The eligibility and enrollment rules for the U

Retiree Health Care SPD Effective January 1, 2012
• you are eligible to participate in the Program and you enroll yourself and your eligible
dependent at the time of your termination; and
• your dependent continues to satisfy one of the following requirements:
• Your spouse/domestic partner* (unless legally separated from you). Under the federal
Defense of Marriage Act (DOMA), a spouse is a husband or wife of opposite sex. A
common-law spouse may be covered only if you reside in a state that recognizes
common-law marriage and you meet the common-law requirements at the time you enroll
the dependent in coverage. To enroll a domestic partner in coverage, you must meet the
eligibility criteria defined under “Domestic Partner Eligibility” section in this SPD.
• You or your domestic partner’s children/grandchildren under age 26** who are:
− Your/your domestic partner’s biological children;
− your stepchildren;
− your/your domestic partner’s foster children;
− children/grandchildren for whom you or your spouse/domestic partner have legal
guardianship***;
− children/grandchildren legally adopted by you or your spouse/domestic partner or
placed with you or your spouse/domestic partner for adoption***; and
− grandchildren who are eligible to be claimed as an exemption on you or your
spouse/domestic partner’s federal income tax return.
• Disabled children age 26 and older who otherwise meet the dependent children definition
may be covered as long as ALL of the following requirements are met:
– the child is severely disabled by prolonged physical or mental incapacity;
– the child became disabled prior to reaching age 26;
– the child was covered by the plan prior to reaching age 26, or, if older than age 26,
loses coverage under a parent’s/guardian’s plan. In the event of loss of coverage, proof of
prior coverage must be provided;
– the child is unmarried and you/your domestic partner provide more than 50% of his or
her support because he or she is unable to earn a living; and
– disabled dependent status is approved by a medical Claims Administrator for
U.S. Bank.
To have the disabled child considered for coverage, you and his or her doctor must
complete an application form for the child. The form is available from the applicable
medical Claims Administrator. To be considered, the form must be received by the
medical Claims Administrator no later than 30 days after the date the child turns age 26.
See the “Important Resources” section of this SPD for telephone numbers for the medical
Claims Administrators. If coverage for the child is approved and the child is not
considered permanently disabled, periodically you will be asked to submit proof to the
medical Claims Administrator that the child continues to meet eligibility requirements.
Failure to provide requested information may result in loss of coverage for the dependent.
*Even though some localities may recognize same-sex marriages, the U.S. Bank Benefits Program is governed by
federal regulations which require that coverage for partners must be paid for on an after-tax basis, and the cost of
coverage be considered imputed income. Therefore, even in the event of marriage or civil union, if you are enrolling
your same-sex spouse you must designate him/her as a domestic partner.
** For health care coverage, a newborn is not considered a dependent until birth.
*** Documentation of legal guardianship or adoption is required. Please call the U.S. Bank Employee Service
Center for instructions. The dependent cannot be added to your coverage until a copy of the applicable documents
are received and verified by the U.S. Bank Employee Service Center.
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