Page 3 - 2013 Adv1FCU Health and Welfare SPD

Table of Contents

Introduction ............................................................................................................................... 2
Plan Overview ........................................................................................................................... 6
Your Eligibility .......................................................................................................................... 6
Eligible Dependents ................................................................................................................. 6
When Coverage Begins ........................................................................................................... 7
Proof of Dependent Eligibility ................................................................................................... 7
Your Contribution for Coverage ................................................................................................ 7
Enrolling for Coverage ............................................................................................................. 8
New Hire Enrollment ............................................................................................................. 8
Late Entrant .......................................................................................................................... 8
Annual Open Enrollment Period ............................................................................................... 8
Effect of Section 125 Tax Regulations on this Plan .................................................................. 9
Special Enrollment Rights ........................................................................................................ 9
When Coverage Ends .............................................................................................................. 9
Cancellation of Coverage ....................................................................................................... 10
Rescission of Coverage ......................................................................................................... 10
Coverage While Not at Work .................................................................................................. 10
If You Take a Leave of Absence (FMLA) ................................................................................ 10
If You Take a Military Leave of Absence ................................................................................. 11
Your Health Care Coverage .................................................................................................... 12
Participation ........................................................................................................................... 12
Benefits Provided ................................................................................................................... 12
Source of Payments ............................................................................................................... 12
Limitations and Exclusions ..................................................................................................... 13
Continuation of Health Care Coverage through COBRA ........................................................ 13
For More Information ............................................................................................................. 13
Your Health Reimbursement Arrangement (“HRA”) ............................................................. 14
How the HRA Works .............................................................................................................. 14
How to File a Claim ................................................................................................................ 14
Benefit Payment .................................................................................................................... 14
Maintaining Records .............................................................................................................. 15
Ineligible Claims ..................................................................................................................... 15
Changes in Coverage ............................................................................................................ 15
When Participation Ends ........................................................................................................ 15
For More Information ............................................................................................................. 16
Your Life and Accidental Death & Dismemberment (“AD&D”) Coverage ............................ 17
Participation ........................................................................................................................... 17
Benefits Provided ................................................................................................................... 17
Source of Payment ................................................................................................................ 17
Plan Limitations and Exclusions ............................................................................................. 17
Coverage Continuation .......................................................................................................... 17
For More Information ............................................................................................................. 18
Your Disability Benefits .......................................................................................................... 19

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