Working Spouse Coverage Obligations Sample Clauses
The Working Spouse Coverage Obligations clause sets out the requirements for providing health insurance coverage to employees whose spouses have access to health benefits through their own employers. Typically, this clause stipulates that if an employee's spouse is eligible for health insurance at their workplace, the employer's plan may limit or restrict coverage for that spouse, or require the spouse to enroll in their own employer's plan first. This approach helps the employer manage healthcare costs and avoid duplicative coverage, ensuring that primary responsibility for a working spouse's health insurance rests with their own employer.
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. If an employee’s spouse is eligible to participate, as a current employee, self-employed indi- vidual (other than a sole proprietor) in a business (e.g., partner), or retiree in a group medical and/or prescription drug insurance sponsored by his/her employer, business, or employer’s retirement plan, the spouse must enroll for at least single coverage in such group medical and prescription drug insurance if he/she is not eligible for Medicare on or before January 1, 2012. 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 employer makes no monetary contribu- tion for said coverage, such plans will not be considered to be “employer-sponsored” plans. This is intended to apply to situations in which the spouse is a current employee in a busi- ness. This determination will not apply to situations in which the spouse is a business own- er, 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 insur- ance plan.
b. This requirement 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 the group medical and/or prescription drug in- surance sponsored by his/her employer, business or employer’s retirement plan.
c. Upon the spouse’s enrollment in a group medical and/or prescription drug insurance spon- sored by his/her employer, business or employer’s retirement plan, that coverage will be- come the primary plan and the coverage sponsored by the University will become the sec- ondary plan according to the primary plan’s coordination of benefits and participation rules. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpreta- tion of these coordination of benefits rules.
d. Any spouse who fails to enroll in any group medical and/or prescription drug insurance cov- erage sponsored by his/her employer, business or employer’s retirement plan, as required by this section, shall be ineligible for benefits under such group medical and prescription drug insurance coverage sponsored by the University.
Working Spouse Coverage Obligations. If 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 to participate, as a for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employee,employer, former employer (for retirees), or business for self-employed individualindividuals (other than a sole proprietor) in a business (e.g., partner), or retiree in a group medical and/or prescription drug insurance sponsored by his/her employer, business, or employer’s retirement plan,proprietors) collectively or individually, “Employer Coverage”, the spouse must enroll for at least single coverage in such group medical and prescription drug insurance if his/her Employer Coverage unless he/she is not eligible for entitled to Medicare as of January 1, 20152. 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.
Working Spouse Coverage Obligations. If 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 to participate, as a for group medical and/or prescription drug coverage sponsored, maintained and/or provided by the spouse’s current employee,employer, former employer (for retirees), or business for self-employed individualindividuals (other than a sole proprietor) in a business (e.g., partner), or retiree in a group medical and/or prescription drug insurance sponsored by his/her employer, business, or employer’s retirement plan,proprietors) (collectively or individually, “Employer Coverage”), the spouse must enroll for at least single coverage in such group medical and prescription drug insurance if his/her Employer Coverage unless he/she is not eligible for entitled to Medicare on or before January 1, 2012.. 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 said coverageEmployer Coverage, such plans will not be considered to be “employer-sponsored” plans.Employer Coverage. This is intended to apply to situations in which the spouse is a current employee in a business. This determination will, but not apply 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.
Working Spouse Coverage Obligations a. If an employee’s spouse is eligible to participate, as a current employee, self-employed individual (other than a sole proprietor) in a business (e.g., partner), or retiree in a group medical and/or prescription drug insurance sponsored by his/her employer, business, or employer’s retirement plan, the spouse must enroll for at least single coverage in such group medical and prescription drug insurance if he/she is not eligible for Medicare on or before July 1, 2012. 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 employer makes no monetary contribution for said coverage such plans will not be considered to be “employer sponsored” plans. This is intended to apply to situations in which the spouse is a current employee in a business. This determination will not apply 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. This requirement 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 the group medical and/or prescription drug insurance sponsored by his/her employer, business or employer’s retirement plan.
c. Upon the spouse’s enrollment in a group medical and/or prescription drug insurance sponsored by his/her employer, business or employer’s retirement plan; that coverage will become the primary plan and the coverage sponsored by the University will become the secondary plan according to the primary plan’s coordination of benefits and participation rules. The rules of O.R.C. §§ 3902.11 to 3902.14 shall govern the implementation and interpretation of these coordination of benefits rules.
d. Any spouse who fails to enroll in any group medical and/or prescription drug insurance coverage sponsored by his/her employer, business or employer’s retirement plan, as required by this Section, shall be ineligible for benefits under such group medical and prescription drug insurance coverage sponsored by the University.
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 his/her Employer Coverage unless he/she is entitled to Medicare 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. payment part of his/her accrued but unused sick leave as defined in the 2008 – 2011 agreement:... [2] ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ 4/7/2015 2:12 PM
b. The requirement of subsection (a) does not apply to any spouse who works less than 25 hours ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM 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. ▇▇▇▇▇▇, ▇▇▇▇▇▇ 7/9/2014 3:01 PM
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 prim...