Spousal Coverage Clause Samples

Spousal Coverage. If an employee’s spouse is eligible to participate, as a current employee or in their current enterprise or retiree, in group health insurance and/or prescription drug insurance sponsored by his/her employer, enterprise or any public or private retirement plan, the spouse must enroll in such group insurance coverage. The requirement does not apply to any spouse who works less than 30 hours per week and is required to pay more than 50% of the single premium to participate in the employer’s group health insurance coverage and/or prescription drug insurance coverage. Upon the spouse’s enrollment in such 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 except when contrary to law. Any spouse who fails to enroll in any group insurance coverage sponsored by the spouse’s employer, enterprise or any public or private retirement plan, as required by this Agreement, shall be ineligible for benefits under the 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, upon request, a 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, enterprise or public or private 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 and prescription drug insurance coverage sponsored by the Board. Additional documentation may be required. An employee who submits false information or fails to timely advise the Board of a change in the spouse’s eligibility for employer, enterprise or retirement plan sponsored group health insurance and prescription drug insurance and such false information, or such failure results in the Board providing benefits to which the spouse is not entitled, the employee will be personally liable to the Board for reimbursement of benefits and expenses incurred by the Board. Any amount to be reimbursed by the employee may be by direct payment by the employee or, if not, shall be deducted through payroll deduction.

Spousal Coverage. Spousal coverage will be available only upon proof that the spouse does not have other medical insurance coverage available to him/her through the spouse’s employer. If such coverage is available, the employee’s spouse must enroll in at least single coverage from his/her employer and will not be eligible for coverage under the City plan. The employee must notify the Plan Administrator immediately in writing of the commencement of such group health insurance coverage for the spouse. The Employer reserves the right to verify this information at any time. It shall be the employee’s responsibility to notify the Employer of any change in spousal coverage or any qualifying event in regard to coverage.

Spousal Coverage. The Employer will allow employees to enroll spouses in their medical insurance plans during the next open enrollment period. If, as a result of this Article, employee spouses who have coverage through the Affordable Care Act are made ineligible for such program or credits, or experience significant cost increases, the Union shall have the ability to modify the Employer’s obligation to provide health coverage at the next available open enrollment opportunity in a manner that will restore such eligibility for all eligible spouses, provided the modification does not result in an increase in the cost to the Employer.

Spousal Coverage. For Employees who now qualify for Benefits under the provisions of Article 23:06, the Employer agrees to provide continuance of coverage to the spouse and dependents until the spouse attains the age of sixty-five (65) or upon remarriage, whichever comes first, but in no case shall extend beyond ten (10) years after the death of the Pensioner. (Dependents defined as per existing Plans.) (2) The above Benefit Plan will be applied in the following manner: (i) The Benefit Package will only be paid until the recipient attains the age of sixty- five (65). (ii) Eligibility for the Benefit Plan - only Employees of the City who have attained fifteen (15) years of continuous service with City of Greater Sudbury, inclusive of any continuous service with any other Local Municipality or Local Board will be eligible for the above-mentioned Package provided: (a) they have elected to apply for and receive either an O.M.E.R.S. Early Retirement Pension within ten (10) years of normal retirement, or an unreduced pension; OR (b) they have elected to apply for and receive an O.M.E.R.S. Disability Pension prior to the age of sixty-five (65); OR (c) when they are no longer an Employee of the City because of a work related disability received while working at and for the City and for which they receive and continue to receive a Permanent WSIB Pension which is and was assessed against the City; OR (d) when they are no longer an Employee of the City because of a disability for which they are receiving benefits from the Weekly Indemnity or Long Term Disability Plan in existence at the City. (iii) The Employer is prepared to extend the eligibility for the Employer Paid Retired/Disabled Employee Benefit Plan to those Employees who would have attained fifteen (15) years of continuous service with the City within twelve (12) months of termination of employment due to disability, and commits to not move an eligible disabled Employee to the Retired/Disabled Plan for the first twenty four (24) months of disability. The effective date of this Retired/Disabled Employee Package would be April 1st, 1987 following ratification of the Contract by the Parties; the Qualifying Date is January 1st, 1987. (3) It is also to be understood that the payment of LTD Benefits will cease when; (a) the gross monthly income payable to the Employee from O.M.E.R.S., Canadian Government Annuities, Canada Pension Plan and Workers' Compensation and supplemental retirement benefits if applicable (including a lump su...

Spousal Coverage. In the event of Employee’s death while receiving Health Insurance Coverage, Employee’s spouse, if any, shall be eligible for Health Insurance Coverage until her death so long as she pays for the Health Insurance Coverage in an amount equal to the cost of coverage under the Company’s group health plan(s) for an employee with identical coverage.

Spousal Coverage. (1) Notwithstanding Section 7.011(a) and (b) If an employee’s spouse is eligible to participate as a current employee or retire in group health, prescription drug, dental and/or vision insurance or coverage (other than Medicare) sponsored by his/her employer or retirement system (collectively referred to as “employer-sponsored group insurance coverage”), the spouse must enroll in such employer-sponsored group insurance coverage, or must pay $325 per month toward their family coverage in addition to any other payments otherwise due. Upon the spouse’s enrollment in any such employer-sponsored group insurance coverage, that coverage will become the primary payor of benefits and the coverage sponsored by the ▇▇▇▇▇▇ City Schools (WCS) will become the secondary payor of benefits for the spouse. This Spousal Coverage Section does not apply to spouses who are eligible for Medicare. (2) If a spouse’s eligibility for coverage with employer-sponsored group insurance coverage is terminated, the spouse may return to ▇▇▇▇▇▇ City Schools primary coverage without penalty. (3) Every WCS employee whose spouse participates in the ▇▇▇▇▇▇ City School’s group health, prescription drug, dental and/or vision insurance coverage shall annually and upon request complete and submit to the WCS, a written declaration (Spouse Eligibility Certification form) verifying whether his/her spouse is eligible to participate in employer-sponsored group insurance coverage. If a completed form is not returned and received by the Benefits Insurance office by September 1 of any year, it will be assumed the spouse is eligible for and declined employer sponsored group insurance coverage and the $325 per month will be deducted from the employee’s salary on a nonrefundable basis until the form is provided. If the form is requested at another time of year, it must be returned within thirty (30) days or, again, it will be assumed the spouse is eligible and declined employer sponsored group insurance coverage and the $325 per month will be deducted from the employee’s salary on a nonrefundable basis until the form is provided. Once the form is provided, the monthly fee assessment will be in accordance with 7.011 (i.)(1), above. (4) Employees must timely notify the ▇▇▇▇▇▇ City Schools Plan of a change in their spouse’s eligibility for employer-sponsored group insurance coverage. Failure to timely notify is considered the equivalent of falsification of the certification form.

Spousal Coverage. ISD 196 shall contribute up to the equivalent of the full family premium (not to exceed two times the ISD 196 contribution for family coverage as listed in Section 7.1.3 above) toward the premium for one family coverage for two teachers employed by ISD 196 with one or more dependents (other than spouse) who qualify for and are enrolled in ISD 196 group health and hospitalization plan. If one or both of the teachers eligible for spousal coverage are in a job share, ISD 196 shall contribute 50% of the ISD 196 contribution for family coverage for each job share teacher toward the premium for one family coverage.

Spousal Coverage. If the spouse of a City employee is employed and is eligible for employer sponsored health coverage with said employer, he/she must enroll in that particular health plan. City employees married to one another shall be covered under City double or family coverage. If the spouse cannot obtain coverage through his or her employer until a certain date or open enrollment period, the spouse will be covered under the City’s plan until he or she can obtain coverage through his or her employer. The spouse must provide documentation to the City that he or she is eligible for coverage. The employee shall notify the Human Resources Department immediately (as soon as possible) and complete the required documentation when there is a change with his or hers spouses health care coverage. Failure to make such notification and complete the required paperwork will result in all monies owed to the City for the difference in premium to be deducted from the Employees paycheck until the balance is paid in full unless other arrangements have been made. Employees whose spouses have health insurance coverage through an employer, which coverage does not provide the same level of benefits as the City plan, are entitled to $1077 in a flexible spending account or reduced premium, at the City’s discretion. Spouses can also remain on the City’s plan under secondary coverage.

Spousal Coverage. Spousal coverage under any of the available plans will be provided only upon proof that the spouse does not have other insurance coverage available to him/her or cannot secure single coverage from his/her employer, retirement system, or other source based on the amount specified by the Consortium. If the spouse can secure single coverage for the amount specified by the Consortium (or less), he/she must enroll in that coverage. Falsification of spousal coverage information shall be grounds for discipline, including termination and shall void insurance coverage. Should the Consortium eliminate spouses from coverage, employees will not be able to acquire coverage for a spouse through the District.