To earn your initial eligibility for the Fund’s health care coverage, you must meet the required length of service and required hours for your job classification.
Required Length of Service
Participants Other Than Clerk’s Helpers and Utility Clerks
You are eligible to enroll on the first day of your seventh month of employment. After your first month of employment, you must have worked at least 20 hours in each of the next three months and the required hours in the fifth month.
If you decide not to enroll when you become eligible, you will have to wait until the next Open Enrollment period to do so.
Clerk’s Helpers and Utility Clerks
You are eligible to enroll on the first day of your 13th month of employment. You must work the required hours in the 11th month for initial coverage in the 13th month.
Note that the Affordable Care Act (ACA) provides you the option to enroll for coverage earlier, by paying the premium cost for coverage (called your “contribution to premium”), as follows:
- You may be eligible to enroll before your 13th month, when you reach 1,200 hours of service.
Contact the Fund Office if you are interested in early enrollment.
Fund Office and Union Local Employees
You come into the plan as a Platinum Plus Participant. Contact the Fund Office for information about establishing your initial eligibility.
Required Hours
To remain covered, you must work the following required hours each month to have health care coverage for yourself and your eligible dependents.
| Job Classification | Required Hours |
| Plan A Clerks | 92 |
| Plan B Clerks | 76 |
| Plan A & B Meat Cutters and Uniform Department | 76 |
| Plan A Clerk’s Helpers & Plan B Utility Clerks | 64 |
| Plan B Utility Clerks | 64 |
| Plan A Pharmacists | 64 |
The hours you work in one week are credited to you as of each Sunday, based on the standard industry workweek, which is Monday through Sunday. Your monthly hours are credited as of the last Sunday of each month.
If you meet the eligibility requirements for the Fund’s health care coverage, you may choose to enroll your eligible dependents. Eligible dependents are defined as follows:
Spouse or certified domestic partner
- Your legally married spouse
- Your certified domestic partner (A Certificate of Registration of Domestic Partnership must be filed with the California Secretary of State. Both partners must satisfy the criteria for domestic partnership under California law, and you may enroll your opposite-sex domestic partner only if at least one of you is age 62 or older.)
- Clerk’s Helpers and Utility Clerks may not enroll a spouse/domestic partner for coverage.
Your child(ren) under age 26, if they are your:
- Natural child
- Legally adopted child (or child placed for adoption)
- Step-child
Your eligible domestic partner’s child(ren)* who meet the following criteria:
- They are unmarried, and
- They are dependent on you for support and maintenance, and
- They are (a) under age 19 or (b) under age 24 if also a full-time student at an accredited educational institution.
A foster child, including:
- A foster child placed by a government agency or court order, under age 26
- A foster child who meets the criteria noted in the Fund’s Application for Coverage of a Foster Child as an Eligible Dependent.
Your unmarried “over age” disabled child who is unemployable and totally dependent on you because of a permanent mental or physical disability.
- The child must meet the criteria noted in the Fund’s Eligibility for Disabled Dependent Children document/form.
*Note that you might be responsible for paying federal taxes on the value of the coverage provided to your domestic partner or to his or her child(ren). Contact the Fund Office for more information.
Waiting Period for Dependent Eligibility
You will find information regarding the dependent eligibility waiting period for Participant job classifications below; and, all Participants should take note of the following general rules:
- If you decide not to enroll your dependents when they first become eligible for coverage, you typically must wait until the next Open Enrollment period to do so.
- Does your covered spouse’s/domestic partner’s employer offer health coverage? If so, he/she must enroll in the best employee-only health coverage available through that employer. Otherwise, his/her coverage under the Fund will be substantially reduced.
- Refer to the Making Changes/Life Events section to see when you may make changes to your dependent coverage elections (e.g., if you have a baby).
Dependents of Participants Other Than Clerk’s Helpers and Utility Clerks
For Silver Clerks who meet the eligibility requirements for the Fund’s health care coverage
- You may enroll your eligible children on the same date you are first eligible for coverage.
- You may enroll your spouse/domestic partner as follows:
- He or she becomes eligible for coverage on the first day of the calendar month after you complete 24 months of employment, or
- You have the option to enroll him or her earlier. You may do so on the first of the month that is 60 days after you work 1,200 hours. If you elect this early enrollment, you will pay the full cost for his or her coverage until you complete 24 months of employment.
For Platinum Clerks (including Pharmacists)
You may enroll your spouse/domestic partner and eligible children on the same date you are first eligible for coverage.
For Platinum Plus Clerks, Fund Office Employees, and Union Local Employees
You may enroll your spouse/domestic partner and eligible children on the same date you are first eligible for coverage.
Dependents of Clerk’s Helpers and Utility Clerks
- You may enroll your eligible children on the same date you are first eligible for coverage. You also have the option for earlier enrollment, as explained above. If you opt for earlier coverage, you may be required to pay up to the full cost of their coverage until you have completed 18 months of employment.
- You may not enroll your spouse/domestic partner.
Step-Up Benefits
Learn how you can earn upgrades to your benefits after reaching certain service milestones.
Silver/Gold/Platinum
Participants other than Clerk’s Helpers or Utility Clerks earn upgrades to their benefits after reaching certain service milestones. The charts below show how Participants progress through Silver, Gold, and Platinum level benefits based on their number of months of employment and date of hire.
Plan A Participants
| Benefit Level | Hire Date | Months of Employment |
| Silver | On or after March 1, 2004 | 6 – 42 |
| Gold | Between March 1, 2004 and July 21, 2007 | 43 – 66 |
| On or after July 22, 2007 | 43 – 78 | |
| Platinum | Between March 1, 2004 and July 21, 2007 | 67+ |
| On or after July 22, 2007 | 79+ | |
| Platinum Pharmacists | On or after October 6, 2011 | 6+ |
Plan B Participants
| Benefit Level | Hire Date | Months of Employment |
| Silver | On or after October 4, 2004 | 6 – 42 |
| Gold | Between October 4, 2004 and October 11, 2007 | 43 – 66 |
| On or after October 12, 2007 | 43 – 78 | |
| Platinum | Between October 4, 2004 and October 11, 2007 | 67+ |
| On or after October 12, 2007 | 79+ |
For more information about benefits coverage, see the Plan Benefits Charts.
Continuing/ Re-establishing Eligibility
Learn the requirements for continuing or re-establishing eligibility for you and your dependents
Continuing Eligibility
Once your health care coverage begins, you must continue to work the required hours each month to earn continuing eligibility. You earn continuing eligibility on a “skip-month” basis—meaning, when you work the required hours in one month, you establish your eligibility for benefits during the second month after. Here are a few examples:
- Working the required hours in April gives you eligibility in June.
- Working the required hours in May gives you eligibility in July.
- If you work the required hours in April but not enough hours in May, you will have June eligibility, but you will not have July eligibility.
Your eligibility will terminate at the end of the month in which your employment ends or if you are laid off.
If your eligibility terminates because your employment ended, you were laid off, or if you failed to work the required hours for eligibility, you may elect COBRA Continuation Coverage.
Re-establishing Eligibility/Break in Service
Your options for re-establishing benefits eligibility depend on the manner in which you lose eligibility and the timing for your return to work:
If you are laid off or terminated and return to work within 120 days from your loss of coverage date: You will re-establish eligibility on a skip-month basis. For example, if you are terminated in May and you return to work in July and work the required hours, you will earn eligibility for benefits for September.
If your employment is terminated, and you are rehired in covered employment before the end of the month in which your coverage ends: In this case, your coverage can continue without interruption. For example, if you terminate with Employer X on July 15 and are hired by Employer Y on July 18, you will remain covered in August. And, provided you work the required hours in July between both Employer X and Employer Y, you will also be covered in September.
If you are laid off or terminated and you return to work after 120 consecutive days or more: You will incur a Break in Service, and you will need to re-establish initial eligibility. However, if you are laid off for more than 120 days but you are recalled by your same employer within 12 months, your eligibility will be re-established on a skip-month basis.