HEALTH DEPARTMENT

Retiree Health Plan Coverage Eligibility

You must be an Active Covered Participant in the Eastern Atlantic States Carpenters Active Plan both at the time of your retirement and the Benefit Period immediately preceding the Benefit Period in which you retire. Participants beginning on or after January 1, 2023 will need to earn 30 Active Health Credits to retire with Health Coverage.

Active Health Plan Credit System

Gold Level = 0.50 Credit

For each 6-month Gold Coverage, Philadelphia Active Health Plan eligibility period*, or Level II eligibility period in the Northeast Active Plan, you are granted 0.5 Active Health Plan Credits

Silver Level = 0.25 Credit

For each 6-month Silver Coverage or Level I eligibility period in the Northeast Active Plan, you are granted 0.25 Active Health Plan Credits

Missed eligibility period (i.e. each eligibility period you did not qualify for coverage, including any Benefit Periods in which you purchased COBRA), you are granted 0 Active Health Plan Credits

*For Participants previously covered under the Philadelphia  Active Health Plan prior Benefit Periods earned through “Vesting” or “Basic” Benefit Periods are not considered eligibility periods and you will not be entitled to Active Health Plan Credits for those periods.

Gold Level Retiree Health Coverage

RETIREE HEALTH

90/10 Coinsurance
  • Retire with Gold Level based on Credit System
  • 1 Gold Eligibility Period = 0.50 Credit
  • 1 Silver Eligibility Period = 0.25
  • Maximum of 1 Credit in a Plan Year

Active Health Plan Credit Requirement

For Retirees previously covered under the Philadelphia Active Plan:

Retirees who were participants in the Philadelphia Active Plan must earn at least 25 Active Health Plan Credits to be eligible for Retiree Plan coverage. Earning 25-29 credits, the monthly copay will be higher than if they earn 30+ credits

For Retirees previously covered under the Northeast Carpenters Active Health Plan:

If your first Hour of Service was before April 1, 2011, you will need 25 Active Health Plan Credits to qualify for Coverage when you retire.

If your first Hour of Service was after April 1, 2011, you will need 30 Active Health Plan Credits to qualify for Coverage when you retire.

Additional Retiree Health Coverage Details

Retirees are responsible for paying a monthly premium toward the cost of their coverage. The required premium is set by the Trustees and will vary based on whether you are Medicare-eligible as well as whether you elect self-only coverage or coverage for you and your Eligible Family Members.

No Retiree Health Coverage

Retirements on or after 1/1/2023 run out benefit period they are in

Retiree Health Coverage

If eligible for retiree coverage (due to hours) - Plus one more active benefit period 

In the event a retired eligible member passes away, their surviving spouse will receive twelve (12) months of health coverage from the date of death, and then have the option to pay the COBRA rate for life. 

COBRA Rate as of 4/1/2024

  • Gold Coverage: $707.05 Single / $1,767.63 Family
  • Silver Coverage: $600.99 Single / $1,502.48 Family

Your Medicare Advantage Plan and Medicare D Prescription Plan are administered by Blue Medicare Advantage.

Click Here to learn more about Medicare Coverage.