Page 40 - Aegion PPO SPDs
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than 30 days, You may not be required to pay more than the active Member contribution, if any, for
continuation of health coverage.
If continuation is elected under this provision, the maximum period of health coverage under the Plan shall
be the lesser of:
The 24-month period beginning on the first date of Your absence from work; or
The day after the date on which You fail to apply for or return to a position of employment.
Regardless whether You continue Your health coverage, if You return to Your position of employment Your
health coverage and that of Your eligible Dependents (if any) will be reinstated under the Plan. No
exclusions or waiting period may be imposed on You or Your eligible Dependents in connection with this
reinstatement unless a Sickness or Injury is determined by the Secretary of Veterans Affairs to have been
incurred in, or aggravated during, the performance of military service.
How to Add Newborns
To cover a newborn, You must complete an Aegion Enrollment Form, adding the newborn within 30 days
of the birth.
Please mail the form to Aegion’s corporate HR office. Any additional employee contribution will be deducted
from Your paycheck.
If the completed form is not received within 30 days, the newborn cannot be added until the next open
enrollment period.
Coverage for Adopted Children
If You adopt a child who is not a newborn, coverage will begin on the date the child is placed in Your home
— as long as You file the adoption petition and Aegion receives Your Enrollment Form for coverage within
30 days of placement. Any additional employee contribution will be deducted from Your paycheck.
When sending Your Enrollment Form to add an adopted child, please provide a copy of the adoption
petition. The petition must show some type of court stamp, or You must include a receipt proving that the
petition was filed with the court.
If You don’t enroll the child within 30 days of placement, the child cannot be enrolled until the next open
enrollment.
Children with Disabilities
Children who are mentally or physically disabled and totally dependent on the Employee for support, past
the age of 26 or older. To be eligible for continued coverage past the age of 26, certification of the disability
is required within 30 days of attainment of age 26. A certification form is available from the Employer or
from the Claims Administrator and may be required periodically. You must notify the Claims Administrator
and/or the Employer if the Dependent’s marital or tax exemption status changes and they are no longer
eligible for continued coverage.
Qualified Medical Child Support Order
If You are required by a qualified medical child support order or court order, as defined by ERISA and/or
applicable federal law, to enroll Your child under the Plan, the Employer will permit Your child to enroll at
any time without regard to any open enrollment limits and shall provide the benefits of the Plan in
accordance with the applicable requirements of such order. A child's coverage under this provision will not
extend beyond any Dependent Age Limit listed in the Schedule of Benefits. Any claims payable under the
Plan will be paid, at the Plan's discretion, to the child or the child's custodial parent or legal guardian, for
any expenses paid by the child, custodial parent, or legal guardian. The Claims Administrator will make
information available to the child, custodial parent, or legal guardian on how to obtain benefits and submit
claims to the Employer or Claims Administrator directly.
40
continuation of health coverage.
If continuation is elected under this provision, the maximum period of health coverage under the Plan shall
be the lesser of:
The 24-month period beginning on the first date of Your absence from work; or
The day after the date on which You fail to apply for or return to a position of employment.
Regardless whether You continue Your health coverage, if You return to Your position of employment Your
health coverage and that of Your eligible Dependents (if any) will be reinstated under the Plan. No
exclusions or waiting period may be imposed on You or Your eligible Dependents in connection with this
reinstatement unless a Sickness or Injury is determined by the Secretary of Veterans Affairs to have been
incurred in, or aggravated during, the performance of military service.
How to Add Newborns
To cover a newborn, You must complete an Aegion Enrollment Form, adding the newborn within 30 days
of the birth.
Please mail the form to Aegion’s corporate HR office. Any additional employee contribution will be deducted
from Your paycheck.
If the completed form is not received within 30 days, the newborn cannot be added until the next open
enrollment period.
Coverage for Adopted Children
If You adopt a child who is not a newborn, coverage will begin on the date the child is placed in Your home
— as long as You file the adoption petition and Aegion receives Your Enrollment Form for coverage within
30 days of placement. Any additional employee contribution will be deducted from Your paycheck.
When sending Your Enrollment Form to add an adopted child, please provide a copy of the adoption
petition. The petition must show some type of court stamp, or You must include a receipt proving that the
petition was filed with the court.
If You don’t enroll the child within 30 days of placement, the child cannot be enrolled until the next open
enrollment.
Children with Disabilities
Children who are mentally or physically disabled and totally dependent on the Employee for support, past
the age of 26 or older. To be eligible for continued coverage past the age of 26, certification of the disability
is required within 30 days of attainment of age 26. A certification form is available from the Employer or
from the Claims Administrator and may be required periodically. You must notify the Claims Administrator
and/or the Employer if the Dependent’s marital or tax exemption status changes and they are no longer
eligible for continued coverage.
Qualified Medical Child Support Order
If You are required by a qualified medical child support order or court order, as defined by ERISA and/or
applicable federal law, to enroll Your child under the Plan, the Employer will permit Your child to enroll at
any time without regard to any open enrollment limits and shall provide the benefits of the Plan in
accordance with the applicable requirements of such order. A child's coverage under this provision will not
extend beyond any Dependent Age Limit listed in the Schedule of Benefits. Any claims payable under the
Plan will be paid, at the Plan's discretion, to the child or the child's custodial parent or legal guardian, for
any expenses paid by the child, custodial parent, or legal guardian. The Claims Administrator will make
information available to the child, custodial parent, or legal guardian on how to obtain benefits and submit
claims to the Employer or Claims Administrator directly.
40
