Eligibility
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You’re eligible for health coverage if:
- You’re an active employee of a participating employer
- You’re a participant continuing coverage via self-pay or COBRA
- You’re a retiree of a participating employer
For active employee health coverage, you become eligible on the first day of the second month after you work at least 360 hours of covered employment over a consecutive four-month period. For example, if you work 360 hours between January and April, your eligibility for health coverage begins on June 1.
Refer to the Health Plan Summary Plan Description for detailed eligibility information.
How to Enroll
To enroll in health benefits, you must submit an Enrollment Form, along with any required documentation, to Zenith American Solutions. Remember to include supporting documentation for any dependents you want to cover. For example, you must submit a certified marriage certificate to cover your spouse, a birth certificate to cover your child, and finalized court records to cover your adopted child.
Mail your signed Enrollment Form and documentation to:
Bricklayers & Allied Craftworkers Local 13 Health Benefits Fund
c/o Zenith American Solutions
2250 S. Rancho Drive, Suite 295
Las Vegas, NV 89102
You may also bring your Enrollment Form and documentation in person to one of our Customer Service Offices:
3900 W. Quail Avenue
Las Vegas, NV 89118
or
318 South 19th Street
Unit 102
Sparks, NV 89431
Customer Service Offices are open Monday to Friday, 8 a.m. to 5 p.m.
If you have questions regarding eligibility, enrollment, or required documentation, call Zenith American Solutions at (725) 238-5768.
Making Changes
If you experience a change that affects your or a dependent’s eligibility, you must provide supporting documents to Zenith American Solutions as soon as possible. Please notify them within 30 days (or 60 days in the event of divorce, marital separation, or loss of dependency status) if you or your dependent experiences any of the following qualifying events:
- Marriage, divorce, or legal separation
- Spouse or dependent gains or loses coverage under another health plan
- Birth or adoption of a child
- Death in the family
- Change of address
- Your employment status changes
- A dependent child turns age 26
In the event of your death, your spouse or one of your other dependents should notify Zenith American Solutions immediately.
Maintaining Coverage
Active Employees
Once you first become eligible for health benefits, your coverage continues on a monthly basis. Each month, hours you work in covered employment are credited to your hour bank. Each month, the Fund will deduct 120 hours from your hour bank to continue your benefits coverage.
To continue coverage, you must have at least 120 hours in your hour bank each month. Additional hours remain in your hour bank, up to a total of 720 hours. Saving up your hours protects you from losing coverage during periods of slow employment, work stoppage, or time off.
Example 1: Brian is eligible to participate in the Plan and has 300 hours in his hour bank at the beginning of June. Brian works 160 hours in June. Since only 120 hours are required to continue coverage, Brian is covered under the Plan for July and his remaining 40 hours go toward his hour bank. Brian enters July with 340 hours in his hour bank.
Example 2: Gina is eligible to participate in the Plan and has 300 hours in her hour bank at the beginning of September. Gina takes two weeks off and only works 70 hours in September. The 70 hours Gina works, plus 50 hours from her hour bank, allow her to continue coverage for October. She enters October with 250 hours in her hour bank.
If you don’t have 120 hours available in your hour bank and are on the Local 13 Out-of-Work list, you can elect to make partial or full self-payments to continue coverage. Self-payments must be received by Zenith American by the 25th of the month prior to the coverage month.
Retirees
Retirees must self-pay for coverage. Continued eligibility depends on timely monthly self-payments. If you miss a self-payment, you lose coverage and it cannot be reinstated.
Self-payments must be received by Zenith American by the 25th of the month prior to the coverage month.
When Coverage Ends
Coverage ends on the last day of the calendar month in which you neither meet the hours requirement nor make self-payments for coverage. If you lose coverage through the Plan, you must meet the initial eligibility requirements—working 360 hours in covered employment over a consecutive four-month period—to have your eligibility reinstated.
If you lose coverage, you may be able to continue coverage under the Plan through COBRA. Electing COBRA coverage means that you’re responsible for the full cost of coverage. Purchasing different coverage through the Health Insurance Marketplace at healthcare.gov may be a cheaper alternative to continuing your coverage through the Plan via COBRA.