Life Event
Changes
Retirees,
spouses and dependent children who are covered under this plan may experience
life event changes which affect enrollment and eligibility. Examples of these
life event changes include marriage, divorce, a child’s loss of
eligibility, and death. This section provides important information about what
the retiree or dependents should do if one of these life events occur, including
how to enroll a new spouse and dependent children in the event of a marriage,
birth or adoption.
Enrollment
Card
The retiree
must
complete a new
Enrollment
Card if he or she experiences
a life event change such as marriage, divorce, legal separation, adding or
removing a dependent child, or if he or she would like to name a different
beneficiary for the life insurance benefit. An up-to-date
Enrollment
Card allows the Trust Office
to process claims more efficiently and helps the Trust Office keep retirees
informed about health and security, and pension plan issues.
New
Dependent Enrollment Form
The retiree must
complete a New Dependent Enrollment Form if he or she wants to enroll for
coverage a new spouse, a new baby or a new dependent child. The retiree must
complete this form in addition to a new Enrollment Card.
Other
Enrollment Documents
The retiree
must
submit certain legal documents as part of the enrollment process to help
determine if his or her dependents qualify under this plan and help establish
the effective date of coverage:
- For
a new spouse or if a spouse has a different last name, a copy of the certified
marriage certificate.
- If
divorced, a complete copy of the divorce decree and, if there are children, a
complete copy of the parenting plan and child support order.
- For
newborns, a copy of the certified birth certificate issued by the Department of
Vital Statistics.
- For
stepchildren, a complete copy of the appropriate divorce decree, parenting plan
and child support order.
- For
a child who is placed for adoption, a copy of the court order specifying legal
custody or a copy of the certified adoption papers.
- For
legally placed children, a copy of the court order specifying legal
custody.
- For
natural children born out of wedlock, a copy of the certified birth certificate
issued by the Department of Vital Statistics and the paternity affidavit, or a
copy of the judgment or decree establishing
paternity.
The
Board of Trustees reserves the right to request documented proof of dependency
at any time. Whenever documented proof of dependency or any other documentation
is requested by the Trust Office, it must be received within 60 days of the
request or the dependent cannot be enrolled in the plan.
Marriage
To enroll a new
spouse for coverage, the covered retiree must complete a new
Enrollment
Card and a
New
Dependent Enrollment Form
within 30 days of the marriage. Coverage for the retiree’s new spouse will
begin after enrollment is completed retroactive to the date of marriage. A copy
of the certified marriage certificate must be provided to the Trust Office with
the enrollment
forms. If a
covered retiree’s new spouse has another group health plan, other health
insurance coverage or COBRA Continuation Coverage, he or she may decline initial
enrollment in the Retired Plan if a Notice To Decline Coverage Agreement is
completed reserving his or her rights to the Retired Plan. The spouse may enroll
for coverage in the Retired Plan within 30 days of termination of the other
health coverage if eligible (please see Loss Of Other Health Care
Coverage).
The retiree
must also decide whether to name his or her new spouse as the beneficiary for
life insurance benefits on the new Enrollment Card.
Newborn,
Adopted, Legally Placed, Or Step Children
To enroll a new
baby or a new dependent child, the covered retiree must complete a new
Enrollment
Card and a
New
Dependent Enrollment Form
within 30 days of the marriage, birth, placement for adoption, adoption, or the
date the child was legally placed in the retiree’s care (please see
Other Enrollment Documents). The
covered retiree’s newborn child will be eligible for coverage on the date
of birth. If a child is placed with the retiree for adoption, he or she will be
eligible for coverage on the date of the placement for adoption as long as the
child satisfies the eligibility requirements of this plan. If a child is legally
placed with the retiree by virtue of a court order, he or she will be eligible
for coverage on the date of the court order. Stepchildren who live in the
retiree’s home are eligible for coverage on the date of the
retiree’s marriage. Please see Eligible Spouse And Dependent
Children for additional details about eligibility.
Legal
Separation Or Divorce
Eligibility for
the covered retiree’s spouse and stepchildren continues until the end of
the month in which the legal separation or dissolution of marriage becomes final
(please see Eligible Spouse And Dependent Children
and Termination Of Coverage). However, the
retiree’s spouse and stepchildren may elect to continue coverage under
COBRA Continuation Coverage for up to 36 months if they would otherwise lose
plan coverage (please see COBRA Continuation Coverage). If,
following a divorce, the retiree wants his or her former spouse to remain the
life insurance beneficiary, then the retiree must complete a new
Enrollment
Card after the divorce
designating the former spouse as the
beneficiary. A
Qualified Medical Child Support Order (QMCSO) could have an effect on benefit
coverage. Please notify the Trust Office if a QMCSO is part of a divorce
proceeding (please see Eligible Spouse And Dependent Children).
Child’s
Loss Of Eligibility
Coverage for the
retiree’s covered dependent children ends on the last day of the month in
which the retiree, spouse or dependent child no longer satisfies the eligibility
requirements of the plan (please see Eligible Spouse And Dependent
Children, Suspension Of Coverage and Termination Of Coverage). The
retiree’s dependent children may elect to continue coverage under COBRA
Continuation Coverage for up to 36 months if they would otherwise lose plan
coverage (please see COBRA Continuation Coverage).
Death Of
Spouse Or Child
The retiree
should notify the Trust Office of the death of a covered spouse or dependent
child. When the Trust Office is notified, the retiree will receive the
information necessary to submit a life insurance claim (please see Life
Insurance Benefits). The
retiree may also want to review the life insurance beneficiary designation to
determine if a new beneficiary should be named.
Death Of
Retiree
A covered
retiree’s surviving spouse and dependent children may continue coverage
under this plan if they (1) were enrolled as dependents under this plan at the
time of the retiree’s death, (2) satisfy the dependent eligibility
requirements, and (3) make the required monthly contribution to the Trust
Office. If the
surviving spouse or dependent children declined enrollment when initially
eligible to enroll under the special enrollment rights described in Loss
Of Other Health Coverage, these special enrollment rights are
unaffected by the retiree’s
death. The
surviving spouse, dependent children or beneficiary should notify the Trust
Office of the retiree’s death. When the Trust Office is notified, the
retiree’s beneficiary will receive the information necessary to submit a
life insurance claim (please see Life Insurance Benefits). A surviving spouse who remains enrolled under this plan must also
complete a
Life
Insurance Beneficiary
Designation –
Surviving
Spouse form naming a new life
insurance
beneficiary. If the
surviving spouse remarries, his or her eligibility and the eligibility of the
retiree’s dependent children in this plan is unaffected. However, members
of the surviving spouse’s new family cannot enroll in this
plan.
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