Spousal Coverage Limitations Sample Clauses
The Spousal Coverage Limitations clause defines the specific terms and restrictions regarding insurance or benefit coverage for an employee's spouse. Typically, this clause outlines eligibility requirements, such as whether a spouse who has access to their own employer-sponsored coverage can be included, and may set maximum benefit amounts or exclude certain types of coverage for spouses. Its core function is to manage the scope of benefits provided, prevent duplicate coverage, and control costs for the employer or insurer.
Spousal Coverage Limitations. The spouse of any employee who is eligible to 29 participate or becomes eligible to participate, as a current employee or retiree, in a group health 30 insurance plan sponsored by his/her employer or retirement plan, must enroll with that Employer 31 or retirement plan for sponsored group insurance coverage. The spouse’s plan will be considered 32 as primary coverage for the spouse. The spouse may opt to additionally enroll in Medina County 33 employee health plan, but the County’s plan will only provide secondary coverage, and spousal 34 enrollment will require the employee to contribute to the monthly cost based upon the full 35 funding rates established on an annual basis by Medina County. 36 37 This requirement does not apply to any spouse who must pay more than fifty (50%) 38 percent of the single premium amount to participate in his/her employer or retirement group 39 health insurance plan. 40 41 The Employer will distribute a request for written certification verifying the spouse’s 42 eligibility to participate in another group health plan. An employee’s spouse will be removed 43 from the Medina County health plan if documentation is not provided within fourteen (14) days 44 of distribution. 45 1 It is the employee’s responsibility to immediately notify Medina County of any 2 subsequent change in a spouse’s eligibility to participate in his/her employer or retirement health 3 plan. If a spouse accepts a new job where coverage is available, he/she must immediately enroll 4 in that plan and the employee must notify Medina County within fourteen (14) days of any 5 change in their spouse’s eligibility. 6
Spousal Coverage Limitations. The spouse of any employee who is eligible to participate or becomes eligible to participate, as a current employee or retiree, in a group health insurance plan sponsored by his/her employer or retirement plan, must enroll with that Employer or retirement plan for sponsored group insurance coverage. The spouse’s plan will be considered as primary coverage for the spouse. The spouse may opt to additionally enroll in ▇▇▇▇▇▇ County employee health plan, but the County’s plan will only provide secondary coverage, and spousal enrollment will require the employee to contribute to the monthly cost based upon the full funding rates established on an annual basis by ▇▇▇▇▇▇ County. This requirement does not apply to any spouse who must pay more than twenty-five (25%) percent of the single premium amount to participate in his/her employer or retirement group health insurance plan. The Employer will distribute a request for written certification verifying the spouse’s eligibility to participate in another group health plan. An employee’s spouse will be removed from the ▇▇▇▇▇▇ County health plan if documentation is not provided within fourteen (14) days of distribution. It is the employee’s responsibility to immediately notify ▇▇▇▇▇▇ County of any subsequent change in a spouse’s eligibility to participate in his/her employer or retirement health plan. If a spouse accepts a new job where coverage is available, he/she must immediately enroll in that plan and the employee must notify ▇▇▇▇▇▇ County within fourteen (14) days of any change in their spouse’s eligibility.
Spousal Coverage Limitations. The spouse of any employee who is eligible to 45 participate or becomes eligible to participate, as a current employee or retiree, in a group health 46 insurance plan sponsored by his/her employer or retirement plan, must enroll with that Employer 1 or retirement plan for sponsored group insurance coverage. The spouse’s plan will be considered 2 as primary coverage for the spouse. The spouse may opt to additionally enroll in Medina County 3 employee health plan, but the County’s plan will only provide secondary coverage, and spousal 4 enrollment will require the employee to contribute to the monthly cost based upon the full 5 funding rates established on an annual basis by Medina County. 6 7 This requirement does not apply to any spouse who must pay more than fifty (50%) 8 percent of the single premium amount to participate in his/her employer or retirement group 11 The Employer will distribute a request for written certification verifying the spouse’s 12 eligibility to participate in another group health plan. An employee’s spouse will be removed 13 from the Medina County health plan if documentation is not provided within fourteen (14) days 14 of distribution. 16 It is the employee’s responsibility to immediately notify Medina County of any 17 subsequent change in a spouse’s eligibility to participate in his/her employer or retirement health 18 plan. If a spouse accepts a new job where coverage is available, he/she must immediately enroll 19 in that plan and the employee must notify Medina County within fourteen (14) days of any 20 change in their spouse’s eligibility. 21