When Coverage Begins
If you have filed a timely application, are determined to be eligible under the rules set forth above, and make the required self-payments, you and your eligible dependents will become covered under this Retiree Plan on your eligibility date.

Your initial eligibility date will be the same as the retirement effective date recognized by the Western Conference of Teamsters Pension Trust, or other Teamsters Pension Trust which provides your retirement benefits.

If it appears your retirement effective date may be postponed due to a delay in processing your Teamsters pension application (or a related Social Security disability benefit application) you will have the following options:

• you may elect to initiate immediate Retiree Plan coverage, at full cost self-payment rates, subject to retroactive adjustment of such payments if and when the pension application is approved; or
• you may elect to waive the commencement of Retiree Plan coverage until such time that you are notified that your pension application has been approved.

Retiree Plan Coverage Can Be Postponed While You Have Other Coverage.
You or your spouse are able to suspend or postpone your Retiree Plan coverage if you have other employmentrelated health coverage. If you wish to suspend your Retiree Plan coverage, contact your Area Administrative Office for the necessary form. If you qualify, no self-payments will be required to and no benefits will be provided by, the Retiree Plan while you have other group health coverage.

When you lose your other group health coverage, you must contact your Area Administrative Office within 30 days to resume your Retiree Plan coverage. Your Area Administrative Office will require documentation that your other group health coverage has been continuous and is now terminated, and they will advise you of your selfpayment amount. When the necessary documentation and self-payment is received, your Retiree Plan coverage will resume.

This provision will help retirees who have other group health insurance and want to preserve their ability to participate in the WTWT.

Coverage for Newly Acquired Dependents
Newly acquired dependent children should be reported to your Area Administrative Office by the use of a Participant Data Form (PDF). They will be automatically covered so long as they are eligible dependents, as defined above, and you are covered under the Plan, but no claims will be paid on their behalf until the completed Participant Data Form and all required documentation is received by your Area Administrative Office. To request a PDF call your Area Administrative Office.

  Download the Participant Data Form in PDF format.

If you are covered by this Plan and should marry for the first time, or re-marry, and you wish coverage for your new spouse, you must notify your Area Administrative Office in writing and make the required self-payment for spouse coverage no later than 60 days after your marriage. If you do not provide written notice and make the required self-payments within 60 days of the marriage, your spouse will not be allowed coverage under this Retiree Plan. A copy of your marriage certificate may be required.

Continuation of Coverage
Subject to the Board of Trustees authority to modify or terminate the Retiree Plan, once coverage under this Retiree Plan has started, you and your eligible dependents will continue to have coverage, on a month-to-month basis, as long as you continue in a retired status and as long as you are making the required monthly self-payments.

When your Coverage Ends - Termination of Coverage
All benefits for you will terminate on the earliest of the following dates:

• The first day, following your return to work as an active employee, you are provided with coverage under any other group health care or service type plan of benefits;
• The first day of January following a calendar year when you fail to return a completed annual earnings affidavit. If you fail to return a completed annual earnings affidavit your coverage will be permanently terminated;
• The first day of January following any calendar year in which you were less than 65 years of age and received more than $15,000 as compensation from gainful employment or services in any other capacity. In the first calendar year of your retirement, the disqualifying compensation shall be that which exceeds an average of $1,250 per month. Retirees who lose their coverage under this rule shall have the option of continuing their coverage by making monthly self-payments equal to the full cost of the health and welfare program then being provided, as such amount is fixed and can be changed from time to time by the Trustees. If you do not make these self-payments while you are disqualified pursuant to this rule (and do not have other continuous group health coverage during this period) your retiree coverage will be permanently terminated. You may return to paying the regular cost for the retiree coverage if and when you submit a new annual earning affidavit certifying that you no longer earn annual compensation which disqualifies you;
• The first day of the month following the month in which there has been a suspension or revocation of your monthly pension benefits from the Western Conference of Teamsters Pension Trust or any other Teamster Trust;
• The first day of the month for which you have failed to make the required monthly self-payment for your coverage;
  Exception: There is a one time reinstatement privilege for Medicare eligible retirees and spouses who drop WTWT coverage to obtain Medicare related coverage outside WTWT and later seek to rejoin the WTWT.
• The first day of the month following the month in which this Retiree Plan is terminated;
• The day of your death.

When Your Spouse’s Coverage Ends - Termination of Coverage
All benefits for your spouse (if he/she is covered under the Plan) will terminate on the earliest of the following dates:

• The day you, as the retiree, lose your coverage, as described above,
  Exception: If your coverage is terminated because of death, your surviving spouse will be covered for the balance of the month in which death occurs. A dependent spouse who is eligible for Medicare on the date of your death may continue coverage under the Retiree Plan for up to three (3) months following the date coverage terminates by making the required monthly self-payments, the amount of which will be equal to the full cost of the Medicare portion of the Retiree Plan as determined at that time. Once the 3 month surviving spouse benefit has been used the surviving spouse may qualify for COBRA coverage.
• The first day of the month for which the required self-payment for spousal coverage was not made,
  Exception: There is a one time reinstatement privilege for Medicare eligible retirees and spouses who drop WTWT coverage to obtain Medicare related coverage outside WTWT and later seek to rejoin the WTWT.
• The first day of the month following the month in which the retiree and the spouse are divorced.

When Your Dependent’s Coverage Ends - Termination of Coverage
All benefits for your dependent children will terminate on the earliest of the following dates:

• The day you, as the retiree, lose your coverage, as described above.
• The first day of the month following the month in which a dependent ceases to be an eligible dependent.
• The last day in the month in which your death occurs.
• The day the dependent enters active military service (except for periods of temporary active duty of 31 days or less).

Special Rule Applicable to Retirees Whose Former Employers Cease Contributions to the Trust
When an employer unit withdraws from participation in the Western Teamsters Welfare Trust, whether at the instance of the employer, the union, or the employees, or because of bankruptcy or business failure, the employer’s obligation to pay monthly contributions for active employees comes to an end and there is no longer any contribution income to support the benefits payable under the Active Employees Plan or this Retiree Plan.

Therefore, if a retiree’s last contributing employer ceases to be a contributing employer, the retirees and their eligible dependents (if any), who are enrolled in this Retiree Plan will no longer share in the allocated por tion of employer contributions intended for the Retiree Plan and will be required to make a monthly self-payment equal to the full cost of the benefit program then being provided. Likewise, any active employees who may have completed the qualification period required under the eligibility rules of this Retiree Plan, but who have not yet retired, will not be entitled to Trust contributions for coverage.

Employer withdrawals shall include, but not be limited to, the following situations:

• As a result of collective bargaining negotiations, the employer is no longer contractually obligated to contribute to the Trust;
• The contribution rate or contribution effective date which the employer and union have negotiated is not the standard contribution rate, or the standard contribution effective date recognized by the Western Teamsters Welfare Trust and, after notice, the parties have failed to correct the situation;
• The employer has transferred, consolidated or abandoned the operation covered by the collective bargaining agreement as a result of which the employer has ceased contributing to the Trust;
• Following the sale, merger or consolidation of a contributing employer with another employer, the surviving employer entity declines to contribute to the Trust;
• There has been a decertification or other loss of union representation, resulting in the cessation of an employer’s obligation to continue contributions to the Trust;
• There has been a cessation of an employer’s obligation to contribute due to the employer’s bankruptcy or general business failure.

In any employer withdrawal situation, it shall be the responsibility of the withdrawing employer to arrange substitute coverage for the retirees and their dependents (if any), and for active employees who have qualified for this Retiree Plan at the time of withdrawal, but have not yet retired. However, if for any reason the withdrawing employer fails to provide the substitute coverage, the retired employees and the active employees who are otherwise qualified, will be allowed to obtain or continue coverage under this Retiree Plan on a month-to-month basis by making a monthly payment equal to the full cost of the health and welfare benefit program then being provided, as such amount is fixed and can be changed from time to time by the Trustees.