Welfare Notes - January 2010

January, 2010

Unfit For Duty

If you are Unfit for Duty, your eligibility for coverage may be extended; however, you must inform the Plan office of your Unfit for Duty status with documentation from your attending physician. Periodic updates of your status should be submitted if your disability continues.

Unfit for Duty does not automatically add time onto the eligibility period. The extension of eligibility due to Unfit for Duty 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 02/01/10 through 01/31/11 and he becomes Unfit for Duty in July 2010 and becomes Fit for Duty in September 2010, his eligibility is not extended. In this example the Fit for Duty date would make October, November, and December the time frame for him to work the 60 days needed to keep eligibility from lapsing. The eligibility period, however, covers him through January 2011 so the Unfit for Duty would not affect the eligibility period.

If a member with an eligibility period of 02/01/10 through 01/31/11 became Unfit for Duty in October 2010 and Fit for Duty in February 2011, his eligibility would be extended for February 2011, as well as, the months of March 2011, April 2011, and May 2011 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 2011 through May 20011, eligibility would terminate in the month following the last extension month (May 2011) 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 in the 120 days within 12 months required if eligibility is terminated. Participants who regain eligibility after being terminated must re-enroll in a plan.

Please check with the Plan office if you have any concerns about your eligibility.


Michelle Chang, Administrator  
Patty Martin  
Virginia Briggs, Claims   
Michael Jacyna, Eligibility