Health Plan Eligibility
What you need to know
You earn eligibility for coverage based on the number of weeks you work. Employers report weeks worked to the Fund Office. Each month, the Fund Office reviews the totals to determine who has earned eligibility for health coverage. You earn eligibility for six months of coverage at a time.
How eligibility works
Currently, you must work at least 11 weeks in a 12-month period to be eligible for any level of health coverage, and you earn coverage for six months at a time.
The level of coverage for which you qualify is based on the number of weeks you work in covered employment. The current tiers are:
- Tier 1: You must work 15 weeks or more in a 12-month period.
- Tier 2: You must work 11 weeks or more in a 12-month period.
There is an exception to help you maintain continuous coverage. If you are currently covered and do not have enough weeks to continue health plan coverage or maintain your current Tier of coverage, you can use weeks you earn in the two-month “waiting period” to extend eligibility for continuous coverage. Learn more.
Want to know if you’re eligible?
Track your work history, and know when you qualify for coverage on the Self-Service Portal.
When your coverage begins
Once it’s determined that you are eligible, you have two months before your coverage begins. During this time, you’ll receive a communication from the Fund Office letting you know that you’re eligible, providing information about your plan options, and telling you how to enroll.
Don’t delay. If you miss the deadline stated within the enrollment packet you will have to wait an additional month to determine if you will qualify for health coverage again.
Some people wish to delay the start of coverage. This allows you to save your weeks and apply them to your next accrual period. However, it’s important to understand that your weeks worked expire after one year.
Learn more about things to consider when choosing your health plan.
Stay up to date
Equity-League staff tracks your covered employment. You’ll receive information and plan details from the Fund Office when you first qualify or newly qualify for coverage. To ensure that you receive this communication in a timely manner, it’s important that you let the Fund Office know when your address and/or email address changes. Log into the Self-Service Portal account and click on the Communications tab to update your contact information.