AETNA PPO PLAN - My Benefits Portfolio - Trinity Health

PARTICIPATION
WHEN PARTICIPATION BEGINS
You may elect coverage under the Plan within 30 days of the date you are first eligible for coverage (your
“Initial Enrollment Period”) or during Annual Open Enrollment. If you are a newly hired benefits-eligible
Associate and you elect coverage for yourself during your Initial Enrollment Period (i.e., within 30 days of
your date of hire), your coverage will begin on the first day of the month after 30 days of employment with
your Employer, measured from your date of hire. If you are a newly hired benefits-eligible Associate and
you elect coverage for your eligible Dependents during your Initial Enrollment Period, your eligible
Dependents’ coverage will begin on the same day your coverage begins.
If you become a benefits-eligible Associate, as defined in your Employer’s policy that defines Associate
classifications, after your initial date of hire by your Employer, your coverage will begin on the first day of the
pay period following the date you become a benefits-eligible Associate (or the first day of the pay period
following the date you complete 30 days of employment with your Employer, if later) if you enroll yourself in
the Plan during your Initial Enrollment Period (i.e., within 30 days of the date you become a benefits-eligible
Associate). If you become a benefits-eligible Associate after your initial date of hire by your Employer and
you elect coverage for your eligible Dependents during your Initial Enrollment Period, your eligible
Dependents’ coverage will begin on the same day your coverage begins.
You must enroll yourself in the Plan in order to enroll your Dependents in the Plan.
The following table shows when participation begins for you and your covered Dependents:
Plan participant Qualified for coverage:
New hire First day of the month following 30 days of
employment
New Dependent: Spouse Date of marriage
New Dependent children: Newborn Date of birth through age 26
New Dependent children: Stepchildren Coverage begins date of marriage and continues
through age 26.
New Dependent children: Adopted, placed
for adoption and/or legal guardianship,
Coverage begins on the date of adoption,
placement for adoption, and/or legal guardianship.
Coverage continues through age 26.
Disabled Dependent children Must be Disabled before reaching age 26. To
remain covered under the Plan, you must notify
your Employer by the end of the calendar year in
which the Dependent reaches age 26.
Upon electing coverage under the Plan for your eligible Dependents, you will have 30 days to provide
documentation to verify the eligibility of each of your covered Dependents, including your spouse. The
required documentation is set forth in the Trinity Health Dependent Verification Documentation
Requirements, a copy of which can be obtained at http://mybenefits.trinity-health.org/
auditdocrequirements.pdf or from the Plan Administrator. Coverage for your Dependents will remain in an
“ineligible” status until appropriate documentation is provided. Failure to provide appropriate
documentation within 30 days will result in the voluntary termination of your election for coverage for your
Dependents.
NOTE: Certification of eligibility may be required periodically for your covered Dependents.
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