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Field Member Health & Welfare Self Pay Subsidy

Jan 17, 2018

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This news article is very important to all construction field members, please take the time to read it and share it with your Union Brothers and Sisters.

Our Field Member Health & Welfare Plan is highly subsidized, in essence, those who contribute the greater number of man hours to the Plan help to defer the costs of those who contribute a lesser amount of man hours. Both active, retired and disabled members are entitled to subsidies under certain conditions. Our retired field members receive a higher subsidy than the actives and I think you will agree that they deserve it.

When a members hour bank is insufficient to cover the monthly cost of benefits, he or she will receive a self pay notice in the mail. The member is asked two questions on which type of payment to choose in order for benefits to continue. Question one is regarding Subsidized Self-Payment, question two is regarding Unsubsidized Self-Payment.

If your choice is Subsidized Self-Payment you must sign and date the declaration certifying that “During the work month of   XXXX  I was not employed or, if I was, it was only with an employer required to make contributions on your behalf to the Boilermakers Lodge 359 Health & Welfare Fund.”

The Subsidized Self-Payment certification then goes on to say that “A false statement will result in having to make full retroactive restitution of premiums at the higher rate shown below and may result in my coverage being terminated.”

Each month, the Plan’s Administrator, Bilsland Griffith, sends copies of the self pay notices to the Union. One Union Representative who is normally a Trustee to the Plans reviews the signed self pay notices and checks individual member dispatch records in order to see if they worked during the self pay month, or to question whether the member was entitled to a subsidized self payment. If the Representative has reason to believe that the member was working outside of the Trade, that member will be contacted by the Representative and questioned about their employment history outside of the Union.

As you can imagine it is very difficult to accurately police subsidized self pays. The Plan has always relied on its members to be truthful and claim their self pay accordingly. In essence, short of requiring each member to supply a copy of their Income Tax Statements and their T4’s to the Plan there is no full proof means to insure 100% compliance. The last thing that the Plans Trustees would ever want to do is eliminate the subsidies, so the next time you sign and date the self pay notice, keep in mind that your decision to choose subsidized or unsubsidized self payments is of paramount importance.

There are two reasons why this news article is being posted on the website at this time, one is for the general information of our field members, the other is because one of our members was just confronted about claiming the subsidy when not entitled to it.

The member that was confronted will remain unnamed, but it is very important to note that the member said that they were unaware of the rules surrounding subsidized self pays. Just as was described above, this member did receive a self pay notice, either chose to read the terms or not, and then selfishly claimed the subsidy. The member also felt that it was unfair that he/she would now be charged the full unsubsidized rate retroactively for the months that he/she was employed with an employer that was NOT required to make contributions on his/her behalf to the Boilermakers Lodge 359 Health & Welfare Fund. I think that you will agree that this member not only cheated the Plan, but has placed the subsidized system for all members in jeopardy.

During the month of June each year, the Health & Welfare Trustees receive a report from the administrator, the report is the annual cost of benefits analysis for the previous year and projections for the current year. Below are a list of facts regarding subsidies from the report for your review.

Plan A – Subsidized Plan B Subsidized Plan A Unsubsidized Plan B Unsubsidized Option E-Disabled
Total Cost of Benefits $292.90 $217.29 $292.90 $217.29 $212.80
Monthly Self Pay Amount $200.00 $168.00 $413.00 $343.00 $0.00
Subsidy $92.90 $49.29 -$120.10 -$125.71 $212.80
Average Number of Members Enrolled 87 6 2 0 13
Annual Subsidy of Self Pay Option $96,992.00 $3,549.00 -$2,882.00 $0.00 $33,197.00
Subsidy 31.7% 22.7% -41.0% -57.9% 100.0%

A footnote to the table above;

  • Using an average of 137 hours per month, the 2016 cost per hour is $2.12, including Plan management costs.
  •  The Hourly contribution rate is $3.49 (since November 1, 2002). Accordingly, $1.37 per hour is used to offset the cost of the subsidies for Field Pensioners, Self Paying Actives and Disabled members.
  • Based on 137 hours, a Field Member contributed $155.36 per month to the cost of the subsidies in 2016.
Plan A – Subsidized Plan B Subsidized Plan A Unsubsidized Plan B Unsubsidized $2000.00 Life Only
Total Cost of Benefits $288.85 $232.19 $320.05 $0.00 $4.80
Monthly Self Pay Amount $135.00 $111.00 $182.00 $0.00 $0.00
Subsidy $153.85 $121.19 $138.05 $0.00 $4.80
Average Number of Members Enrolled 391 15 2 0 36
Annual Subsidy of Self Pay Option $721,885.00 $21,815.00 $3,313.00 $0.00 $2,074.00
Subsidy 53.3% 52.2% 43.1% N/A 100.0%


Ken Noga
Assistant Business Manager

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