Common use of Spousal Coordination of Benefits Clause in Contracts

Spousal Coordination of Benefits. Spouses of employees who are eligible for medical insurance through their own employer by an employer-sponsored plan or a retiree eligible for medical insurance by a retirement system group health insurance plan are required to enroll in at least Single coverage through their employer or retirement system. Upon the spouse’s enrollment in any such employer or retirement plan sponsored group medical insurance coverage that coverage will become the primary payor of benefits and the coverage sponsored by the District will become the secondary payor of benefits. Spouses of the bargaining unit member affected by this change effective July 1, 2022 will remain under current coverage until the next open enrollment period provided by their employer if necessary. If the employee’s spouse has to wait for the next open enrollment, he/she will provide a letter from his/her spouse’s employer indicating the next open enrollment period. Employees affected by the spousal coordination of benefits clause are eligible for a forty percent (40%) reduction in monthly medical co-pays. The monthly co-pay reduction will be for those employees eligible for an employee+spouse plan who take the single plan and forty percent (40%) per month for those employees eligible for a family plan who take the employee+child(ren) plan.