When Coverage Ends
When Your Medical and Prescription Drug Coverage Ends
Retiree
Coverage under a Trust Early Retiree Medical Plan automatically ends for you and your covered dependents on the last day of the month (except where noted) when:
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You lose eligibility for coverage
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You reach age 65 or otherwise become eligible for Medicare
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You fail to make any required payments for the following month's coverage
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You die while covered (see "Dependents" for benefits available to surviving eligible dependents); if you die, coverage ends on the date of death
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The Trust Early Retiree Medical Plan or the option in which you participate is terminated
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The active employee classification from which you retired no longer participates in the Trust or no longer provides for an early retiree medical plan option for which you are eligible as contained in this handbook.
Your dependents may continue coverage on a self-pay basis if the Trust's requirements for continuing coverage on a self-pay basis are met. (See " Continuing Coverage on a Self-Pay Basis" for more information.)
Dependents
Please be aware that if an individual who has been reported as your dependent receives benefits after Trust eligibility has or should have ended, the Trust may recover the improperly paid benefits from you.
Coverage for dependents ends when the coverage for the early retiree ends (except for the provision allowing coverage to continue after the retiree's death) and in the following additional situations:
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Spouse
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Coverage ends on the last day of the month before your spouse becomes eligible for Medicare.
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Coverage for your spouse ends the last day of the month in which a divorce or annulment becomes final. Your ex-spouse may continue coverage on a self-pay basis if the Trust's requirements for continuing coverage on a self-pay basis are met. (See "Continuing Coverage on a Self-Pay Basis" for more information.)
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Failure to make payment for the following month's coverage.
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Domestic partner
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Coverage ends for your domestic partner on the last day of the month before your domestic partner becomes eligible for Medicare.
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Coverage for a domestic partner and his or her covered children ends on the last day of the month in which the domestic partnership ends. The domestic partner and/or his or her eligible children may continue coverage on a self-pay basis if the requirements for continuing coverage on a self-pay basis are met. (See "Continuing Coverage on a Self-Pay Basis" for more information.)
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Failure to make payment for the following month's coverage.
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Dependent children
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Coverage automatically ends on the last day of the month in which an otherwise eligible dependent child reaches age 26 or the last day of the month in which the child otherwise no longer meets the Trust's requirements for dependent eligibility.
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Coverage can be continued past age 26 if a dependent child is unmarried, financially dependent on you and incapable of self-support due to a physical or mental disability.
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A dependent child whose coverage ends may continue coverage on a self-pay basis if the requirements for continuing coverage on a self-pay basis are met. (See "Continuing Coverage on a Self-Pay Basis" for more information.)
You should inform the Trust if a dependent spouse, domestic partner or child is no longer eligible to receive benefits from the Trust.
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