Page 2 - KEMBA CHARLESTON FCU

KEMBA CHARLESTON FCU 2017-18

Table of Contents

Introduction .................................................................................................................................... 3

Changing Your Benefits ................................................................................................................... 3
Newborns’ & Mothers’ Health Protection ........................................................................................ 4

Women’s Health & Cancer Rights Act (WHCRA) ............................................................................... 4
Protecting Your Privacy ................................................................................................................... 4

Qualified Medical Child Support Order ............................................................................................ 4

USERRA ........................................................................................................................................... 5
The Genetic Information Nondiscrimination Act of 2008 (GINA) ...................................................... 5

Special Enrollment Notice ................................................................................................................ 5
New Health Insurance Marketplace Coverage Options and Your Health Coverage ........................... 6

Benefits Provided to Our Employees ................................................................................................ 8
Waiver of Medical Coverage – Opt Out Option ................................................................................ 8

Summary of Benefits & Coverage .................................................................................................... 8

For More Information About Our Coverage ..................................................................................... 9
Employee Contributions .................................................................................................................. 9

Notice of Creditable Coverage for Medicare Rx .............................................................................. 10
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) ............. 12

Summary of Benefits Coverage – Active Employee Plan ................................................................. 15

Notes ............................................................................................................................................ 25

Information about Medicare

If you have Medicare or will become eligible for Medicare within the next 12 months, a
new Federal law gives you more choices about your prescription drug coverage.
Please see pages 10-11 for details.

Important Note

This Benefits Enrollment Guide is only a brief summary of your benefits. It is not intended to provide a complete description of each plan.
Please refer to the Summary Plan Description and any other official documents for complete information about each benefit. We have tried to
ensure its accuracy but if there is any discrepancy between the benefits discussed in the guide and the official plan documents, the official
plan documents will rule. The company reserves the right to amend or terminate the Plan at any time and for any reason. The information in
the guide and accompanying materials applies to the Kemba Charleston Federal Credit Union Employee Benefit Plan, Plan Number 501, and
meets the requirements for a Summary of Material Modification as required by the Employee Retirement Income Security Act (ERISA).

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