Double Coverage. Dependent family members of two employees/retirees under provisions of this contract are entitled to health plan coverage in one plan only. The employees/retirees may elect to join different health plans, but they are not entitled to coverage both as a subscriber and dependent. In the Delta Dental plan each employee/retiree may be a subscriber and only one subscriber may carry the dependents.
Double Coverage. Dependent family members of two employees who are married are entitled to health plan coverage in one plan only; the married employees may elect to join different health plans, but they are not entitled to coverage both as a subscriber and dependent. In the Delta Dental plan each employee may be a subscriber.
Double Coverage. “Opt Out” Employees currently receiving the waiver (opt-out) incentive will be changed from a deferred compensation contribution to a $125 per pay period taxable cash benefit effective as soon as administratively possible following council adoption and will be grandfathered into the benefit. No new enrollments will be allowed into the waiver (opt-out) benefit effective the pay period of council adoption. If a grandfathered employee enrolls in City medical, therefore forfeiting their waiver benefit, they will not be able to opt back in at a later date. Employees are only eligible for “Opt Out” compensation if they demonstrate that they have other Affordable Care Act compliant group health coverage.
Double Coverage. Employees, spouses or dependents of employees who are insured with a health or dental insurance plan provided through the Employer of the employee's spouse, are not eligible for coverage under this Agreement.
Double Coverage. Workers who qualify for the retirement health credit conversion may elect double coverage at the rate of two (2) units for every month of paid health insurance.
Double Coverage. It is common for family members to be covered by more than one health care plan. This happens, for example, when a husband and wife both work and choose to have family coverage through both employers. When you are covered by more than one health plan, state law permits your insurers to follow a procedure called “coordination of benefits” to determine how much each should pay when you have a claim. The goal is to make sure that the combined payments of all plans do not add up to more than your covered health care expenses. Coordination of benefits (COB) is complicated, and covers a wide variety of circumstances. This is only an outline of some of the most common ones.
Double Coverage. It is common for family members to be covered by more than one health care plan. This happens, for example, when a husband and wife both work and choose to have family coverage through both employers. When you are covered by more than one health plan, state law permits your insurers to follow a procedure called “coordination of benefits” to determine how much each should pay when you have a claim. The goal is to make sure that the combined payments of all plans do not add up to more than your covered health care expenses. COB is complicated and covers a wide variety of circumstances. This is only an outline of some of the most common ones. If your situation is not described, read your evidence of coverage or contact the Texas Department of Insurance. Primary or Secondary? You will be asked to identify all the plans that cover members of your family. We need this information to determine whether we are the “primary” or “secondary” benefit payer. The primary plan always pays first when you have a claim. Any plan that does not contain Texas’ COB rules will always be primary unless the provisions of both plans state that the complying plan is primary. When This Plan is Primary If you or a family member is covered under another plan in addition to this one, we will be primary when: Your Own Expenses the claim is for your own health care expenses, unless you are covered by Medicare and both you and your spouse are retired. Your Spouse’s Expenses the claim is for your spouse, who is covered by Medicare, and you are not both retired. Your Child’s Expenses the claim is for the health care expenses of your child who is covered by this plan and: o you are married and your birthday is earlier in the year than your spouse’s, or you are living with another individual, regardless of whether or not you have ever been married to that individual, and your birthday is earlier than that other individual’s birthday. This is known as the “birthday rule”; or o you are separated or divorced and you have informed us of a court order that makes you responsible for the child’s health care expenses; or o there is no court order, but you have custody of the child.
Double Coverage. If an employee is otherwise covered by health insurance and elects to drop the health insurance coverage provided for in subsection (A) above, the employee's wages shall be increased by three hundred dollars ($300) per month.
Double Coverage. The District will not be obligated to provide more than one (1) health insurance program to a family unit. If the employee's spouse is also an employee of the District, the bargaining unit member shall designate who is to be the carrier of health insurance and the other shall be eligible for the option. Employees receiving primarily comparable insurance coverage through a spouse shall not be eligible for insurance coverage provided by the District. There shall be no double coverage.
