Common use of Spouse Coverage Clause in Contracts

Spouse Coverage. 1. If a spouse of a covered employee is eligible for his/her employer’s health insurance plan, for which the employer pays a minimum of 50% of the insurance premium or an equivalent amount in cash or contribution to Internal Revenue Code Section 125 (cafeteria plan), the Health Insurance Plans will only pay claims as if it were secondary to the spouse’s employer’s plan. 2. A spouse covered by his/her employer’s insurance plan may remain as a participant in the Health Insurance Plans, but coordination of benefits shall apply and the employer’s plan will be primary. 3. If the insurance coverage available to the spouse through his/her employer is limited by a pre-existing condition, the Health Insurance Plans will act as primary for the pre-existing condition until the spouse has satisfied the pre-existing con- dition limitation. The spouse must present a declination of coverage due to the pre-existing condition limitation. The information must be from the employer’s health insurance carrier or the spouse’s physician. 4. If a spouse currently under the Health Insurance Plans is ineligible for his/her employer’s health insurance as outlined in paragraph one, or due to medical conditions is unable to become eligible under his/her employer’s plan, he/she may remain solely on the Health Insurance Plans. 5. If a spouse becomes ineligible for his/her employer’s plan, he/she may enroll as a dependent in one of the Health Insurance Plans during the open enrollment period, and a spouse can enroll outside the enrollment period if one of the three qualifying events listed in the Plan document occurs. In such an event, any pre-existing conditions limitations of the Health Insurance Plans shall be waived.

Spouse Coverage. 1. If a spouse of a covered employee is eligible for his/her employer’s health insurance plan, for which the employer pays a minimum of 50% of the insurance premium or an equivalent amount in cash or contribution to Internal Revenue Code Section 125 (cafeteria plan), the Health Insurance Plans will only pay claims as if it were secondary to the spouse’s employer’s plan. 2. A spouse covered by his/her employer’s insurance plan may remain as a participant in the Health Insurance Plans, but coordination of benefits shall apply and the employer’s plan will be primary. 3. If the insurance coverage available to the spouse through his/her employer is limited by a pre-existing condition, the Health Insurance Plans will act as primary for the pre-existing condition until the spouse has satisfied the pre-existing con- dition condition limitation. The spouse must present a declination of coverage due to the pre-existing condition limitation. The information must be from the employer’s health insurance carrier or the spouse’s physician. 4. If a spouse currently under the Health Insurance Plans is ineligible for his/her employer’s health insurance as outlined in paragraph one, or due to medical conditions is unable to become eligible under his/her employer’s plan, he/she may remain solely on the Health Insurance Plans. 5. If a spouse becomes ineligible for his/her employer’s plan, he/she may enroll as a dependent in one of the Health Insurance Plans during the open enrollment period, and a spouse can enroll outside the enrollment period if one of the three qualifying events listed in the Plan document occurs. In such an event, any pre-existing conditions limitations of the Health Insurance Plans shall be waived.

Spouse Coverage. 1. If a spouse of a covered employee is eligible for his/her employer’s health insurance plan, for which the employer pays a minimum of 50% of the insurance premium or an equivalent amount in cash or contribution to Internal Revenue Code Section 125 (cafeteria plan), the Health Insurance Plans will only pay claims as if it were secondary to the spouse’s employer’s plan. 2. A spouse covered by his/her employer’s insurance plan may remain as a participant in the Health Insurance Plans, but coordination of benefits shall apply and the employer’s plan will be primary. 3. If the insurance coverage available to the spouse through his/her employer is limited by a pre-existing condition, the Health Insurance Plans will act as primary for the pre-existing condition until the spouse has satisfied the pre-existing con- dition condition limitation. The spouse must present a declination of coverage due to the pre-existing condition limitation. The information must be from the employer’s health insurance carrier or the spouse’s physician. 4. If a spouse currently under the Health Insurance Plans is ineligible for his/her employer’s health insurance as outlined in paragraph one, or due to medical conditions is unable to become eligible under his/her employer’s plan, he/he/ she may remain solely on the Health Insurance Plans. 5. If a spouse becomes ineligible for his/her employer’s plan, he/she may enroll as a dependent in one of the Health Insurance Plans during the open enrollment period, and a spouse can enroll outside the enrollment period if one of the three qualifying events listed in the Plan document occurs. In such an event, any pre-existing conditions limitations of the Health Insurance Plans shall be waived.

Spouse Coverage. 1. If a spouse of a covered employee is eligible for his/her employer’s health insurance plan, for which the employer pays a minimum of 50% of the insurance premium or an equivalent amount in cash or contribution to Internal Revenue Code Section 125 (cafeteria plan), the Health Insurance Plans will only pay claims as if it were secondary to the spouse’s employer’s plan. 2. A spouse covered by his/her employer’s insurance plan may remain as a participant in the Health Insurance Plans, but coordination of benefits shall apply and the employer’s plan will be primary. 3. If the insurance coverage available to the spouse through his/her employer is limited by a pre-existing condition, the Health Insurance Plans will act as primary for the pre-existing condition until the spouse has satisfied the pre-existing con- dition condition limitation. The spouse must present a declination of coverage due to the pre-existing condition limitation. The information must be from the employer’s health insurance carrier or the spouse’s physician. 4. If a spouse currently under the Health Insurance Plans is ineligible for his/her employer’s health insurance as outlined in paragraph one, or due to medical conditions is unable to become eligible under his/her employer’s plan, he/she may remain solely on the Health Insurance Plans. 5. If a spouse becomes ineligible for his/her employer’s plan, he/she may enroll as a dependent in one of the Health Insurance Plans during the open enrollment period, and a spouse can enroll outside the enrollment period if one of the three qualifying events listed in the Plan document occurs. In such an event, any pre-pre- existing conditions limitations of the Health Insurance Plans shall be waived.