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Summary Plan Description (SPD)
TERMINATION OF COVERAGE FOR SPOUSE
Voluntary Termination
At any time, you and your spouse can terminate your spouse’s participation in the Retiree Health Plan. To terminate your spouse’s coverage, you must give the Administrative Office 30 days advance notice, by letter, signed by you and your spouse. This letter must have both the retiree and spouse’s signatures notarized. Once terminated, however, a spouse will not be permitted to re-enroll in the Retiree Health Plan.
If you and your spouse request termination of coverage for your spouse, your spouse’s coverage will end on the last day of the month following the completion of a thirty-day period beginning on the date the Administrative Office received your notice. For example, if the Administrative Office received you letter on May 15, the thirty-day period would end on June 14, and coverage would end at midnight on June 30.
Required Termination
Your spouse’s coverage under the Retiree Health Plan can be terminated or reduced for the same reasons as your own. In addition, spouse coverage will end upon dissolution, annulment, when you are divorced or legally separated. You must notify the Administrative Office of the occurrence of any of these events within the periods specified under the COBRA provisions of this Plan. The coverage will end or be reduced on the earlier of the following dates:
- The date these benefits are terminated or reduced by the Board of Trustees.
- The last day of the month preceding the month in which you will no longer
receive pension benefits from the Pension Plan. (For example, if you
will no longer receive pension benefits in June, midnight on May 31 is the
last day of your health coverage).
If your pension benefits are suspended and later reinstated, you will be advised of your Retiree Health Plan status when your pension benefits are reinstated. - The date the spouse no longer meets the Plan’s eligibility rules for being a spouse because of legal separation or divorce. Remember, you must notify the Administrative Office of a divorce or legal separation. Refer to the section entitled "Consolidated Omnibus Budget Reconciliation Act (COBRA)" to see how legally separated or divorced spouses may temporarily continue coverage.
SPECIAL RULE FOR MEDICARE “DOUBLE COVERAGE” MEMBERS
Commencing August 1, 2008 Medicare advised the HMOs that a Medicare eligible retiree and/or spouse could not be enrolled in two Health Plans. This most frequently occurs when a retiree and spouse both receive retiree coverage from different Health Plans due to prior employment and each is enrolled in the other’s Plan as a dependent. Medicare is applying this restriction even when all enrollment is in a single HMO. Retirees and/or spouses who are in such a, “double coverage” situation will be advised by their HMO or Medicare they must terminate coverage under one Health and Welfare Plan and elect coverage under the other Health and Welfare Plan. If the retiree and/or spouse fail to make the election the HMO will terminate their coverage under one Health and Welfare Plan. This special rule is adopted due to Medicare’s actions. It provides an exception to the general eligibility rule that termination of participation in the Retiree Plan prohibits any later re-enrollment. All of the following seven conditions must be met in order for a right to re-enrollment to exist.- The Medicare Retiree and/or Spouse must have been enrolled in this Retiree Plan.
- The Medicare Retiree and/or Spouse must have received a “Double Coverage Notice” from their HMO or Medicare.
- The Medicare Retiree and/or Spouse must have, in response to the Notice, elected to terminate coverage under this Retiree Plan or had such coverage terminated by their HMO or Medicare.
- The Medicare Retiree and/or Spouse must have continued coverage under the other Health Plan.
- The Medicare Retiree and/or Spouse must have subsequently lost coverage under the other Health Plan.
- The Medicare Retiree and/or Spouse within 30 days of loss of coverage under the other Health Plan re-enrolls in this Retiree Plan.
- The Medicare Retiree and/or Spouse must submit with their re-enrollment application written proof of conditions (1) thru (6) set forth above.