The eligibility and enrollment rules for the U

More documents

Recommendations

Info

Retiree Health Care SPD Effective January 1, 2012 This is the summary plan description (SPD) for the U.S. Bank Retiree Health Care Program and the U.S. Bank Wellness Program, components of the U.S. Bank Benefits Program. Please read the information carefully and file it with your benefits materials. U.S. Bank has established the U.S. Bank Comprehensive Welfare Benefit Plan (“Plan”), which provides severance, wellness, health, dental, and retiree health care benefits for certain eligible U.S. Bank employees and former employees. The U.S. Bank Comprehensive Welfare Benefit Plan consists of distinct programs, each of which covers a specific category of benefits for a particular group of employees. For convenience, U.S. Bank has created a separate summary for each program. This SPD applies to retirees enrolled in the Early Retiree Medical, Comprehensive, Medica, UnitedHealthcare or Kaiser Retiree Health Care Program benefit options. The materials you receive about your benefit option will include important information regarding the doctors you may see, the medical services you may receive, any copayments or other out-ofpocket expenses for which you may be responsible, requirements you must satisfy before receiving services (e.g., preadmission notification and prior authorization) and the services and expenses that are excluded under the benefit option. Additionally, your materials may include specific rules regarding dependent eligibility under the benefit option that may be different from the other benefit options offered under the Program. It is important for you to read the SPD and the materials you receive from the UnitedHealthcare or Medica Plan option and Kaiser option (if applicable) fully and carefully. You should keep these materials available for future reference. For a list of the summary plan descriptions describing the other benefits under the U.S. Bank Comprehensive Welfare Benefit Plan, please see the "Benefits Administrative Information" section of this SPD. This document is intended only to provide a summary of the benefits that are available. The final administration of claims is handled by the Claims Administrator. If there is any discrepancy between this document and the official plan/program documents (for benefits where the summary plan description is not part of the plan document), the official plan/program documents govern. If You Have Questions or Need Information If you have questions about the U.S. Bank Retiree Health Care Program, call the U.S. Bank Employee Service Center, which serves employees and retirees, at 1-800-806-7009. Follow the prompts for retirees or former employees to be directed to the appropriate area. Representatives are available Monday through Friday (excluding holidays) from 8 a.m. to 8 p.m. CT. Questions about health care options and what is covered, pre-existing conditions limitations and/or claims information should be directed to the appropriate third-party administrator or the insurance company, listed in the “Important Resources” section of this SPD. You may also access information about the Program at www.yourbenefitsresources.com/usbank. 6
Retiree Health Care SPD Effective January 1, 2012 ELIGIBILITY AND ENROLLMENT The eligibility and enrollment rules for the U.S. Bank Retiree Health Care Program (the Program) differ based upon your date of retirement and your employee status at the time of retirement. This section describes the eligibility and enrollment requirements for retirements on and after January 1, 2012. See the Appendix to this SPD for the eligibility and enrollment rules for employees who retired prior to January 1, 2012. Eligibility and Enrollment Rules 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); • you retire from U.S. Bank; and • you are eligible for and enrolled in a U.S. Bank active employee health care option as of your termination. You are not a participant in the Program until you have satisfied all the eligibility requirements listed above. While certain employees may accumulate retiree health credits while still employed, the accumulation of these credits does not make employees participants in the Program. Note: If you are not eligible for and covered under a U.S. Bank active employee health care option immediately before your termination, you will not be eligible to participate in the Program, even if you have accumulated retiree health care credits while employed. Dependent Eligibility “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 your U.S. Bank active employee health care option at the time of your termination; • 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 7
Page 1 and 2: Retiree Health Care SPD Effective J
Page 5: Retiree Health Care SPD Effective J
Page 57 and 58:
Retiree Health Care SPD Effective J
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
show all

The eligibility and enrollment rules for the U

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?