Group Benefits Package for
Employees Represented by
SPEEA
Retiree Medical Plan
Attachment B
Technical Unit
November 14, 2008
___________________________________________
ATTACHMENT B
CONTENTS
Eligibility....................................................................................................................... 1
Retiree Medical Plan Enrollment.................................................................... 3
Effective Date of Retiree
Medical Coverage............................................ 6
Summary of Medical Plan
Benefits.................................................................. 7
Termination of Retiree Medical
Coverage.................................................. 7
TRICARE Supplement Plan
Description of Benefits................................. 9
You are eligible for the retiree medical plan if you retire
from the service of the Company under the Company-sponsored retirement plan as
follows:
·
You are an active employee and age 55 or older
with 10 or more years of vesting service under a Company-sponsored retirement
plan.
·
You are disabled, become eligible for disability
benefits under the Company-sponsored retirement plan, and are age 50 or older
with 10 or more years of vesting service at retirement.
·
You are on an approved leave of absence, you are
age 55 or older with 10 or more years of vesting service at retirement,
and you retire under the Company-sponsored retirement plan directly from your
approved leave of absence.
·
You are on layoff, you are at least age 55
with 10 or more years of vesting service at retirement, and you retire under
the Company-sponsored retirement plan within 6 years following your layoff.
If you are eligible for retiree medical coverage as
described above, you can defer your retiree medical coverage or receipt of your
retirement plan benefit. See Effective Date of Retiree Medical Coverage and the
Deferred Enrollment section of Retiree Medical Plan Enrollment for more information.If you are hired on or after January 1,
2007, you will not be eligible for retiree medical coverage when you retire
from the Company. For purposes of determining retiree medical plan eligibility,
you are considered to be hired before January 1, 2007, if:
·
You are on an authorized leave of absence on December 31,
2006, and return to active employment directly from that authorized leave of
absence.
·
You are on layoff on December 31, 2006, and
return to active employment within 6 years following your layoff.
·
You are an active employee on December 31,
2006, go on an authorized leave of absence, and return to active employment
directly from that authorized leave of absence.
·
You are an active employee on December 31,
2006, are laid off, and return to active employment within 6 years following
your layoff.
You are no longer eligible for coverage under the retiree medical
plan after attaining age 65 or becoming eligible for Medicare.
Dependents eligible for the retiree medical plan are your
legal spouse (as recognized under both applicable state law and the Internal
Revenue Code) and children (natural children, adopted children, children
legally placed with you for adoption, and stepchildren) who are under age 25,
unmarried, and dependent on you for principal support.
You may request coverage for
the following dependents:
·
An opposite-gender common law spouse if the
relationship meets the common-law requirements for the state where you entered
into the common-law relationship.
·
A same-gender domestic partner if:
–
You and your partner live in the same permanent
residence in a permanent, exclusive, emotionally committed, and financially
responsible relationship similar to a marriage.
–
Your partner is at least 18 years old, is not
related to you by blood, is not married to or separated from another person,
and is not involved in another domestic partner relationship.
–
Your domestic partner relationship is not solely
to obtain coverage under the Plan.
·
Unmarried children of your same-gender domestic
partner who are under age 25 and dependent on you for principal support. These
children are considered stepchildren for the purpose of the medical plans.
·
Other children, as follows, who are under age 25,
unmarried, and dependent on you for principal support:
– Children
who are related to you either directly or through marriage (e.g.,
grandchildren, nieces, nephews).
– Children
for whom you have legal custody or guardianship (or for whom you have a pending
application for legal custody or guardianship) and are living with you.
Proof of dependent eligibility will be required.
In accordance with Federal law, the Company also provides
medical coverage to certain dependent children (called alternate recipients) if
the Company is directed to do so by a qualified medical child support order
(QMCSO) issued by a court or state agency of competent jurisdiction.
Documentation is required to request coverage for dependents,
including a child named in a QMCSO or a child for whom you have been given
legal custody or guardianship, or a spouse or same-gender domestic partner. You
must provide the Boeing Service Center with any required supporting
documentation by the date specified by the Boeing Service Center or your
request will be denied.
If you or any of your dependents is covered or becomes
covered (or eligible for benefits by reason of having been covered) under
another Company-sponsored plan providing medical benefits, that person is not
eligible for the retiree medical plan. If you and your spouse or same-gender
domestic partner are both employed by or retired from Boeing, you each must be
covered by your own Boeing-sponsored medical coverage. However, if your spouse or
same-gender domestic partner is a part-time Boeing employee or on an approved
leave of absence or layoff, your spouse or same-gender domestic partner and
eligible children are considered eligible dependents if other Boeing coverage
is waived. If your spouse or same-gender domestic partner and eligible children
are covered under your spouse’s or same-gender domestic partner’s Boeing-sponsored
plan, they will be considered eligible for the retiree medical plan at the time
they no longer are eligible for coverage under your spouse’s or same-gender
domestic partner’s plan.
No person may be covered both as a retired employee and as a
dependent, and no person will be considered as a dependent of more than 1
retired or active employee.
Upon your death, your spouse or same-gender domestic partner
and any other covered dependents remain eligible for coverage under the retiree
medical plan until the earliest of these dates:
·
Your spouse or same-gender domestic partner or other
dependent attains 65 years of age.
·
Your spouse or same-gender domestic partner or other
dependent becomes eligible for Medicare.
·
The end of the last month for which
contributions are paid.
A disabled child age 25 or older may continue to be eligible
if a physician documents that the child is incapable of self-support due to any
mental or physical condition that began before age 25. You may be required
to confirm the disability from time to time. The child must be unmarried and
dependent on you for principal support. Coverage may continue under the retiree medical plan for the duration of the incapacity as
long as you continue to be enrolled in the plan and the child continues to meet
these eligibility requirements.
Special applications for coverage are required for disabled
dependent children age 25 or older.
You and your eligible dependents automatically will be
enrolled at the time you become eligible, provided you pay any required
contributions. You and your dependents will be enrolled in the same plan as
immediately before retirement, if available.
You may elect to change medical plans by calling the Boeing
Service Center within 31 days of the date you retire. The Company will supply
enrollment instructions at the time of your retirement.
All family members, including you, must be enrolled in the
same medical plan.
Each retired employee enrolling a spouse or same-gender
domestic partner must provide information regarding coverage available through
another employer to determine whether special contributions are required to
enroll the spouse or same-gender domestic partner. If you do not authorize a
required contribution, your spouse or same-gender domestic partner will not be
enrolled for medical coverage. You will not be able to enroll your spouse or
same-gender domestic partner until the date your spouse or same-gender domestic
partner loses the option to be covered under the other employer-sponsored
medical plan.
The Company will require periodic verification of data.
If you declined
coverage in the retiree medical plan for yourself and/or your eligible
dependents when you were first eligible because you or your dependents had
other employer-sponsored medical coverage, you may enroll yourself and/or your
eligible dependents if you or your dependent experiences one of these special enrollment
events:
· You
or your dependent loses or becomes ineligible for other employer-sponsored
medical coverage because of an event such as loss of dependent status under
another employer’s plan (through divorce, legal separation, termination of a
same-gender domestic partnership, or dependent child reaching the limiting
age), death, termination of employment, reduction in hours of employment,
termination of employer contributions toward the coverage, elimination of
coverage for the class of similarly situated employees or dependents, moving
out of the plan’s service area with no other coverage available from the other
employer, or reaching the lifetime limit on all benefits under the other
employer’s plan.
· If
you or your dependent reaches the lifetime limit under a Company plan, and you
are eligible for another Company plan in your area, you and your dependents may
enroll in that other plan.
· You
or your dependent exhausts any continuation coverage from another employer;
that is, coverage provided under the Consolidated Omnibus Budget Reconciliation
Act of 1985, as amended (COBRA), ends.
· You
gain a new dependent because of marriage, same-gender domestic partnership,
birth, adoption, or placement for adoption.
If you experience a
special enrollment event, you can enroll yourself and/or your eligible
dependents in the retiree medical plan as described above. You can enroll in
any family status tier and any health plan option available to you.
Special enrollment
is not available if you lose coverage because of failure to make timely premium
payments or termination from the plan for cause (such as for making a
fraudulent claim).
If you
decline enrollment in the retiree medical plan because of other
employer-sponsored health care coverage (such as through your spouse’s or
same-gender domestic partner’s employer), you may be able to enroll yourself
and your eligible dependents in the Company-sponsored retiree medical plan at a
later date as long as enrollment is within 60 days after other coverage ends.
·
If you are not
enrolled in the Company-sponsored retiree medical plan and have a new dependent
as a result of an event such as marriage, same-gender domestic partnership, birth,
adoption, or placement for adoption, you may enroll yourself, your spouse or
same-gender domestic partner, and any dependent children during the year as
long as enrollment is requested within 60 days after the event by contacting
the Boeing Service Center.
·
If you are
enrolled in the retiree medical plan and have a new dependent as a result of
marriage, same-gender domestic partnership, birth, adoption, or placement for
adoption, you may enroll your new dependent during the year as long as
enrollment is requested within 120 days after the qualified event.
·
If you are enrolled in the retiree
medical plan and have not enrolled your eligible dependents because of other
employer-sponsored health care coverage, you may be able to enroll your
eligible dependents in the Company-sponsored retiree medical plan at a later
date as long as enrollment is within 60 days after the other coverage ends. The
coverage loss must be due to loss of eligibility for the health care coverage
(including from divorce, legal separation, termination of same-gender domestic
partnership, death, termination of employment, or reduction in hours of
employment), termination of employer contributions toward such coverage, or
reaching the other plan’s lifetime maximum benefit.
Transfer between plans is
permitted only during authorized annual enrollment periods or following a
change of residence.
·
Annual enrollment period.
The Company establishes an annual enrollment period on or
before January 1 each year when you may change medical plans.
·
Change of residence.
If you move out of an EPO, HMO, or
coordinated care plan service area, you have 60 days to select a medical plan
available in the new location by calling the Boeing Service Center. It is your
responsibility to notify the Company of the change in residence within the
60-day period.
If you already are enrolled for this retiree medical
coverage, you may be able to change or add an eligible dependent if you
experience one of the status changes described below. Any change to your
coverage must be consistent with the status change that affects your or your
dependent’s eligibility for Company-sponsored health care coverage or health
care coverage sponsored by your eligible dependent’s employer. Status changes
include the following:
·
You acquire a new, eligible dependent through
marriage, entering a same-gender domestic partnership, birth, adoption, or
placement for adoption.
·
You lose a dependent through divorce, legal
separation, dissolving a same-gender domestic partnership, or annulment of your
marriage.
·
Your covered dependent dies.
·
Your covered dependent starts or stops working.
·
Your covered dependent has any other change in
employment status that affects eligibility for coverage such as changing
from full time to part time (or part time to full time), salaried to hourly (or
hourly to salaried), strike or lockout, a transfer between a nonunion salaried
position and a union-represented position, or beginning or returning from an
unpaid leave of absence.
·
You or your covered dependent experiences a
significant increase in the cost of employer-sponsored health care coverage or
the employer-sponsored health care coverage ends, including expiration of COBRA
coverage.
·
The Company adds a new benefit option or
significantly improves an existing benefit option.
·
You or your covered dependent experiences a
significant curtailment or cessation of employer-sponsored medical coverage.
·
You or your covered dependent becomes eligible
or ineligible for Medicare or Medicaid.
·
Your dependent child becomes eligible for, or no
longer is eligible for, health care coverage due to age limits, principal
support status, or a similar eligibility requirement.
·
Your covered dependent makes an enrollment
change in his or her employer-sponsored health care coverage, either because of
a qualified change in status or an annual enrollment.
·
You or your covered dependent changes place of
residence or work, affecting access to care within the current plan or access
to network providers.
You also may change an election to comply with a qualified
medical child support order (QMCSO) to provide or cancel coverage for a dependent
child resulting from a divorce, annulment, or change in legal custody.
If you are eligible to add new dependents, you must request
the dependent enrollment change within 60 days after the qualified event.
You can enroll a new dependent within 120 days following your marriage or entering
a same-gender domestic partnership or your dependent child’s birth, adoption,
or placement for adoption. Enrollment may be requested by calling the Boeing
Service Center. To request enrollment for a new dependent more than
60 days but within 120 days after marriage or entering a same-gender
domestic partnership, birth, adoption, or placement for adoption, you must call
the Boeing Service Center and speak with a customer service representative.
You must provide the Boeing Service Center with any supporting
documentation by the date specified by the Boeing Service Center or your request
will be denied.
You may drop coverage for yourself or your dependents at any
time. However, you may reenroll only if you and your dependents are
continuously covered by an employer-sponsored plan and that coverage ends, as
described in Deferred Enrollment.
If you are a newly retired employee, the plan becomes
effective on the first day of the second month following the month in which
your active employment ends, provided you pay any required contributions.
If you are eligible for retiree medical coverage at the time
active employment with the Company ends, or as otherwise described in
Eligibility, you may:
·
Defer enrollment in the retiree medical plan
until the date your benefits begin under the Company-sponsored retirement plan,
or
·
Enroll in the retiree medical plan and defer
receipt of benefit payments under the Company-sponsored retirement plan, or
·
Defer enrollment in the retiree medical plan
until your coverage ends under another employer-sponsored health care plan
(such as through your spouse’s employer), as described in the Deferred
Enrollment section of Retiree Medical Plan Enrollment.
You are not eligible for the retiree medical coverage
described in this Agreement after becoming eligible for Medicare or attaining
age 65.
Current
eligible dependents are covered for retiree medical benefits on the same date
your coverage is effective, provided proper application is made and you pay any
required contributions. Eligible dependents acquired after your coverage is
effective become covered on the date of marriage or entering a same-gender
domestic partnership, date of birth, or date the child is legally placed with
you for adoption, if application is made within 120 days of the event and
you pay any required contributions. For other newly eligible dependents,
coverage is effective on the date dependency is established, if application is
made within 60 days and you pay any required contributions.
The medical plans offered to retired employees are the same
as the plans offered to active employees except that the TRICARE Supplement
Plan is available to retirees only.
Effective January 1, 2010, benefit
and plan payment provisions will be based on a benefit year of January 1
through December 31.
Your medical coverage stops on whichever of the following
dates occurs first:
·
You attain 65 years of age.
·
You become eligible for Medicare.
·
The end of the last month that any required
contributions are paid.
Your covered dependents can continue their coverage until
they reach their termination date, as described below.
Coverage for your eligible
dependents terminates on whichever of the following dates occurs first:
·
Your dependent no longer qualifies as an
eligible dependent.
·
Your dependent attains 65 years of age.
·
Your dependent becomes eligible for Medicare.
·
The end of the last month you are covered under
this retiree medical plan or the Company-sponsored Medicare Supplement Plan,
except in the case of your death.
·
The end of the last month that any required
contributions are paid.
If medical coverage for your
dependents otherwise would terminate due to one of the following reasons, these
benefits may continue for specified periods under Public Law 99-272,
Title X, as amended, if the individual makes a timely request to the
Company and pays the required contribution.
·
Your death.
·
Your divorce or dissolution of domestic
partnership.
·
You become entitled to Medicare.
·
Your dependent child ceases to be a dependent as
defined under this plan. (A child eligible to be continued under the plan’s
incapacitated child provision will still be considered
to have dependent status.)
If
medical coverage terminates for reasons other than voluntary cancellation of
coverage or by becoming eligible for another Company-sponsored plan, the
service representative will make available an individual program of medical
benefits similar to those then being issued for group conversion. The benefits
provided under the individual plan will not exactly duplicate the benefits
provided under this group medical plan. This conversion privilege is available
to your covered dependents who cease to qualify under
the group policy and to surviving covered dependents if you die. No evidence of
insurability is required.
|
The plan is
insured by Hartford Life and Accident Insurance Company |
|
|
Eligible Employees and Dependents* |
·
Individuals enrolled in TRICARE (Department of
Defense coverage): –
Military retirees and their dependents –
Dependents of active duty military personnel |
|
Benefits Supplementing TRICARE Standard/ |
·
100% of annual deductible amounts ·
100% of military hospital subsistence charges ·
100% of civilian hospital coinsurance amounts ·
100% of outpatient services coinsurance
amounts ·
100% of deductibles and copayments for
prescription drugs ·
100% of charges in excess of usual and
customary |
|
Benefits Supplementing TRICARE Prime/POS |
·
100% of HMO network and pharmacy copayments ·
50% of nonnetwork deductibles ·
50% of nonnetwork coinsurance amounts ·
100% of charges in excess of usual and
customary |
|
Vision Care |
·
Provided through the Boeing vision care
program |
|
Coverage Ends |
·
For retiree and spouse at age 65 or earlier
entitlement to Medicare ·
For dependent children at age 21 or 23 if
full-time students |
|
* Includes retired
employees and their dependents who are not eligible for Medicare |
|