Page 4 - 2016 Open Enrollment Non-Union
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Beneits Enrollment
General Beneits Definition of Dependent
Eligibility You can also choose to cover certain dependents under
Hussmann’s health and welfare beneits. Your eligible
dependents include the following.
You are eligible for the beneits described
in this guide based on the following hours Your legal spouse
worked per week. Eligible children including
20 to 29 hours—eligible for life, You, your legal spouse’s, adopted (or placed for
AD&D, and STD adoption) or foster children, or your stepchildren, who
30+ hours—eligible for life, AD&D, are under age 26
medical, dental, vision, lexible Any other unmarried child under age 26 who lives
spending account, disability, STD, LTD, with you in a parent-child relationship based on IRS
and health savings account (depending guidelines and who is primarily dependent on you, or
on medical plan selection) your legal spouse for support (for more information on
the IRS guidelines, go to www.IRS.gov)
Your coverage under most of the plans Any other child under age 26 which you, or your legal
described in this guide is effective on spouse are required to cover because of a divorce
your date of hire (your irst day of active decree or qualiied medical child support order
employment). (QMCSO)
A covered child who, as of the date his or her coverage
Working Spouse Surcharge would have otherwise ended, is mentally or physically
This surcharge is intended to help manage incapable of self-support and primarily dependent upon
the overall costs of health beneits while you or your spouse for inancial support; to continue
maintaining the value of our programs.
Hussmann will pay the majority of coverage covering a disabled child because of mental or physical
costs for a working spouse who is enrolled in disability beyond the age coverage would otherwise end,
our medical plan, but you will pay a $1,300 you must provide satisfactory proof of the incapacity
annual surcharge if your spouse is eligible for and notify Hussmann within 30 days of the date the
subsidized group medical coverage through child would otherwise lose coverage because he or she
his or her employer, waives coverage, and
chooses to enroll in medical coverage through is no longer eligible
Hussmann. This surcharge will come out evenly Hussmann validates your dependent(s) eligibility upon close
from each paycheck. To calculate the amount
which will be deducted from your paycheck, of enrollment. Documentation will be requested during the
divide the annual amount by 26 if you are paid validation period.
bi-weekly or 52 for bi-monthly.
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General Beneits Definition of Dependent
Eligibility You can also choose to cover certain dependents under
Hussmann’s health and welfare beneits. Your eligible
dependents include the following.
You are eligible for the beneits described
in this guide based on the following hours Your legal spouse
worked per week. Eligible children including
20 to 29 hours—eligible for life, You, your legal spouse’s, adopted (or placed for
AD&D, and STD adoption) or foster children, or your stepchildren, who
30+ hours—eligible for life, AD&D, are under age 26
medical, dental, vision, lexible Any other unmarried child under age 26 who lives
spending account, disability, STD, LTD, with you in a parent-child relationship based on IRS
and health savings account (depending guidelines and who is primarily dependent on you, or
on medical plan selection) your legal spouse for support (for more information on
the IRS guidelines, go to www.IRS.gov)
Your coverage under most of the plans Any other child under age 26 which you, or your legal
described in this guide is effective on spouse are required to cover because of a divorce
your date of hire (your irst day of active decree or qualiied medical child support order
employment). (QMCSO)
A covered child who, as of the date his or her coverage
Working Spouse Surcharge would have otherwise ended, is mentally or physically
This surcharge is intended to help manage incapable of self-support and primarily dependent upon
the overall costs of health beneits while you or your spouse for inancial support; to continue
maintaining the value of our programs.
Hussmann will pay the majority of coverage covering a disabled child because of mental or physical
costs for a working spouse who is enrolled in disability beyond the age coverage would otherwise end,
our medical plan, but you will pay a $1,300 you must provide satisfactory proof of the incapacity
annual surcharge if your spouse is eligible for and notify Hussmann within 30 days of the date the
subsidized group medical coverage through child would otherwise lose coverage because he or she
his or her employer, waives coverage, and
chooses to enroll in medical coverage through is no longer eligible
Hussmann. This surcharge will come out evenly Hussmann validates your dependent(s) eligibility upon close
from each paycheck. To calculate the amount
which will be deducted from your paycheck, of enrollment. Documentation will be requested during the
divide the annual amount by 26 if you are paid validation period.
bi-weekly or 52 for bi-monthly.
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