Report Reminds Members About New Eligibility Rules


February 2014


Back to Issue

During the January membership meetings, Seafarers were reminded about new rules for eligibility under the Seafarers Health and Benefits Plan (SHBP).


As previously reported, the SHBP was required to make some changes – effective at the start of 2014 – in order to comply with mandates of the Affordable Care Act (ACA). These changes are detailed in a letter that was mailed to individual SHBP participants and posted on the SIU website; they were also described at membership meetings last year and in prior issues of the LOG.


“These new rules are now effective,” SHBP Administrator Maggie Bowen said in her January report. “Beginning this year, eligibility for existing employees will be based upon a defined six-month period, instead of based on the prior calendar year. The year will be divided into two six-month periods (Jan. 1-June 30 and July 1-Dec. 31). You will need 60 days in each six-month period to maintain your eligibility.”


The report continued, “During the first six months of 2014, the old eligibility rule will apply. This means that from Jan. 1, 2014 through June 30, 2014 you will be eligible for benefits if you had 125 days of covered employment in 2013, and one day of covered employment in the past six months prior to the date a claim accrues.


“For purposes of maintaining eligibility for benefits, there is no change in the way that the Plan will count the days you attend upgrading classes at the Seafarers Harry Lundeberg School of Seamanship at the Paul Hall Center, days when you receive Sickness and Accident benefits and days when you receive Maintenance and Cure.


“If you did not have eligibility on Dec. 31, 2013 you will establish eligibility on the ninety-first day of covered employment.”


While the new rules allow members to obtain eligibility much faster compared to the old system, the SIU and the SHBP recognize that this type of change generates questions about various individual scenarios. Members are encouraged to read the participant letter and the article in the November LOG (both also available online), contact their port agents and call the SHBP at 1-800-252-4674 with any questions.



Share |