Health Summary Plan Description

Extended Spousal Eligibility

For the latest updates to these rules and information, please see the Fall 2015 Take 2.

The Extended Spousal benefit provides Senior Performers Health Plan benefits to your qualified dependents when you die, provided you meet certain requirements at the time of your death. A qualified dependent includes your dependent children and your surviving spouse, provided you and your spouse were married for at least 12 months immediately preceding your death. Your same-sex domestic partner is eligible for the Extended Spousal benefit provided he or she meets the Plan's criteria for domestic partnerships as in effect on or after July 1, 2011 (see page 5) and the partnership had been in effect for at least 12 months immediately preceding your death. Permanently disabled dependent children age 26 or older are only eligible for the Extended Spousal benefit if your surviving spouse or same-sex domestic partner is covered under the Extended Spousal benefit.

The Extended Spousal benefit is provided to your qualified dependents if you meet one of the following conditions:

  • You were age 65 or older at the time of your death and you had at least 15 Pension Credits.
  • You were age 65 or older at the time of your death and you had at least 10 Pension Credits as of December 31, 2001 and were age 55 or older as of December 31, 2002.
  • At the time of your death, you were at least age 50, you had at least 20 Pension Credits and your age plus years of Pension Credit were at least 75. Coverage for your dependents starts when you would have reached age 65 if you had lived.

Important: Pension Credits earned under the Alternative Eligibility Program do not count toward eligibility for the Extended Spousal benefit.

If the Health Plan premium is paid, coverage for your spouse or same-sex domestic partner continues until:

  • Your spouse or same-sex domestic partner dies; or
  • Your spouse or same-sex domestic partner marries or enters into a same-sex domestic partnership or civil union.

Coverage for dependent children continues until they no longer qualify as dependents unless the child is age 26 or older and permanently disabled. In that case coverage will terminate when the spouse or same-sex domestic partner's coverage terminates. The Plan Office requests verification of the spouse's marital status or the partner's partnership status annually during the Open Enrollment Period. Eligibility will not be extended until a completed questionnaire is received by the Plan Office.

In some cases, additional benefits may be available under the Self-Pay Program. Qualified dependents will be notified by the Plan Office if this additional coverage is available.

Extended Spousal eligibility may be replaced with Earned coverage if the minimum Covered Earnings or Days of Employment requirement is met. Your dependents will receive Earned Plan I coverage.

If you and your spouse or same-sex domestic partner both have Senior Performers coverage and one of you dies, the surviving spouse or partner will not receive Extended Spousal coverage. They will continue to receive their own Senior Performers coverage secondary to Medicare, provided they continue to pay the required premium.