Working Spouse Ineligibility for Primary Coverage/Secondary Coverage Only. If an employee’s spouse is eligible to participate, as a current employee or retiree in group health insurance and/or prescription drug insurance sponsored by his/her employer or any public retirement plan, the spouse must enroll in such employer (or public retirement plan) sponsored group insurance coverage(s). This 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 his/her employer’s group health insurance coverage and/or prescription drug insurance coverage. This requirement also does not apply to any spouse who is a retiree under a public retirement plan and enrolled in Medicare coverage. Upon the spouse’s enrollment in any such employer (or public retirement plan) sponsored group insurance coverage that coverage will become the primary payor of benefit and the coverage sponsored by the Board will become the secondary payor of benefits. Any spouse who fails to enroll in any group insurance coverage sponsored by his/her employer or any public retirement plan, as required by this Section, shall be ineligible for benefits under such 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 or any insurance coverages provided in this Article VIII 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 (dental, vision or other such insurance) coverages sponsored by the spouse’s employer or any public 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. If an employee submits false information or fails to timely advise the Plan of a change in his/her spouse’s eligibility for employer (or public retirement plan) sponsored group health insurance and/or prescription drug insurance (or dental, vision or other such insurance), and such false information or such failure results in the Plan providing benefits to which the employee’s spouse is not entitled, the employee will be personally liable to the Plan for reimbursement of benefits and expenses, including attorneys’ fees and costs, incurred by the Plan. Any amount to be reimbursed by an employee may be deducted from the benefits to which he/she would otherwise be entitled. In addition, the employee’s spouse will be terminated immediately from the group health insurance and/or prescription drug, dental, vision or other insurance coverage under the respective insurance Plan. If an employee submits false information, he/she may be subject to disciplinary action, up to and including termination of employment.
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