SSMC Employee Health Benefit Plan
23
month following three full months of eligible employment (six full months for eligible part-time
Employees working 20.50 to 30 hours per week).
D. Monthly Participation Payment
Currently, SSMC provides Plan individual and family coverage to eligible Employees at no costs. However,
SSMC has the authority to amend the Plan, at its discretion, to require Participation Payments by Enrollees.
Please Note
The Plan does require Participation Payments for Continuing Coverage under USERRA or Continuing Coverage under
COBRA shown later in this section.
E. End of Coverage
Plan coverage for you or your Dependents will end when you or your Dependents no longer meet the eligibility
requirements of the Plan. Expenses Incurred after Plan ends will not be considered for Plan benefits. However,
you or your Dependents may be eligible and elect to continue coverage under COBRA. Refer to Continuing
Coverage Under COBRA, shown later in this section. Eligibility and coverage ends for the following unless
enrollment under COBRA is made:
1. For any and all Plan participants when the Plan is terminated.
2. For Employee and all his or her enrolled Dependents when no longer eligible due to termination of
employment, reduction in hours or retirement. Coverage ends on the date eligible employment status is
terminated.
3. For Employee and all his or her Dependents, coverage ends on the date after 30 days of full time active
duty in the military service or armed forces of any country. However, the Employee may elect Continuing
Coverage under USERRA shown later in this section.
4. For Employee and all his or her Dependents for Nonpayment of Plan Participation Payment, if any. For
Dependents, non-payment of Plan Participation Payment for family coverage, if any.
5. Divorce, annulment or other dissolution of your marriage. Coverage ends for your ex-Spouse on the date
dissolution of your marriage becomes final.
6. If Employee dies, coverage ends for the Employee and all his enrolled Dependents unless Dependents are
eligible as Survivors.
7 For a Dependent, coverage ends for that Dependent on the date after 30 days of full time active duty by that
Dependent in the military service or armed forces of any country.
8. Dependent Child coverage also ends on:
a. The date the child marries.
b. The date the child no longer qualifies as a Dependent according to eligibility rules shown in Section II
- Eligibility and Enrollment. For example:
1) 12:01 A. M. on the date no longer dependent on the Employee for support or no longer resides in
the Employee's home.
2) 12:01 A. M. on January 1 following the Calendar Year in which the eligible child turns age 19 and
is not a full-time student or is no longer eligible as a disabled/handicapped child dependent on the
Employee for support.
3) 12:01 A. M. on January 1 following the Calendar Year in which the eligible full-time student
between the ages 19 and 23 is no longer eligible as a full-time student or graduates.
4)
12:01 A. M. on January 1 following the Calendar Year in which the full-time student turns age 23.
5)
12:01 A. M. on the date a pre-adoptive child is removed from placement for adoption or the
Employee is no longer legally responsible for total or partial support of the pre-adoptive child.
6) 12:01 A. M. on the date a child previously eligible as a handicapped or disabled child marries, is
able to earn his or her own living, fails to provide proof of disability, or to participate in a required
Physician exam or the date SSMC establishes that the child no longer meets criteria as a disabled
