U.S. retirement benefits normally need 40 quarters (10 years) of credits. If you split a career between the U.S. and Uruguay, you might fall short in each country alone. As long as you have at least 6 quarters of U.S. credits, the agreement lets you add your Uruguay credits to reach eligibility — the U.S. then pays a benefit pro-rated to your U.S. credits only.
A Certificate of Coverage is the document that proves you're exempt from one country's social security. For U.S. coverage, the employer requests it from the SSA Office of Earnings & International Operations. Uruguay's authority issues the equivalent when Uruguay covers you.
Under the U.S.–Uruguay agreement, a worker sent by a U.S. employer for 5 years or less normally stays under U.S. Social Security only and is exempt from Uruguay's system. Your employer obtains a U.S. Certificate of Coverage as proof. Beyond 5 years, coverage shifts to Uruguay.
Yes. If you have at least 6 quarters (about 1.5 years) of U.S. credits, the agreement lets you combine ("totalize") your U.S. and Uruguay credits to reach the 40-quarter (10-year) threshold for a pro-rated U.S. retirement benefit.
The agreement has been in force since 2018.
Pension taxation depends on Uruguay's domestic law and the separate U.S.–Uruguay income tax treaty (if any), not the totalization agreement. The totalization agreement only governs which country's social security system covers you and how credits combine. Confirm pension taxation with a cross-border tax advisor.