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NOTICE OF OPPORTUNITY TO ENROLL IN CONNECTION
WITH EXTENSION OF DEPENDENT COVERAGE TO AGE 26
To: Participants in the District No. 9, International Association of Machinists and Aerospace Workers Welfare Plan
This Revised Notice replaces the Notice that was sent to you on May 25, 2011. That prior Notice has been revised to include certain changes to the Plan’s Adult Child (age 19 up to age 26) eligibility requirements that the Trustees adopted after the original Notice was sent to you.
- If you are a member with an Adult Child that is eligible for coverage under an employer-sponsored health plan other than a parent’s group health plan, you must complete in full and submit the attached “Adult Child Eligibility Form”, even if you previously submitted this form. Like under the prior Notice, in the event your Adult Child is eligible for coverage, the Adult Child’s coverage will be effective July 1, 2011.
- If you are a member who does not have an Adult Child that is eligible for coverage under an employer-sponsored health plan other than a parent’s group health plan, you are not required to take any further action in connection with this Revised Notice.
As you are probably aware, the health care reform law known as the Patient Protection and Affordable Care Act (Affordable Care Act), among other things, requires that group health plans provide coverage for children of plan participants until age 26. This requirement applies to children of participants in the District No. 9, International Association of Machinists and Aerospace Workers Welfare Plan, effective July 1, 2011.
Federal regulations require us to notify you that individuals whose coverage ended, or who were denied coverage (or were not eligible for coverage), because the availability of dependent coverage of children ended before attainment of age 26, are eligible to enroll in the District No. 9, International Association of Machinists and Aerospace Workers Welfare Plan. Individuals must be given an opportunity to request enrollment for such children for a period of at least 30 days from the date of notice. For children who are enrolled within this 30 day period, coverage will be effective July 1, 2011.
Under the Affordable Care Act, all children who are age 19 up to age 26 (referred to as “Adult Children”) are eligible to continue their coverage under the Plan beyond age 19 if the Adult Child does not have group health plan coverage through the Adult Child’s employer or through the employer of the Adult Child’s spouse. If the Adult Child does have coverage available through the Adult Child’s employer and the Adult Child is an unmarried full-time student, the Trustees have amended the Plan beyond the Affordable Care requirements to permit the Adult Child to continue coverage under the Plan up to age 26, provided the child remains unmarried. Consult your Summary Plan Description or contact the Fund Office at (314) 739-6442 for more information on what is required to maintain full-time student status.
If you want to enroll your Adult Child, please use the Adult Child Enrollment Form. Additional forms are available on the Plan website. For more information, please contact the Fund Office at (314) 739-6442.
Note: Grandfathered Plan Disclosure Statement
Federal regulations also require us to advise you that this group health plan believes this plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the “Affordable Care Act”). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.
Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at:
District No. 9, International Association of Machinists
and Aerospace Workers Welfare Plan
12365 St. Charles Rock Road
Bridgeton, Missouri 63044
(314) 739-6442
You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.
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