th through December 20th). If you do not enroll at the open-enrollment period, your eligibility is forfeited, except for HIPAA special enrollment.

An Eligible Member MUST complete the Life Insurance Beneficiary Form in order to be covered under the Life Policy provided by Prudential.  No Life benefit will be available if there is no beneficiary form on file at the Fund office.

Learn more about the 2020 life insurance modifications.

 
 
 

Becoming a Plan Participant

 
 
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Once the Member has become eligible for benefits as described above, the following is required to obtain coverage through and become a Participant in the Plan:

  1. Complete an enrollment application.

  2. Submit any required Member co-premium and dependent premium in a timely manner.

  3. Comply with all other regulations and requirements of the Trust Fund and Plan.

To receive coverage under the benefit plans you must complete an enrollment application indicating the benefit for which you and your dependents wish to enroll.

The Administrator must receive the application and premium payment by the enrollment deadline.

 
 
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Enrollment Forms

 

If you have been notified that you are eligible for benefits, please print and complete this form. Enrollment forms are accepted at the Administrator’s office at Open Enrollment (November 20th through December 20th).

NOTE: Submitting an enrollment application is not proof of enrollment.