FY2024-39 KIB/Alaska Electrical Health & Welfare Fund Special Agreement Providing Health Insurance Coverage Of Certain Non-Bargaining Unit Personnel with Alaska Electrical Health & Welfare FundCONTRACTS TRANSMITTAL FORM
RETENTION SCHEDULE: CL -09 CONTRACTS
Records related to obligations under contracts, leases, and other agreements between the Borough and outside parties,
successful bids, and proposals. Active records are kept by the corresponding department. Apply retention (plus 4 years) once
contract or agreement expires, or once product is procured. Apply retention (plus 25 years) for agreements that involve
real property.
DATE: 11 /24/25 TRANSMITTED BY: Sue Zimmerman DEPT: Finance
CONTRACT NO.: FY 2024-39 VENDOR OR CONTRACTOR: Alaska Electrical Health & Welfare Fund
CONTRACT TITLE(Please provide details that are available such as purpose and/or the amount):
KIB/Alaska Electrical Health & Welfare Fund Special Agreement Providing Health Insurance
Coverage of Certain Non -bargaining Unit Personnel
Administrative contracts are contracts approved by the manager that are within the spending
authority allowed by code. Assembly approved contracts are beyond the manager's spending
authority and require approval by the Assembly during a meeting.
APPROVED BY: Administrator DATE OF APPROVAL: 02/29/24
TYPE OF CONTRACT: Other: Health Insurance Special Agreement
PROVIDE DETAILS FOR ANY AUTOMATIC RENEWALS OR EXTENSIONS BELOW:
This agreement does not have an expiration date, a new agreement needs to be
EXPIRATION OR REVIEW DATE: PURGE DATE:
If there's no expiration date or the contract is open-ended, enter 9999 in the date field and explain when
it should be flagged for review:
This contract is open ended.
Are all relevant attachments, exhibits, referenced documents attached? IZI
Are the successful bids and proposals incorporated in the attachments? ❑
ONLY COMPLETE THIS SECTION IF THE RECORD AMENDS, EXTENDS, IS A
CHANGE ORDER, OR AN ADDENDUM TO AN EXISTING CONTRACT
DATE:
CONTRACT NO.: FY
REQUESTED BY:
CATEGORY: Select One
APPROVED BY: Select One TYPE OF CONTRACT: Select One
PROVIDE DETAILS FOR ANY AUTOMATIC RENEWALS OR EXTENSIONS BELOW:
EXPIRATION DATE: PURGE DATE:
If there is no expiration/purge date, enter 9999 as the year for open-ended contracts AND explain the
process below on how or when it should be flagged for review.
Rev. 04/09/2025
ALASKA ELECTRICAL HEALTH & 'WELFARE FUND
SPECIAL AGREEMENT
Providing for the Coverage of
Certain Non -bargaining Unit Personnel RECE''1 ED
To: Joint Board of Trustees MAR Q 4 1024
Alaska Electrical Health & Welfare Fund
701 E. Tudor, Suite 200 AE rp
Anchorage, AK 99503
EMPLOYER'S REQUEST TO PARTICIPATE
I. The undersigned Employer, Kodiak Island Borough hereinafter referred to as
"Employer", is a party to a collective bargaining agreement with IBEW Local Union 1547
and intends to be a party to such subsequent and future agreements thereafter as negotiated
and agreed by the parties thereto.
2. Said collective bargaining agreement provides for the making of contributions to the
Alaska Electrical Health & Welfare Fund (hereinafter referred to as the "Fund") for the
purpose of providing bargaining unit employees with health & welfare coverage.
The Employer now requests that the Trustees permit it to make contributions to the Fund
for the following non -bargaining unit personnel, which personnel are defined as follows:
corporate officers or members engaged full-time in the affairs of the
corporation or limited liability company.
sole proprietors and partners engaged full-time in the affairs
of the company or partnership; and
all employees not represented by IBEW Local 1547 or by any other labor
organization, regardless of the nature or type of work being performed.
(hereinafter collectively referred to as "Personnel" or individually referred
to as "Covered Individual")
The Employer agrees to make contributions for all such personnel in the above categories
beginning the month of January , 20 24 , and continuing each month during the
terms of the aforesaid collective bargaining agreement and each subsequent collective
bargaining agreement, in accordance with the alternatives selected below: (initial one)
X A. ALL Personnel (including full-time, part-time, but excluding
employees classified as seasonal or temporary)
1250.010 dor.
ALASKA ELECTRICAL HEALTH & WELFARE FUND
SPECIAL AGREEMENT
B. FULL-TIME Personnel only (120 or more compensable hours in
a month, excluding employees classified as temporary or seasonal)
4. The contribution rate for plan 551 601 701 801 901 shall be $___2 352per month
per Covered Individual (for April 2024 hours, $2,411), or such other rate as may be fixed
from time to time by the Board of Trustees. The Trustees shall notify the Employer in
writing of such change. Coverage begins on the first day of the first month after the
employee's first day of work. (For example: An employee hired on or after June I will be
covered beginning July 1.)
If an employee separates employment on or before the 15th of the month, coverage
terminates at the end of that month. If the employee separates employment after the 15`h of
the month, coverage terminates at the end of the month following the employee's date of
separation.
This Special Agreement shall supersede any prior Special Agreement the Employer had
with respect to the Fund. It shall continue to be in full force and effect during the interim
period between an expired collective bargaining agreement and a negotiated subsequent
bargaining agreement.
The Employer agrees that it is solely responsible for the making of contributions to the
Fund. Contributions shall not be accepted from a Covered Individual.
5. This Special Agreement shall be terminated upon the complete and apparently permanent
termination of the collective bargaining agreement or apparently permanent failure to enter
a new collective bargaining agreement between the Employer and IBEW Local Union 1547
as certified by the Employer and IBEW Local Union 1547 to the Trustees or may be
terminated upon the mutual agreement of the Employer and Trustees as permitted by the
Employment Retirement Income Security Act of 1974, (ERISA) as amended, and other
applicable laws and regulations.
Should this Special Agreement be terminated by mutual consent, the Employer understands
that the Trustees reserve the right to refuse approval to any subsequent proposal for a
Special Agreement by the Employer at a later time, since
-Agzeemept is that it he cilective dwing the Employer's ontirr. span of bus. -RCS; aGti;44?
t�itl�ir�-the-eieckrical,iudusty�,.
In the event the Employer ceases to exist, the Fund shall immediately cancel this Special
Agreement and shall mail or deliver a written notice of such cancellation to the Employer
thirty (30) days in advance of the Employer's termination from the Fund.
The details of the health & welfare program will be determined by the Trustees. The
undersigned acknowledges receipt of a copy of the Trust Agreement creating the Alaska
Electrical Health & Welfare Fund and agrees to be bound by said Trust Agreement and all
AEHWF Special Agreement _ Rev. 1/2024
1250.010 doc
ALASKA ELECTRICAL HEALTH & WELFARE FUND
SPECIAL AGREEMENT
amendments hereto or hereafter and administrative policies adopted by the Trustees. The
undersigned does further agree to accept, as its representatives, the Employer Trustees who
serve on the Board of Trustees and their successors.
7. Contributions will be paid to the Fund by the Employer by the 15th day of the month
following the month for which the contributions are earned or by such other due date as
may be established by the Trustees. The Trustees will furnish transmittal forms for use by
the Employer in making the contributions.
9. The Employer acluiowledges that the Fund is intended to be qualified under Section 501.
(c)(9) of the Internal Revenue Code and agrees to promptly take any action, including but
not limited to making additional contributions or terminating this agreement or providing
any payroll records, data, reports, documents or other materials or information reasonably
required by the Trustees to ensure the Fund's continued qualification.
This special Agreement constitutes the entire agreement between the parties with respect
to the subject matter hereof and supercedes all other prior or contemporaneous agreements,
oral or written, between the parties not included herein. No modifications, amendments,
deletions or alterations of this Special Agreement shall be effective unless in writing and
signed by all of the parties hereto or such representatives of the parties as have been duly
authorized to make such change. This Special Agreement and the respective rights and
obligations of the parties shall be construed and interpreted in accordance with the laws of
the State of Alaska to the extent not preempted by ERISA.
Submitted this 21flp-
day of C- 20 2-`- .
Name and address of Employer:
By:C , 'MV— A"-4VJ—
Authors ed Representative
0
0 3:
3.
ATTEST:
Kodiak Island Borough
710 Mill Bay Road
Kodiak AK 99615
� rzro c� C�E-t iLt.A�i4-frC-�
Title of Authorized Representative
Unl-Crtrf�-CMC
Deputy Clerk
DATE: 2 4 q
AMIW - Special Agreement 3 Rev. 1/2024
1250.010 doc
ALASKA ELECTRICAL HEALTH & WELFARE FUND
SPECIAL AGREEMENT
Employer is a:
X Borough (governmental employer)
Aimee Williams, Borough Manager _Attest: Borough Clerk
Sole Proprietorship (print names of owner and spouse)
Partnership (print names of partners)
APPROVAL OF SPECIAL AGREEMENT
The Board of Trustees of the Alaska Electrical Health & Welfare Fund has approved this Special
��tnU� tZ,l ? 0 `!, at theirsy� , meeting.
Agreement, effective
Dated this \) -kt',day of __,oy�L , 20 2X.
Joint Board of Trustees
Alaska Electrical Health & Welfare Fund
AEHWF Special Agreement 4 Rev. 112024
1250.010 doc