Hours you work for contributing employers, for which contributions have been received, will be credited to your hour bank account. You become eligible for benefits after accumulating a minimum of 325 hours in at least two but not more than six consecutive months. The month after you complete the required number of hours is a waiting period. Coverage will begin on the first day of the month following the waiting period.

After you meet the Plan's initial eligibility requirements, all hours that you work for contributing employers are credited to your hour bank account. For each month of coverage under the Plan, 135 hours will be deducted from your hour bank account. You will be allowed to accumulate excess hours in your hour bank account up to a maximum of 810 hours (six months of coverage).

NOTE: Each eligible employee is responsible for knowing what his/her hour bank account balance is at any time. Please contact the Call Centre to verify eligibility before incurring any expenses.

If your new employer is required to make contributions, your hour bank account will continue to be credited with hours reported.

This is an account kept by FAS for each member who works for a contributing employer. Employers report the numbers of hours worked by the member to FAS. The hours are placed in the member's hour bank account.

This is like a bank account with hours being deposited instead of dollars. In order to pay for coverage, a member has hours deducted or withdrawn from his/her account.

For example: If a member has 190 hours in his/her hour bank account at the beginning of the month, his/her account would operate as follows.

Month	Hour Bank Account Balance at Beginning of Month	Hours Reported in Month*	Hours Charged For Coverage	Hour Bank Account Balance
1	190 Hours	136 Hours	135 Hours	191 Hours
2	201 Hours	185 Hours	135 Hours	251 Hours
3	261 Hours	95 Hours	135 Hours	221 Hours
4	231 Hours	Nil	135 Hours	96 Hours
5	106 Hours	100 Hours	135 Hours	71 Hours
6	81 Hours	125 Hours	135 Hours	71 Hours

• These hours are the hours worked two months before the current month. Hours are reported to FAS in the month following the month they are worked. The hours are then credited to the next month. For example, hours worked in January are reported in February and provide March eligibility.

Self-payments are designed for members who have run out their hour bank and have no benefit coverage for the following month. If your hour bank account falls below 135 hours, you will receive a notice that your coverage will terminate. Provided you are a member in good standing with the Union at the time your coverage terminates (and this is verified by your Local Union) , you will be provided with a one-time option to continue your coverage by making self-payments on a month-to-month basis.

When you first become eligible to make a self-payment you will have two choices:

• to continue the coverage level you currently have excluding coverage for Weekly Disability and the Health Care Expense Option, or
• to continue coverage for the Plan 1 only excluding coverage for Weekly Disability.

The amount of your self-payment is based on your choice. You will not be permitted to change your self-payment option once your first self-payment has been made.

You may continue Plan coverage through self-payment for up to a maximum of 6 consecutive months for Plans 1 - 3 or 9 consecutive months for Plan 4, provided you remain a member in good standing with the Union.

WHEN SELF-PAYMENT IS DUE

Self-payments are due in advance of the month for which coverage is desired; however, the following grace periods will be applied:

• the first payment must be made by the last business day of the month for which that self-payment applies,
• second and subsequent self-payments must be made by the 7th calendar day of each month.

All payments must be made on a continuous, uninterrupted basis. If there is an interruption, you cannot re-start self-payments at a later date.

Contact FAS for further information about the amount of self-payment and other requirements that must be met.

Whenever an apprentice employee attends a recognized trade school related to his/her employment for at least two consecutive weeks in any calendar month, no deduction will be made from his/her hour bank account for that month. This will continue until the month following the month in which his/her said classes end, provided, however, that an employee may not obtain a deduction deferment under this clause for any period of school longer than six consecutive months for any one series of apprenticeship classes. The member must complete a Freezing of Hours form and have it signed by the Local Union office. "Freezing of Hours" forms may be obtained from your Local Union Office, FAS or by clicking on the Freezing of Hours form in the Forms & Documents section.

A Registration Form must be completed immediately and sent to FAS. If you delay returning the Registration Form it may impact the reimbursement of claims. Blank Registration Forms are available from your Local Union Office, FAS or in the Forms & Documents section.

Whenever you have an address change or name change you are required to complete the Registration Form in full and return the original document to FAS. Changes may include:

• Change of name or address
• Change of marital/dependent status
• Change of beneficiary
• Change of benefit coverage for dependents

A new Registration Form will be required to have your new dependent(s) added to your benefit plan. The Registration Form must be completed in full again including existing and new dependent information.

Coverage for unmarried dependents may be extended beyond the age of 21 but under 25 years of age if the child is attending an accredited educational institute, college or university on a full-time basis provided they meet the criteria for an Over Age Dependent. Proof of school must be submitted to FAS.

Your eligible dependents become covered for benefits at the same time you become eligible. A Registration Form must be on file for at least one year before your common-law spouse and any children of that common-law spouse (as indicated on the form) are eligible for coverage (unless the Statutory Declaration on the Registration Form has been completed). Refer to your Plan Booklet for a description of the benefits your dependents qualify for. A copy of the Plan Booklet can be found in the Forms & Documents section and can also be requested by contacting the Call Centre.

Coordination of Benefits refers to a process wherein reimbursement for claims is coordinated or shared between two or more plans. With Coordination of Benefits, claims could be covered up to 100% depending on the specific provisions of each plan.

• If the claim is for you (the member), your benefit plan is the first-payer and your spouse's plan is second-payer.
• If the claim is for your spouse, your spouse's plan is the first-payer and the member's plan is the second-payer.
• If the claim is for your dependent children, you must first determine which parent's birthday occurs earliest in the calendar year. For example, if the members's birthday is October 19, and the spouse's is October 8, claims for the dependent children would go to the spouse's plan first and the members's plan second.
• If you are separated or divorced, the claim is submitted first to the plan of the parent with custody.

To apply for Weekly Disability benefits you will need to complete a Weekly Disability form and have a medical physician complete the Attending Physician's Statement. In order to receive benefits from the Trust Fund you MUST be under the care of a physician.

If you qualify for Accident and Sickness benefits under the Employment Insurance (E.I.) plan, the Fund's benefits will be suspended when E.I. benefits begin (not later than 14 days from the date of disability). If you continue to be disabled after exhaustion of your E.I. benefits (maximum 15 weeks), then this Fund will resume its payments to you for a maximum period of protection of 52 weeks of disability including the period covered by E.I. benefits. Updated medical documentation will be required.

If you do not qualify for E.I. benefits, this Fund's benefit will be payable as long as you remain disabled up to a maximum of 52 weeks of disability.

In order to be eligible for payment, Weekly Disability claims must be submitted within 180 days of the commencement of disability.

To apply for benefits complete the Weekly Disability Benefits Form and send it to FAS.

If you are an eligible employee who becomes disabled and receives disability benefits from one of the sources listed below for at least two weeks in any calendar month, no deduction will be made from your hour bank account for Plan coverage for that month. In other words, even though your Plan coverage will continue, your hour bank account will be "frozen." For any one continuous period of disability, the maximum period that your Plan coverage will continue with your hour bank account "frozen" is 12 consecutive months.

The Plan will freeze your hour bank account if you are receiving:

• Workers' Compensation benefits,
• Laborers' Health & Welfare Trust Fund of Western Canada Weekly Disability Benefits, or
• Employment Insurance (E.I.) Sickness and Accident benefits.

If you receive any of the above benefits, you must notify FAS immediately of the duration of your disability so that your hour bank account may be frozen for the period, as described above. Request for Freezing of Hours forms may be obtained from your Local Union office or FAS.

A pre-determination is a proposed course of treatment submitted to FAS by your dentist or orthodontist to determine allowable procedures, the eligible amount payable, and the maximum allowance for the calendar year (January to December).

We strongly recommend you submit a pre-determination well in advance of any proposed treatment if the estimated cost is $300 or more. If necessary, your dentist may be required to submit dental x-rays to support the planned treatment. If so, the x-rays will be promptly returned to your dentist after the review is complete.

Yes, your dentist or orthodontist must submit a pre-determination to FAS prior to the start of the treatment for your expenses to be eligible for reimbursement. Failure to do so will cause unnecessary delays.

As coverage varies based on the option you choose, please refer to the Summary of Plan Options or contact the Call Centre to confirm the vision coverage you are eligible for.

As coverage varies based on the option you choose, please refer to the Summary of Plan Options or contact the Call Centre to confirm the dental coverage you are eligible for.

Orthodontic Claim
When you submit an orthodontic claim without a dentist's or orthodontist's signature, you must attach all necessary original receipts. Monthly adjustments will only be reimbursed once the service has been provided.

Paramedical Practitioner
For paramedical practitioner services such as massage therapy and physiotherapy, please ensure that the practitioner's name and license number are on the receipt. Having the practitioner include their registration and license number will allow for faster payment of your claim. Staple the receipts to the Supplementary Health Claim form along with a letter from your doctor if a doctor's referral is required – refer to your benefits booklet or contact the Call Centre to confirm if a referral is required.

Completed claim forms, original receipts and other supporting documentation should be sent to:

          Funds Administrative Service Inc.
          10154 – 108 Street, NW
          Edmonton, Alberta T5J 1L3

The deadlines for the various types of claims are as follows:

• 6 months after the date of death under the Death Provision for Life Insurance Benefits;
• 12 months after the date the employee ceases active work because of total and permanent disability under the Permanent Total Disability Provision for Life Insurance Benefits;
• 12 months after the date of loss for Accidental Death and Dismemberment Benefits;
• 180 days after the start of Disability, for the Weekly Disability Benefit; and
• within 12 months of the date the expense was incurred for Supplementary Health and Dental benefits unless Insurance terminates for any reason in which case claims must be submitted within 90 days of the date of termination.

For dental offices to submit claims electronically they must include the following:

Policyholder - Laborers' Health & Welfare Trust Fund of Western Canada
Plan Policy Number – 38B00
Carrier Identification Number – 610614

Please contact the Call Centre to confirm eligibility.

If the total cost of your Flex Works election is a lower cost per hour than your negotiated hourly contribution rate, your excess contributions will be credited to a Heath Care Expense Option (HCEO) established in your name.

Contributions directed to a Health Care Expense Option are set aside so that you may reimburse yourself for certain health-related expenses that are not covered by the Flex Works Plan or by your Provincial Health Plan. Generally, any expense that would be considered an allowable medical expense on your income tax return is eligible for reimbursement. These include charges such as co-payment amounts, orthodontia, vision care, hearing aids and many other expenses.

The money credited to your Health Care Expense Option is not taxed either when it is deposited or when you receive your reimbursement. That means that you pay for your eligible expenses with pre-tax dollars. Reimbursements you received from the HCEO do not have to be claimed as income for tax purposes. On the other hand, expenses which are reimbursed from your HCEO cannot also be claimed as deductions on your tax return.

As mentioned, excess contributions are credited directly to your own Health Care Expense Option. You cannot contribute directly to the account.

When you have an eligible health care expense, you pay it. Next, you submit your claim for reimbursement under any applicable insurance plan. Any amount that is not paid by the insurance Plan can then be submitted for reimbursement from the Health Care Expense Option. Reimbursements will be paid to you directly; they cannot be paid to providers of care.

Health Care Expense Option claims can be submitted to FAS at any time, however, reimbursement will only be processed four times per year.

Any balance remaining in your Health Care Expense Option after December 31 can be carried forward. However, the Income Tax Act requires that no more than two years of contributions can be credited to the Option at any time.

FOR EXAMPLE:

	James had $100 in his Health Care Expense Option on December 31, 2016 and submitted eligible claims totalling $60. He received a reimbursement cheque for $60 and a $40 balance was carried forward to the next year.
	During the 2017 year, James had $120 credited to his Health Care Expense Option but had no eligible expenses to submit. Only $120 will be carried forward to the 2018 Plan year. The $40 cannot be carried forward a second time.

To obtain a list of the eligible expenses please visit the Canada Revenue Agency website. Generally, any expense that would be considered an allowable medical expense on your income tax return is eligible for reimbursement. Reimbursements can be made for expenses incurred on your behalf, or on behalf of your spouse or any dependent children, provided your dependents are eligible as per the Plan rules.

You should have received a letter in the mail which confirmed your user name and password. If you did not receive this letter, please email us at questions@fasadmin.com to request a new letter with your user name and password. Please include confirmation of your mailing address in your email. You can also call us during regular business hours at 1-800-661-7369.