The eligibility and enrollment rules for the U

Retiree Health Care SPD Effective January 1, 2012
Eligibility and Enrollment Rules Section B
This eligibility and enrollment section only applies to:
• West Employees who retired before January 1, 2002;
• West Employees who retired between January 1, 2002, and December 31, 2002, and who
elected the fixed subsidy option;
• West Employees whose LTD or severance period began before January 1, 2002; and
• West Employees who retired or whose LTD or severance period began between January 1,
2002, and December 31, 2002, and who elected the fixed subsidy option.
Retiree Eligibility
You are eligible to participate in the Program if:
• you are age 55 or older at the time of your termination, or if you are involuntarily terminated,
the date that your subsidized health care benefits end;
• you have five or more Years of Service as determined under the terms of the U.S. Bank
Pension Plan; except if you are involuntarily terminated, any period of time that you are
enrolled in subsidized health care benefits will count for purposes of calculating a Year of
Service (refer to the “Glossary of Terms” section of this SPD for the definition of Years of
Service);
• your age and Years of Service total at least 65; and
• you are eligible for and enrolled in a U.S. Bank active employee health care option at the
time of your termination.
Dependent Eligibility
Refer to the materials from Kaiser for information about dependent eligibility under this
option.
“Eligible dependents” for the purposes of U.S. Bank benefits are listed below. You will need to
provide your dependent’s Social Security number (SSN) when adding or enrolling a dependent.
Refer to “Dependent Data Requirement” in this SPD for further information about this
requirement. In addition, U.S. Bank and its designated administrators may request proof of
dependent eligibility at any time. Failure to provide such proof may result in termination of
coverage.
Your dependent(s) will be eligible to participate in the Program, if:
• your dependent was covered by your U.S. Bank active employee health care option at the
time of your termination; and
• your dependent continues to satisfy one of the following requirements except as noted:*
• 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;
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