Page 3 - AAACU Health & Welfare SPD rev 09012013

Table of Contents

Introduction .............................................................................................................................. 2

Table of Contents ..................................................................................................................... 3
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 ................................................................. 8
Qualifying Change in Status .................................................................................................... 9
Special Enrollment Rights ....................................................................................................... 9
When Coverage Ends ............................................................................................................10
Cancellation of Coverage .......................................................................................................10
Rescission of Coverage .........................................................................................................10
Coverage While Not at Work .................................................................................................. 11
If You Take a Leave of Absence (FMLA) ................................................................................ 11
If You Take a Military Leave of Absence ................................................................................. 11

Your Health Care Coverage ....................................................................................................12
Participation ...........................................................................................................................12
Benefits Provided ...................................................................................................................12
Source of Payments ...............................................................................................................12
Opt-Out Credits ......................................................................................................................13
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
Health Care Flexible Spending Account and HRA ..................................................................16
For More Information .............................................................................................................16

Your Life and Accidental Death & Dismemberment (“AD&D”) Coverage ............................17

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