Unfit For Duty
If you are Unfit for Duty, your eligibility for coverage may be extended; however, you must have your attending physician submit documentation to the SUP Welfare Plan including the date he treated you and the dates that you were Unfit for Duty. Extensive information of your disabling condition is not required. Your employer will not automatically send documentation to the Plan office if you are injured on the ship. Periodic updates of your status should be submitted if your disability continues.
Unfit for Duty status does not automatically add time onto the eligibility period. The extension of eligibility due to Unfit for Duty status is dependent upon the Unfit For Duty dates and the Fit For Duty date.
When an eligible member becomes Fit for Duty, he has 3 months starting in the month after becoming Fit for Duty to work 60 days to continue his eligibility.
As an example, if a member’s eligibility period is 02/01/18 through 01/31/19 and he becomes Unfit For Duty in March 2018 and becomes Fit for Duty in June 2018, his eligibility is not extended. In this example, the Fit For Duty date would make July, August, and September the time frame for him to work the 60 days needed to keep eligibility from lapsing. The eligibility period, however, covers him through January 2019, so the dates that the member was Unfit for Duty would not affect the eligibility period.
If a member with an eligibility period of 02/01/18 through 01/31/19 became Unfit for Duty in October 2018 and Fit for Duty in February 2019, his eligibility would be extended for February 2019, as well as, the months of March 2019, April 2019, and May 2019 when he would have to work at least 60 days to keep his eligibility from terminating.
If the member in this example failed to work 60 days between March 2019 through May 2019, eligibility would terminate in the month following the last extension month (May 2019) and the member must work 120 days within 12 months to become eligible again.
Time worked in the extension months after becoming Fit for Duty does not count for the 120 days within 12 months required if eligibility is terminated. Participants who regain eligibility after being terminated must enroll in a plan again.