Retiree Health Summary Plan Description
As of February 1, 2018
En Español (PDF)

3.2 Dependent Coverage (Eligible Spouse)

Your Spouse is the only eligible dependent under your Retiree Health Plan benefits. For your Spouse to be eligible, you and your spouse must have been legally married on the date of your first pension check from the Southern California IBEW-NECA Pension Plan.
Your children (biological children, adopted children, step-children or otherwise) are not eligible dependents under the Retiree Health Plan.

You and your Spouse must select the same coverage option. For example, if you select the Kaiser Permanente HMO plan, your Spouse must also enroll in the Kaiser Permanente HMO plan. In this example, if you are not Medicare-eligible and your Spouse is Medicare-eligible, your Spouse would be covered under the Kaiser Permanente Senior Advantage plan.

If you decline coverage for your Spouse when you enroll for Retiree Health Plan coverage, you cannot later add the same Spouse to your Retiree Health Plan coverage. The only exception to this rule is if your Spouse's HIPAA Special Enrollment rights were preserved as detailed in Article 3.3.1: 30-Day Application Deadline.)

The deadline for the Retiree Health Plan enrollment is 30 days after the latest of the following:

  1. First meeting the eligibility requirements for Retiree Health Plan coverage;
  2. Receiving pension benefits from the Southern California IBEW-NECA Pension Plan;
  3. Exhausting all Hours Bank Reserve coverage under the Active Plan;
  4. Exhausting all COBRA coverage under the Active Plan; and
  5. Special enrollment rights under HIPAA (See Article 3.3.2: HIPAA Special Enrollment Rights).

If you do not enroll in the Retiree Health Plan coverage by the applicable deadline listed above, you will permanently lose the right to elect Retiree Health Plan coverage. (See Article 3.3: Enrolling in Coverage.)
If your Spouse is a retired Participant eligible for Retiree Health Plan benefits, he or she is not an eligible Dependent under your coverage.

3.2.1 Divorce, Legal Separation or Annulment

Your Spouse will no longer be an eligible dependent under your Retiree Health Plan. Your Spouse's coverage ends on the first day of the month following the date of divorce, legal separation or annulment.

Because you will need to refund any unauthorized benefits, received by an ineligible Spouse, you must notify the Administrative Office of the divorce, legal separation, or annulment as soon as possible. See Article 9.1: COBRA Continuation Coverage on page 43 for more information on COBRA continuation coverage.

3.2.2 Remarriage After Retirement

If you remarry after retirement, you must contact the Administrative Office and provide written proof of marriage (e.g. marriage certificate) by the end of the second calendar month following the date of your marriage. Coverage for your new Spouse will begin on the first day of the month following enrollment.

For example, if you remarry in January 2018, you must enroll your new Spouse by March 31, 2018. Your Spouse's Retiree Health Plan coverage would begin April 1, 2018.

3.2.3 Eligibility After the Death of the Retiree

Your enrolled surviving Spouse may continue Retiree Health Plan coverage after your death.

If you delayed Retiree Health Plan coverage because you had Active Health Plan coverage, were exhausting the Hours Bank Reserve coverage or enrolled in COBRA coverage, your surviving Spouse may enroll in Retiree Health Plan coverage no later than the exhaustion of the Hours Bank Reserve coverage or COBRA coverage ends.