The eligibility and enrollment rules for the U

Retiree Health Care SPD Effective January 1, 2012
Eligibility and Enrollment Rules Section C
This eligibility and enrollment section only applies to:
• East Employees who retired prior to January 1, 2002;
• Employees formerly employed by Mercantile Bancorporation who retired before January 1,
2003;
• Former eligible Mercantile employees that went out on severance or LTD prior to January 1,
2003. (This includes eligible employees that went out on severance or LTD prior to January
1, 2003, and with severance or LTD ending after January 1, 2003.)
Retiree Eligibility
You are eligible to participate in the Program if you satisfied the age, service and any other
eligibility requirements in effect under the terms of the retiree health care plan applicable to you
at the time of your termination.
Employees formerly employed by Mercantile Bancorporation that went out on severance or LTD
prior to January 1, 2003 (this includes eligible employees that went out on severance or LTD
prior to January 1, 2003 and whose severance or LTD ended after January 1, 2003) did not need
to be enrolled in a U.S. Bank active employee health care option at the time of termination to be
eligible for this Program.
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. 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 a Firstar Group Health Insurance Plan benefit option at the
time of your termination (except dependents of employees formerly employed by Mercantile
Bancorporation who terminated before January 1, 2003 and dependents of former eligible
Mercantile employees that went out on severance or Long-Term Disability (LTD) prior to
January 1, 2003);
• 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;
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