PPO/DRP Medical Plan - Advocate Benefits - Advocate Health Care

The Basics
Eligibility
To be eligible to participate in the Plan, you must
be employed by Advocate or one of its affiliated
companies that participates in the Plan (an
“Advocate Company”) as a:
Full-time associate—who works at least 40
hours per work week (or who works 36 hours
per week and is classified as an “E9” or
“N9” associate),
Part-time A associate—who works at least 32
(but less than 40) hours per work week, or
Part-time B associate—who works at least 20
(but less than 32) hours per work week.
You must also have completed 30 days of
employment with Advocate or one of its
affiliated companies to be eligible to participate.
Satisfying these requirements means that
you are a “benefits-eligible” associate or in a
“benefits-eligible” position or status as referred
to throughout this summary.
You can purchase medical coverage for eligible
family members, including:
Your lawful spouse
Your domestic partner or civil union partner
Note: For more information about the eligibility
of a civil union or domestic partner for
coverage under the Plan, refer to the Partner
Benefits Information Guide online at
www.advocatebenefits.com (go to Benefits
Information > Partner Benefits).
Your children up to age 26. Note: Children
include your:
– Natural children,
– Stepchildren,
– Adopted children (including children
placed with you for adoption),
– Foster children, and
– Any children for whom you have
legal guardianship.
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Note: You cannot be covered under any of
the Advocate medical plan options as both an
associate and a dependent. If both parents are
benefits-eligible associates, only one parent can
cover the children as dependents. You or your
dependents may not elect to be covered under
more than one Advocate medical plan option.
Are my married children eligible for inclusion
under my Advocate medical coverage?
Yes, your married children are eligible for
coverage up to age 26. However, your child’s
spouse is not eligible to participate.
Enrollment
To enroll initially or to change your
existing coverage after a transfer to
benefits-eligible status, you must log on to
www.advocatebenefits.com. You will receive a
system-generated Benefits Enrollment Guide,
which will specify your designated enrollment
period, as well as provide you with a Personal
Identification Number (PIN) to access the
Advocate Benefits Service Center benefits
enrollment system.
Advocate reserves the right to periodically audit
the eligibility process and request documentation
from Plan participants to verify eligibility for
the Plan or the payment of benefits under the
Plan. Associates found to be involved in acts of
dishonesty are subject to disciplinary action, up
to and including termination of employment.
Important! You should review your enrollment
materials carefully to ensure you are aware of
your designated enrollment period. If you do not
enroll during your designated enrollment period,
you will not be able to enroll for coverage until
the next annual enrollment period—unless you
have a qualified work, family or eligible life status
change (see Work, Family or Eligible Life Status
Change, page 14).