Common use of Working Spouse Coverage Obligations Clause in Contracts

Working Spouse Coverage Obligations. a) As a condition of eligibility for coverage under the University’s group medical and/or prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their Employer Coverage unless they are entitled to Medicare. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) The requirement of subsection (a) does not apply to any spouse who works less than 25 hours per week AND is required to pay more than 50% of the single premium funding rate OR $300 per month, whichever is greater, in order to participate in Employer Coverage. c) An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) a. As a condition of eligibility for coverage under the University’s group medical and/or prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their his/her Employer Coverage unless they are he/she is entitled to Medicare. The use of the word “spouse” in this Article refers to a traditional spouse as well as a same-sex domestic partner. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) b. The requirement of subsection (a) does not apply to any spouse who works less than 25 hours per week AND is required to pay more than 50% of the single premium funding rate OR $300 per month, whichever is greater, in order to participate in Employer Coverage. c) c. An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) d. Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) As a condition of eligibility for coverage under the University’s group medical and/or prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their his/her Employer Coverage unless they are he/she is entitled to MedicareMedicare as of January 1, 2015. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) The requirement of subsection (a) does not apply to any spouse who works less than 25 hours per week AND is required to pay more than 50% of the single premium funding rate OR $300 per month, whichever is greater, in order to participate in Employer Coverage. c) An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) As a condition of eligibility for coverage under the University’s group medical and/or and prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or and prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their Employer Coverage unless they are entitled to Medicare. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) The requirement of subsection (a) does not apply to any spouse who works less than 25 twenty-five (25) hours per week AND is required to pay more than fifty percent (50% %) of the single premium funding rate OR three hundred dollars ($300 300) per month, whichever is greater, in order to participate in Employer Coverage. c) An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) a. As a condition of eligibility for coverage under the University’s group medical and/or and prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or and prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their Employer Coverage unless they are entitled to Medicare. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or and prescription drug insurance plan. b) b. The requirement of subsection (a) does not apply to any spouse who works less than 25 twenty-five (25) hours per week AND is required to pay more than fifty percent (50% %) of the single premium funding rate OR three hundred dollars ($300 300) per month, whichever is greater, in order to participate in Employer Coverage. c) c. An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) d. Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) a. As a condition of eligibility for coverage under the University’s group medical and/or prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their his/her Employer Coverage unless they are he/she is entitled to MedicareMedicare as of January 1, 2015. The use of the word “spouse” in this Article refers to a traditional spouse as well as a same-sex domestic partner. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) b. The requirement of subsection (a) does not apply to any spouse who works less than 25 hours per week AND is required to pay more than 50% of the single premium funding rate OR $300 per month, whichever is greater, in order to participate in Employer Coverage. c) c. An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) d. Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.

Working Spouse Coverage Obligations. a) As a condition of eligibility for coverage under the University’s group medical and/or prescription drug plan(s) (“University Coverage”), if an employee’s spouse is eligible for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employer, former employer (for retirees), or business for self-employed individuals (other than sole proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in their theirhis/her Employer Coverage unless they are arehe/she is entitled to MedicareMedicare as of January 1, 2015. For purposes of this section, in instances where the spouse’s employer makes no monetary contribution for Employer Coverage, such plans will not be considered to be Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business, but not to situations in which the spouse is a business owner, including partner of a company and/or firm, is a self-employed individual (other than a sole proprietor) in a business, or retiree in a group medical and/or prescription drug insurance plan. b) The requirement of subsection (a) does not apply to any spouse who works less than 25 hours per week AND is required to pay more than 50% of the single premium funding rate OR $300 per month, whichever is greater, in order to participate in Employer Coverage. c) An employee’s spouse who fails to enroll in Employer Coverage, as outlined above, shall be ineligible for University Coverage. d) Upon the spouse’s enrollment in Employer Coverage, that coverage will become the primary plan and the University Coverage will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. Notwithstanding the foregoing, in the event the spouse is a Medicare beneficiary and and (i) Medicare is secondary to the University Coverage, and (ii) Medicare is primary to the spouse’s Employer Coverage, the University Coverage will be the primary coverage. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.