The benefits currently provided for retirees and their spouses are not “vested” benefits. This means the Trustees have the right, at any time, to change the eligibility rules or benefits, to increase self-payments for the benefits, or to reduce or completely terminate the benefits provided for any category of participants or beneficiaries.
Retirement is a qualifying event under COBRA coverage. If you are entitled to Medicare when you retire, you can elect COBRA coverage for up to 18 months, but you cannot elect the Plan’s Retiree Comprehensive Plan coverage.
Medicare entitlement is a terminating event under COBRA coverage. If you elect COBRA before you are entitled to Medicare, but you become entitled to Medicare before your COBRA period ends, your COBRA coverage will terminate at that time (but your dependents may continue COBRA coverage).
If you elect COBRA coverage, you cannot get into the Retiree Comprehensive Plan later, regardless of the length of your COBRA coverage period or the reason your COBRA coverage ended.
If you are eligible for the Retiree Comprehensive Plan and elect to make self-payments for that coverage, you forfeit your right to elect COBRA coverage in the future.
In order to be eligible for benefits under the Retiree Plan, you must meet ALL of the following requirements:
Dependent children are not covered under the Retiree Plan.
EFFECT OF OTHER COVERAGE AND MEDICARE
Retiree coverage CANNOT be elected for any person who is covered by another group health care plan or who is eligible for Medicare.
If your spouse has other group health care coverage when you retire (for example, if she continues to work and, therefore, remains covered under her employer’s plan), she will not be covered under this Plan. If she later retires and loses her other coverage, she will then become eligible for benefits from this Plan—provided you have maintained your own eligibility by making all required self-payments.
Neither you nor your spouse can be covered under this Plan if you are eligible for Medicare (whether or not you have actually enrolled in Medicare).
The medical and prescription drug benefits provided to retirees are very similar to the benefits provided to active employees. These benefits are summarized on the Schedule of Benefits.
The Active and Retiree Plans are separate from each other. Your benefits, including the deductible, will start over when your retiree coverage starts, even if it is in the middle of a year.
The self-payment amount required for coverage is determined by the Trustees and may be changed at any time. If you are eligible and make the required self-payments, your spouse will also be covered for the same self-payment amount. (The amount is the same for the retiree only or for both the retiree and his spouse.)
Payments are due on the first day of the month for which coverage is desired.
If you die while you are making retiree self-payments for yourself and your spouse, your surviving spouse can continue making the self-payments under the same terms and conditions that applied to your coverage until she remarries, becomes covered under another group health plan or Medicare, or until the occurrence of one of the other events listed in the section entitled “Termination of Benefits for Spouses of Retirees,” whichever occurs first.
The spouse of an eligible retiree may be able to make self-payments for COBRA coverage in the following circumstances:
Except as specified above, the rules governing COBRA coverage for spouses of retirees are the same as the rules for active participants.
Your benefits will automatically terminate on the first to occur of the following dates:
If your coverage under the Retiree Plan is terminated for any of the reasons stated above, you will not be able to get back into the Plan later.
Benefits for your spouse will automatically terminate on the first to occur of the following dates: