Spousal Eligibility Clause Samples
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Spousal Eligibility a. For employees hired on or after August 1, 2003: If the spouse of an employee is covered by any PEBTF health care plan, and he/she is eligible for coverage under another employer’s plan(s), the spouse shall be required to enroll in each such plan, which shall be the spouse’s primary coverage, as a condition of the spouse’s eligibility for coverage by the PEBTF plan(s), without regard to whether the spouse’s plan requires cost sharing or to whether the spouse’s employer offers an incentive to the spouse not to enroll.
b. For employees hired before August 1, 2003: Effective October 1, 2003, if the spouse of an employee covered by any PEBTF health plan also is eligible for coverage under another employer’s plan(s), the spouse shall be required to enroll in each such plan, provided that the plan in question does not require an employee contribution by the spouse or the spouse’s employer does not offer an incentive to the spouse not to enroll. Once covered by another employer’s plan, that plan will be the spouse’s primary coverage, and the PEBTF plan will be secondary.
c. Nothing herein shall be construed to limit the authority of the Board of Trustees to modify or adopt these or other spousal eligibility rules.
a. The Employer shall allow each individual who was eligible as an active employee under the Fund’s health benefits plan to elect coverage upon retirement under the Retired Employees Health Program (hereinafter REHP). In addition, dependency coverage shall be allowed where the dependents of the annuitant qualify under such Program.
b. Employees who retire on or after July 1, 2007, and who elect REHP coverage, shall be eligible for the medical and prescription benefits in effect for active employees, provided that the Employer will modify the REHP plan of benefits from time-to-time to conform to the medical and prescription benefits in effect for the active employees. Annuitants who are eligible for Medicare will participate in Medicare medical and prescription plans, and those annuitants who are eligible to enroll in Medicare Part B will not receive benefits through the REHP for benefits which are provided by Medicare Part B. It is understood that the REHP plan of benefits may be amended or modified by the Employer from time-to-time.
c. Employees who retire on or after July 1, 2007, and elect REHP coverage shall be required to contribute to the cost of coverage. The annual retiree contribution rate shall be a percentage of the employee’s final annual ...
Spousal Eligibility. If the employee’s spouse is eligible for medical coverage through their own employer, the spouse must use their employer’s insurance as their primary form of coverage. The spouse may remain on the City’s health insurance plan, but the City’s plan will be a secondary plan, and the spouse’s employer’s plan must carry the spouse as primary.
Spousal Eligibility. Spouses with access to subsidized health coverage through their own place of employment, where the employer contributes at least 50% or more of the cost, are restricted to secondary University coverage allowance at full employee cost for the same.
Spousal Eligibility. 45.1 In accordance with 2015 case law by the Supreme Court of the United States, the University of Toledo will hereby discontinue eligibility to domestic partners as it pertains to any and all University benefits.
45.2 To satisfy spousal eligibility for any and all University benefits, employees must be in lawfully recognized marriages, including marriages that were validly entered into outside of the United States so long as those marriages could have been entered into in at least one state.
Spousal Eligibility. This section shall apply only to employees who began their employment with the Board on or after July 1, 2015. If an employee’s spouse is eligible to participate, as a current employee or retiree in group health insurance and prescription drug insurance sponsored by his/her employer or any public retirement plan that is affordable as defined under the Affordable Care Act, the spouse must enroll in such employer (or public retirement plan) sponsored group insurance coverage within thirty (30) days of the spouse becoming eligible for group health insurance through his/her employer. Upon the spouse’s enrollment in any such employer (or public retirement plan) sponsored group insurance coverage, that coverage will become the primary payor of benefits. Any spouse who fails to enroll in any group insurance coverage sponsored by his/her employer or any public retirement plan, as required by this Section, shall be ineligible for benefits under such group insurance coverage sponsored by the Board of Education. Every employee whose spouse participates in the Board of Education’s group health insurance coverage and prescription drug insurance coverage shall complete and submit to the Board of Education, upon request, a written certification verifying whether his/her spouse is eligible to participate in group health insurance coverage and prescription drug insurance coverage sponsored by the spouse’s employer or any public retirement plan within thirty (30) days of the spouse becoming eligible for group health insurance. Additional documentation may be required. If the employee submits false documentation the employee may be subject to disciplinary action by the Board, up to and including termination of employment.
Spousal Eligibility a. For employees hired on or after August 1, 2003: If the spouse of an employee is covered by any PEBTF health care plan, and he/she is eligible for coverage under another employer’s plan(s), the spouse shall be required to enroll in each such plan, which shall be the spouse’s primary coverage, as a condition of the spouse’s eligibility for coverage by the PEBTF plan(s), without regard to whether the spouse’s plan requires cost sharing or to whether the spouse’s employer offers an incentive to the spouse not to enroll.
b. For employees hired before August 1, 2003: Effective October 1, 2003, if the spouse of an employee covered by any PEBTF health plan also is eligible for coverage under another employer’s plan(s), the spouse shall be required to enroll in each such plan, provided that the plan in question does not require an employee contribution by the spouse or the spouse’s employer does not offer an incentive to the spouse not to enroll. Once covered by another employer’s plan, that plan will be the spouse’s primary coverage, and the PEBTF plan will be secondary.
c. Nothing herein shall be construed to limit the authority of the Board of Trustees to modify or adopt these or other
Spousal Eligibility. When the spouse of a member is employed on a full‐time basis (defined as 32 or more hours of work per week) or retired and the spouse’s employer or retirement plan makes health care coverage available to the spouse—regardless of the cost—the City’s coverage of the spouse shall be limited to being secondary to the coverage that is available from the spouse’s employer or retirement plan. As an alternative to obtaining health care coverage from their primary employers, employed spouses may elect to enroll in the City’s health care plan by paying a monthly premium equal to the greater of 2/7 the established premium rate for single coverage or any sum received by the employed spouse from his/her employer to decline health care coverage from said employer. In the event the member’s spouse ceases to have health care coverage available from his/her employer, either through a change in employment status, or through the employer’s cessation of health care benefits, then the member’s spouse shall be immediately returned to the City’s health care plan. In the event a married couple are both employed by the City of Cuyahoga Falls, each will be enrolled with single coverage, provided that if they have dependent children, the married couple shall be enrolled together under a single enrollment for family coverage or single and employee/child(ren) coverage. No employee or dependent shall be covered under more than one health care plan offered through the City of Cuyahoga Falls Health Benefits Plan.
Spousal Eligibility. If an employee's spouse is eligible to participate as a current employee or retiree in group health insurance and/or prescription drug insurance sponsored by his/her employer or any retirement plan, the spouse must enroll in such employer or retirement plan sponsored group insurance coverage(s). This requirement does not apply to any spouse who is required to pay more than fifty percent (50%) of the single premium to participate in his/her employer's group health insurance coverage and/or prescription drug insurance coverage. This requirement also does not apply to any spouse who is a retiree and enrolled in Medicare coverage. Upon the spouse's enrollment in any such employer or retirement plan sponsored group insurance coverage, that coverage will become the primary payor of benefits and the coverage sponsored by the Board will become the secondary payor of benefits. Any spouse who fails to enroll in any group insurance coverage sponsored by his/her employer or any retirement plan, as required by this Section, shall be ineligible for benefits under such group insurance coverage sponsored by the Board. Every employee whose spouse participates in the Board's group health insurance coverage and/or prescription drug insurance coverage shall complete and submit to the Board an annual written certification verifying whether his/her spouse is eligible to participate in group health insurance coverage and/or prescription drug insurance coverage sponsored by the spouse's employer or any retirement plan. If any employee fails to complete and submit the certification form by the required date, such employee's spouse will be removed immediately from all health insurance and prescription drug insurance coverages sponsored by the Board. Additional documentation may be required. If false information is submitted or the Board is not advised in a timely manner of a change in a spouse's eligibility for employer or retirement plan sponsored group health insurance and/or prescription drug insurance, and such false information or such failure results in the Plan providing benefits to which a spouse is not entitled, the employee will be personally liable to the Plan for reimbursement of benefits and expenses, including attorneys' fees and costs, incurred by the Plan. Any amount to be reimbursed by the employee may be deducted from the benefits to which the employee would otherwise be entitled. In addition, the employee's spouse will be terminated immediately from group health ...
Spousal Eligibility. Effective January 1, 2016, if the employee’s spouse is eligible for medical coverage through their own employer, the spouse must use their employer’s insurance as their primary form of coverage. The spouse may remain on the City’s health insurance plan, but the City’s plan will be a secondary plan, and the spouse’s employer’s plan must carry the spouse as primary.
Spousal Eligibility. The District will only provide health care coverage to an eligible employee’s spouse if the spouse does not have health care coverage available through his/her employer. The employee and his/her spouse must certify that coverage is not available and must also authorize the District to verify the coverage status of the spouse. If the spouse does have coverage available, the employee may obtain coverage for his/her spouse from the District by purchasing such coverage at 100% of the additional cost. If the spouse is removed from the District’s health care plan due to this provision and is unable to obtain dental and vision coverage through his/her employer or is eligible for Medicare, a bargaining unit employee may obtain dental and vision coverage for his/her spouse from the District by purchasing the coverage. The cost of such coverage shall be equal to 50% of the difference in cost of a single dental and vision plan versus a family dental and vision plan.