06/01/04 - Is Your Enrollment Card Up-to-Date?

You must keep an up-to-date Enrollment Card on file at the Trust Office at all times. An up-todate Enrollment Card allows the Trust Office to process medical claims more quickly and efficiently, and is your guarantee that life insurance benefits under the health care plan and pre-retirement death benefits under the pension plans will be administered and processed according to your wishes. A new Enrollment Card is required if you add or remove a dependent child, you marry, divorce, or are widowed, or if you want to name a different beneficiary for the various plans. If you would like to know if your current Enrollment Card is up-to-date, please contact the Eligibility Department at the Trust Office. They can verify the information currently on file and can provide you with a new Enrollment Card if required by your current circumstances. The following family-related changes require a new Enrollment Card and related enrollment information. New dependents are covered under the Carpenters Health and Security Plan only if you are covered:

1. Marriage

Carpenters Health and Security Plan – Employed and Retired Carpenters

To enroll a new spouse for coverage, you must complete a new Enrollment Card within 60 days of the marriage. Coverage for the new spouse will begin after enrollment is completed retroactive to the date of marriage. A copy of the certified marriage certificate must be provided to the Trust Office with the new Enrollment Card. A New Dependent Enrollment Form is also required under the Retired Plan.

Carpenters Health and Security Plan – Retired Carpenters

If your new spouse is covered under another group health plan, other health insurance coverage or COBRA Continuation Coverage, he or she may decline initial enrollment in the Retired Plan. However, a Notice To Decline Coverage Agreement must be completed to reserve his or her right to enroll in the Retired Plan at a later date. This form is available from the Trust Office.

The spouse may then enroll for coverage in the Retired Plan within 60 days of termination of the other health coverage. Additional special enrollment provisions are listed in the plan booklet.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

If you are married, your spouse is the beneficiary of your preretirement death benefit under these two plans, even if you designate a nonspouse beneficiary. When completing a new Enrollment Card, please follow the guidelines provided in Sections 4 and 5 of the Enrollment Card instructions.

2. Newborn, Step, Adopted or Legally Placed Children

Carpenters Health and Security Plan – Employed and Retired Carpenters

To enroll a new baby or a new dependent child, you must complete a new Enrollment Card within 60 days of the:

• Birth – A newborn child will be eligible for coverage on the date of birth.
  
  
• Marriage to the child’s legal custodial parent – Stepchildren who live with you are eligible for coverage on the date of your marriage to the child’s legal custodial parent.
  
  
• Placement for adoption or adoption – If a child is placed with you for adoption, he or she will be eligible for coverage on the date of the placement for adoption.
  
  
• Date the child was legally placed in your care – If a child is legally placed with you by virtue of a court order, he or she will be eligible for coverage on the date of the court order.

In addition to a new Enrollment Card, the following documentation is also required:

• For newborns – A copy of the birth certificate that has been certified by the Department of Vital Statistics.
  
  
• For natural children born out of wedlock – A copy of the birth certificate that has been certified by the Department of Vital Statistics, the paternity affidavit or a copy of the judgment or decree establishing paternity, the child support order, and a Paternity Questionnaire.
  
  
• For stepchildren – A complete copy of the appropriate divorce decree, parenting plan and child support order, a Child Enrollee Questionnaire, and a copy of the certified marriage certificate.
  
  
• For a child who is placed with you for adoption – A copy of the court order specifying your legal custody or a copy of the adoption papers that have been certified by the court, and a Child Enrollee Questionnaire.
  
  
• For legally placed children– A copy of the court order specifying you have legal custody and a Child Enrollee Questionnaire.

A New Dependent Enrollment Form is also required under the Retired Plan.

Carpenters Health and Security Plan – Retired Carpenters

Additional special enrollment provisions are listed in the plan booklet.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

When completing a new Enrollment Card, please follow the guidelines provided in Sections 4 and 5 of the Enrollment Card instructions.

3. Legal Separation or Divorce

Carpenters Health and Security Plan – Employed and Retired Carpenters

Eligibility for your spouse and stepchildren continues until the end of the month in which the legal separation or dissolution of marriage becomes final. You must complete a new Enrollment Card at that time. A complete copy of the divorce decree and, if you have children from that marriage, a complete copy of the parenting plan and child support order are also required.

If you want your ex-spouse to remain the beneficiary for your life insurance benefit, you must re-name him or her on a new Enrollment Card.

A Qualified Medical Child Support Order (QMCSO) could have an effect on benefit coverage. Please notify the Trust Office if a QMCSO is part of a divorce proceeding.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

If you divorce, you should review your beneficiary designation for these two plans. If you want your exspouse to remain the beneficiary for pre-retirement death benefits under these two plans, you must re-name himor her on a new Enrollment Card. When completing a new Enrollment Card, please follow the guidelines provided in Sections 4 and 5 of the Enrollment Card instructions. You must also provide a Qualified Domestic Relations Order (QDRO) if your divorce decree or property settlement agreement calls for a division of your pension plan(s). Please contact the Retirement Department at the Trust Office for assistance.

4. Child’s Loss of Eligibility

Carpenters Health and Security Plan – Employed and Retired Carpenters

Coverage for your unmarried dependent children ends on the last day of the month in which you, your spouse or your dependent child no longer satisfies the eligibility requirements of the plan. Children no longer satisfy the eligibility requirements when they attain age 19 or age 24 if a full-time student.

Please see “National Student Clearinghouse” on page 6 for the plan’s new method for verifying student eligibility.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

You may want to review your beneficiary designation under these two plans to determine if a new beneficiary should be named. A new Enrollment Card is required to change your beneficiary under these two plans. In general, these plans are unaffected by a child’s loss of eligibility under the Carpenters Health and Security Plan.

5. Death of a Spouse or Child

Carpenters Health and Security Plan – Employed and Retired Carpenters

You should notify the Trust Office of the death of a covered spouse or dependent child. If you notify the Trust Office, you will receive the information necessary to submit a life insurance claim. You may also want to review your life insurance beneficiary designation to determine if a new beneficiary should be named. A new Enrollment Card is required to change our life insurance beneficiary.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

You may want to review your beneficiary designation under these two plans to determine if a new beneficiary should be named. A new Enrollment Card is required to change your beneficiary under these two plans.

6. Death of the Participant or Retiree

Carpenters Health and Security Plan – Employed and Retired Carpenters

Please contact the Eligibility Department at the Trust Office for assistance with continuation coverage options and life insurance.

Carpenters Retirement Plan and Carpenters Individual Account Pension Plan

Please contact the Retirement Department at the Trust Office for assistance with possible pre-retirement death benefits or contingent payments.■

Life Insurance Beneficiary Designation

Life insurance benefits are part of the Carpenters Health and Security Plan. Subject to applicable community property laws, your life insurance beneficiary can be anyone except an employer. Your named beneficiary receives the proceeds of the life insurance benefit at death. A life insurance claim must be filed with the Trust Office within 12 months of death. Claim forms are available from the Trust Office only.

If your beneficiary does not survive you, or if you fail to name a beneficiary, proceeds are paid to the first survivor in the following order:

• Spouse.
  
• Children, in equal shares.
  
• Parents, in equal shares.
  
• Brothers and sisters, in equal shares.
  
• Executors or administrators.

If you designate a person who is or subsequently becomes your spouse, the beneficiary designation is automatically revoked if the marriage is subsequently dissolved or invalidated. If you would like to maintain your ex-spouse as your life insurance beneficiary, you must redesignate him or her as such on a new Enrollment Card following the dissolution or invalidation of the marriage. If no new beneficiary reaffirmation is made after the divorce and you fail to name another individual as beneficiary, then the above stated order of beneficiary determination will be used.

You must complete a new Enrollment Card if you marry, divorce, or wish to change your beneficiary designation. Enrollment Cards are available at the Trust Office or your Local Union.

The Carpenters Retirement Plan and the Carpenters Individual Account Pension Plan may also provide preretirement death benefits to a spouse or designated beneficiary.■