Page 10 - Enrollment Guide

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Spousal/Biometric Surcharge

Spousal Surcharge

You will be charged a $150 monthly surcharge to cover your spouse as a
dependent under the health plan if your spouse is employed and is eligible
for healthcare beneits through his/her employer. You will not be charged
the spousal surcharge if your spouse is:

„ Not employed

„ Not eligible for his/her employer’s health coverage

„ Employed, but his/her employer doesn’t offer healthcare beneits
„ Employed, and is covered by his/her employer’s health coverage
(meaning EnTrans’s coverage would be secondary)

Biometric Screening Surcharge

You will be charged a $20 monthly surcharge if you do not participate in
October’s biometric screening event, or if you don’t complete a biometric
screening and fax the appropriate doctor form by October 16, 2015.
An additional $20 monthly surcharge will be applied if your covered
spouse does not participate in the biometric screening event nor obtain

a biometric screening and submit the appropriate documentation in the
Spousal/Biometric/Tobacco
same time frame. The spousal biometric screening surcharge is only
applicable to employees who cover their spouse as a dependent on the
medical plan.

Surcharge