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Answers to Frequently Asked ELIGIBILITY Questions How do I initially qualify for benefits? If you have never been eligible before, or have been ineligible for 5 (or more) preceding six-month eligibility periods (2.5 years or 30 months), you need to earn a minimum of 600 hours in one (or 2 consecutive) six-month Qualifying Periods. How do I maintain my current coverage? After you initially qualify, you need to earn a minimum of 300 hours during each applicable Qualifying Period. If I don't earn enough hours, can I use my bank? As long as the number of hours in your bank combined with your work hours equal 300 or more, and you are still available for work in the motion picture industry, you will be offered a Bank of Hours extension in the event you do not qualify based on earned hours. You will be sent an extension form about two weeks prior to the end of your benefit period. You must sign and return the extension form to the West Coast Plan office in order to receive the Bank of Hours extension. I've been on disability. What will happen to my benefits? If your disability benefits began within 90 days of your last date of covered employment, we will calculate 40 hours per week (excluding holidays) that you were disabled during the Qualifying Period. If this adds up to at least 300 hours within the Qualifying Period, you will be eligible for a 6-month extension of benefits. Please note that hours on disability are not banked or combined with a Bank of Hours. Also, you may not have two consecutive temporary disability extensions; nor may you have two disability extensions based on the same disability claim. What happens if I still don't qualify after all of my extensions have been used up? You will be given the option to continue your coverage by self-payment of premium through COBRA for an 18-month period, less any temporary disability extensions granted after your initial qualifying event. Once you have exhausted 18 consecutive months of extended coverage, you will be offered a direct conversion policy through the hospital/medical plan in which you are enrolled. You also have the option to enroll directly into the conversion policy, within 31 days of your loss of eligibility, without first paying for COBRA. How long can I pay for COBRA and how much will it cost? The maximum period for extended coverage is 18 months. For example, if you use a temporary disability extension and do not qualify for the next benefit period, you will be entitled to 12 months of COBRA coverage. The cost of these benefits will depend on the number of dependents you wish to cover, and whether you elect the Core or Noncore benefits. Noncore benefits include hospital, medical, prescription, dental and vision; Core benefits include hospital, medical and prescription only. I have a new dependent and need to add him/her to my coverage. You need to complete a new beneficiary/enrollment card. Return this card to the West Coast Plan office with a copy of the marriage/birth certificate (or hospital record) and we will add your dependent as of the date of marriage/date of birth. For non-biological children, a separate application and additional documentation (e.g. placement agreements, legal guardianship documents) will be required. Can I add my same-sex domestic partner? Plan benefits are available to qualified same-sex domestic partners of Health Plan participants. For Active Participants, please see “Same Sex Domestic Partner Coverage,” and Retirees and Survivors should refer to: “Same Sex Domestic Partner Coverage.” My divorce is final this month and I need to take my ex-spouse off of my coverage. What do I need to do? You need to complete a new beneficiary/enrollment card; indicating the date of divorce in the appropriate space. Return this card to the West Coast Plan office with a copy of the page of your divorce documents with the dissolution of marriage date. Your ex-spouse will be covered through the end of the month of the divorce date; he/she will be given the option to continue coverage by self-payment through COBRA. If a current mailing address for the ex-spouse is not provided to the Plan office, the COBRA notification will be sent to the last known address. My child will be 19 next month. What happens to his/her coverage? As long as he/she is a full-time student and depends on the participant for primary support, coverage will continue until age 23. To be considered full-time, the student must complete 12 units per semester, or 10 units per quarter. To ensure continued coverage, you must send us a copy of the schedule of classes at the beginning of each session. At the end of each session, you must send us a copy of the grades.If he/she is not a full-time student, he/she has the option to continue coverage by self-payment of premium through COBRA. What if my child withdraws from a class? Student eligibility will terminate at the end of the month in which he/she withdrew from class, bringing the course load to below full-time. He/she will be given the option to continue their coverage by self-payment of premium through COBRA. I have a change of address. You must submit your change of address in writing, with your signature and social security number. You can either mail or fax a letter, or complete and submit a change of address card. I want to transfer from my HMO (or pre-paid dental plan) into the MPIHP/Blue Shield (or Delta Dental Plan). Please send us a letter, with your signature and Social Security number, stating that you would like to change your enrollment from the HMO or prepaid dental plan in which you are currently enrolled, to the MPIHP/Blue Shield Plans. Your plan change will be effective on the first of the month following our receipt of your letter. When can I enroll into an HMO or prepaid dental plan? During Open Enrollment, which is in July of each year, for an effective date of August 1. TOP