SSMC Employee Health Benefit Plan
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3. Schedule B Benefits Minimum Requirements. Covers only the eligible Employee. Dependent
coverage is not available. Schedule B Benefits cover SSMC Hospitalization and ambulance only. The
minimum requirement for Schedule B Benefits is:
Part Time Employees. Eligible Employees hired to work a regular part-time schedule of 18 hours
but less than 22.50 hours.
4. Dependent Eligibility Schedule A Benefits only. Dependents are only covered for Employees who are
eligible and enrolled in Schedule A Benefits. Proof of Dependent status may be required. Criteria of
support will be considered met if the Employee shows at least 50 percent of the financial support for the
Dependent child and that child qualifies as an exemption under federal income tax rules.
If you are not eligible for Plan enrollment in Schedule A Benefits, you cannot enroll your Dependents
under this Plan. The term Dependent means your Spouse and eligible children. To be eligible for
enrollment in your family coverage, your Dependents must meet the following requirements:
a. Legal Spouse. (A legally separated Spouse may be enrolled in the Plan, but a divorced spouse is not
eligible.) You may enroll your legal Spouse if she or he is a residence in the same country in which
you reside. For part-time Employees who work 22.50 but less than 30 hours per week, Dependents are
not eligible for the first five years of that Employee's continuous eligible employment.
Please Note
The Spouse or survivor Spouse of an eligible retiree maintains eligibility under This Plan until age
65. At age 65, the Spouse/survivor Spouse becomes eligible under the SSMC Retiree Health
Benefits Plan. The SSMC Human Resources can provide full details concerning eligibility and
costs for this coverage.
b. Unmarried Children of Active Employees. For part-time Employees who work 22.50 but less than
30 hours per week, Dependents are not eligible for the first five years of that Employee's eligible
employment. The following rules apply to you if you are in eligible employment at SSMC:
Your unmarried children who have never been married and are residents of the same country in which
you reside may be considered Dependents. To be eligible, for enrollment in your family coverage the
children must meet the following child definition and age requirements:
1) Child Definition. A child (children) means:
a) The Employee's own unmarried child or legally adopted unmarried child who is dependent
on the Employee for support and qualifies as Dependent under federal income tax rules;
b) Any unmarried stepchild of the Employee who permanently resides in the Employee's home
and qualifies as a Dependent under federal income tax rules;
c) Any other unmarried child related to the Employee or who is under legal guardianship
before the child is age 19 and who is permanently living in the Employee's home;
supported by the Employee and qualifies as a dependent under federal income tax rules;
d) Any unmarried child placed for adoption before the child reaches age 18. The term placed for
adoption means a child placed in the Employee's home and the Employee's assumption and
retention of a legal obligation for total or partial support of a child in anticipation of adoption
of the child. This eligibility ends when such legal obligation terminates. Proof of pre-
adoption status will be required by SSMC to establish eligibility. Once the child is legally
adopted, he/she retains eligibility as a legally adopted child shown above; or
