Deferring Coverage for a Spouse or Surviving Spouse of a Non-Medicare Eligible Retiree

At the time you retire, and provided your spouse produces evidence that your spouse is covered by another health benefit plan, you may elect that no self-contributions be paid for coverage of your spouse under this Plan, thereby excluding your spouse from coverage. There will be no coordination of benefits for such excluded spouse.

This election to defer your spouse’s coverage is limited to your spouse at the time of your retirement only, or your surviving spouse, and will not cover any other future spouse. The election will not cover any spouse who marries you after your retirement. If your spouse loses other medical coverage during your retirement, you may elect to have your spouse added to coverage under this Plan within ninety (90) days of your spouse’s loss of coverage. You may exercise this election only one time.

If your spouse or surviving spouse is, or becomes, eligible for this Plan and has health coverage under another plan through employment, your spouse or surviving spouse will be given a one-time opportunity to defer coverage under this Plan until your spouse or surviving spouse is no longer covered by your spouse’s or surviving spouse’s employer health plan.

To defer Plan coverage, you, your eligible spouse or surviving eligible spouse must meet the following requirements:

  • Your eligible spouse or surviving eligible spouse must be eligible for coverage under this Plan,
     
  • Your eligible spouse or surviving eligible spouse who becomes eligible for coverage under this Plan after September 1, 1995, must file a written election with the Fund Office,
     
  • Your eligible spouse or surviving eligible spouse must provide proof of other insurance with the election, and
     
  • If your eligible spouse or surviving eligible spouse does not file an election, your spouse will not be permitted to defer coverage.

To resume coverage, your eligible spouse or surviving eligible spouse must meet the following requirements:

  • Your eligible spouse or surviving eligible spouse must have made a valid election to defer coverage as stated above in the third paragraph.
     
  • Your eligible spouse or surviving eligible spouse must have been continuously covered by the health plan of his or her employer since the date that your spouse opted out of this Plan, and provide proof of that coverage,
     
  • Your eligible spouse or surviving eligible spouse must apply to resume coverage with the Fund Office in writing, on or before the 90th day after termination of coverage under the health plan of your spouse’s employer. If your spouse does not enroll within this period, your spouse will not be allowed to enroll at a future date, and
     
  • Your eligible spouse or your surviving eligible spouse must make the contributions and payment required by the Sheet Metal Workers’ Local 73 Welfare Fund Plan for Retired Members to maintain coverage.