Spousal Rule. Effective August 1, 2011, a Spousal Rule shall be implemented for all employees. The Spouse of an employee shall be eligible to remain on the Corporation Group Health Plan in the event that said spouse does not have access to coverage through their employment. All dependents shall be allowed to remain on the Corporation Group Health Plan per applicable laws.
Spousal Rule. If your spouse works full time for an employer that offers medical insurance for its employees and your spouse’s employer shares in the cost of that coverage and the employer’s contribution meets the ACA affordability guidelines (the employee is responsible for providing sufficient documentation if their spouse’s employer does not meet the ACA affordability guidelines), your spouse must enroll in that employer’s medical plan first, and that plan becomes primary for the spouse. You may then enroll your spouse in the Employee Health Plan, and the two plans will coordinate benefits as terms and conditions of the respective Plans allow. Medical insurance benefits shall continue to the dependent surviving spouse of a deceased employee, to include dependent children, provided that at the time of death the employee had completed at least ten (10) years of credited service with the Company. Continuation of coverage under this provision shall cease upon the remarriage of the dependent surviving spouse.
Spousal Rule. In order for the spouses of District employees to be covered by the District health insurance benefits, the spouse's contribution (premium share) must exceed the following cost of such other insurance: • 2019- 30% • 2020-30% • 2021-35% • 2022-40% • 2023-50% The percentages above will be based on the non-district employer plan that is the same or similar actuarial value (closest in actuarial value) of the District plan. The District will provide the Association with the actuarial value of the District-provided plan no later than one month before open enrollment. Proof of such actuarial value(s) must be provided annually in writing no later than December 1 for the following Agreement coverage year. An employee and spouse may opt back into the District health insurance coverage on a date other than January 1 of each year if the employee and spouse were covered under a group health plan that was discontinued or cancelled. If the employee or spouse lost the other coverage as a result of the individual's failure to pay premiums or for cause (such as making a fraudulent claim), that individual does not have a special enrollment right.
Spousal Rule. Effective January 1, 2024, the spouse of an employee will only be eligible to be covered by the District’s healthcare benefits if the premium payment required by the spouse’s employer for single employee coverage on the least valued health care plan provided by the spouse’s employer is in excess of fifty percent (50%) of the spouse’s employer’s COBRA rate for the plan. A form shall be issued annually to the MBU and MBU’s spouse’s employer to determine the eligibility of the spouse. Failure to complete the form by the close of enrollment will result in automatic spousal ineligibility for that plan year.
