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Self-Pay Premiums
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Self-Pay Premiums

In addition to the earnings requirements for Tier I, II and III coverage, to be eligible for Welfare Fund coverage, you are required to submit self-pay premium payments to the Fund Office. The rate for your self-pay depends on the Tier of your coverage, and the coverage type you have elected (Participant, Participant + 1, or Family). If you have Tier I or II coverage and wish to buy up to Tier III coverage, there are special rates. Follow this link for a chart showing the current Self-Pay Premium Chart.

You will receive an invoice from the Fund Office in advance of the first day of each quarterly period. If it is more convenient, please note that you have the option to pay your self-pay premium up front for the full year, or every 6 months, instead of every quarter. You can remit payment to the Fund Office via:

  • Credit card on our website fundoneiatse.com, by calling (212)247-5225 or in person at the Fund Office.
  • Check made payable to “The Welfare Fund of Local No. One, I.A.T.S.E. There will be a $15.00 charge for any check returned from the bank.  Post-dated checks not accepted.
  • Cash in person at the Fund Office located at 320 W. 46th St.,   6th Floor.

Late Fees and Coverage Termination
Your self-pay insurance premiums are due in advance and must be received no later than the first day of each quarterly period (July 1st, October 1st, January 1st, and April 1st). If your payment is made after the due date, you will be charged a $25 late fee. If we do not receive your self-pay premium and $25 late fee by the end of the month in which it was due, your coverage will be terminated retroactive to the first day of the quarter for which you failed to timely pay, and you will not have another opportunity to enroll for the remainder of the Plan year. Please note that no claim will be considered for benefit payment if timely payment of the premium has not been received for the quarterly period during which the claim arose (i.e., the three-month period in which the medical service was rendered).

Changes to Coverage Elections
While it is not possible to change your buy-up election after open enrollment ends, there are certain circumstances that may allow you to change your coverage election (Participant, Participant +1, and Family). These include situations where a dependent loses eligibility for other insurance, or you have changes in your immediate family like marriage, divorce, birth or adoption, and death. If you experience such a qualifying change, you must request a change in coverage in writing and provide valid documentation within 60 days of the event. If you do not request the change within the 60-day window, you will have to wait until the next open enrollment to make the change. For additional information, see the “Mid-Year Coverage Changes” section on the Eligibility and Enrollment page, or contact the Fund Office.

Disability Waivers
If you become disabled, you may be eligible to have self-pay payments waived. For more information, please follow the link to the Disability Crediting & Waivers page.

News, Notes and Links

 

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