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Apply for Extended Dependent Coverage

Normally, your dependent child loses eligibility under the health and welfare plan at age 19. There are, however, circumstances under which coverage may be extended.

For example, if your dependent child is continuing his education, he may be eligible for coverage if he fulfills the following requirements:

  • attends an accredited educational institution and enrolls for at least 8 units of credit per semester (or equivalent credits);
  • is solely dependent on you for support; and
  • qualifies as a dependent for federal income tax purposes.

To apply for extended coverage, contact the Fund Office shortly before your child’s 19th birthday and request an Application for Student Extended Dependent Coverage.

Complete the application form in full. Be sure to sign and date in the space marked Laborer’s Signature. Mail or deliver the completed application to the Fund Office. You should receive an acknowledgement letter from the Fund Office, within 15 days, advising you whether your child is qualified for extended coverage and if so, the period of coverage.

If your child does not qualify for Student Extended Dependent Coverage, he may extend coverage by electing COBRA Continuation Coverage. For more information on COBRA Continuation Coverage, refer to your printed Health and Welfare Plan booklet or contact the Fund Office.

Copyright ©2003; Laborers Funds Administrative Office of Northern California, Inc. All rights reserved.
Derechos Reservados Propiedad Literaria ©2003, La Oficina Administrativa de Fondos de los Obreros del Norte de California, Inc.