Benefits Handbook Date July 1, Participating in Healthcare Benefits Marsh & McLennan Companies

Transcription

1 Date July 1, 2016 Participating in Healthcare Benefits Marsh & McLennan Companies

2 Participating in Healthcare Benefits This section explains which employees are eligible to participate in the Marsh & McLennan Companies (Company) healthcare benefits. This section also explains which family members are eligible to participate in the healthcare plans. Participation Information for Non-Employees For the healthcare plans that provide benefits for those who are not current employees (such as Medicare eligible retirees), the eligibility and participation information is generally contained in the section that describes the applicable benefit. However, information on pre 65 retiree medical coverage can be found in the section called Participating in Pre-65 Retiree Medical Coverage. You, Your, and Employee As used throughout this Handbook, employee, you and your always mean: For Marsh & McLennan Companies participants: a US regular employee of Marsh & McLennan Companies or any subsidiary or affiliate of Marsh & McLennan Companies (other than MMA and Mercer PeoplePro). For MMA participants: a US regular employee of MMA-Corporate, MMA-Alaska, MMA- Southwest, MMA- Northeast, or Security Insurance Services of Marsh & McLennan Agency. Benefits Handbook Date July 1, 2016

3 Contents Eligible Employees Your Eligibility Date Eligible Family Members Spouses and Domestic Partners Children Retiree Plan Participation Retiree Eligibility Requirements Transfers/Status Changes/Rehires Enrollment Enrolling/Terminating Retiree Medical Plan Coverage... 9 Deferring Retiree Medical Plan Coverage Costs Taxes When Coverage Starts If You Have Other Coverage Changing Levels of Coverage When Coverage Ends Continuing Coverage About COBRA Coverage COBRA Eligibility and Enrollment COBRA and Flexible Spending Accounts Employee Enrollment in COBRA Coverage Enrolling a Family Member under COBRA Changes While on COBRA Paying for COBRA Coverage Extending Benefits Due to Disability Impact of Medicare Eligibility When COBRA Coverage Ends Filing a Claim under COBRA COBRA Contact HIPAA How HIPAA Works Enrollment Pre-existing Conditions and Coverage Information Benefits Handbook Date July 1, 2016

4 Eligible Employees To be eligible for the Company healthcare benefits described in this Benefits Handbook you must meet the eligibility criteria listed below. Eligibility If you are an employee of Marsh & McLennan Companies or any subsidiary or affiliate of Marsh & McLennan Companies and you meet the requirements set forth below, you become eligible on your eligibility date. You can also cover your eligible family members. Approved opposite gender or same gender domestic partners are eligible for coverage under this Plan. Eligibility Requirements Eligible Marsh & McLennan Companies Employees (other than MMA and Mercer PeoplePro) You are eligible if you are an employee classified on payroll as a US regular employee of Marsh & McLennan Companies or any subsidiary or affiliate of Marsh & McLennan Companies (other than MMA and any of its subsidiaries (MMA) and Mercer PeoplePro). Individuals who are classified on payroll as temporary employees or who are compensated as independent contractors are not eligible to participate. Eligible MMA Employees You are eligible if you are an employee classified on payroll as a US regular employee of Marsh & McLennan Agency LLC Corporate (MMA-Corporate), Marsh & McLennan Agency LLC Alaska (MMA-Alaska), Marsh & McLennan Agency LLC Southwest (including Prescott Pailet Benefits) (collectively MMA Southwest) (MMA-Southwest), Marsh & McLennan Agency LLC Northeast (MMA-Northeast), or Security Insurance Services of Marsh & McLennan Agency. Individuals who are classified on payroll as temporary employees or who are compensated as independent contractors are not eligible to participate. Your Eligibility Date There is no waiting period if you are ACTIVELY-AT-WORK. Your eligibility date is the first day you are Actively-At-Work on or after your date of hire. Eligible Family Members If you are an eligible employee, you may enroll eligible family members for coverage under certain Company healthcare benefit plans. Benefits Handbook Date July 1,

5 To enroll your family members for any Company healthcare benefit: you must meet the employee eligibility requirements for the plan, the family members you want to cover must meet the eligibility requirements for the plan, and the benefit plan must provide coverage for the eligible family member you wish to cover. Is evidence of insurability required for coverage? No, evidence of insurability is not required for coverage under the Company healthcare plans. Spouses and Domestic Partners Adding a spouse or same gender or opposite gender domestic partner to certain benefits coverage is permitted upon employment or during the Annual Enrollment period for coverage effective the following January 1 st if you satisfy the plans criteria, or immediately upon satisfying the plans criteria if you previously did not qualify. To obtain spousal or domestic partner coverage, you will need to complete an Affidavit of Eligible Family Membership declaring that: Spouse / Domestic Partner You have already received a marriage license from a US state or local authority, or registered your domestic partnership with a US state or local authority. Spouse Only Although not registered with a US state or local authority, your relationship constitutes a marriage under US state or local law (e.g. common law marriage or a marriage outside the US that is honored under US state or local law). Domestic Partner Only Although not registered with a US state or local authority, your relationship constitutes an eligible domestic partnership. To establish that your relationship constitutes an eligible domestic partnership you and your domestic partner must: be at least 18 years old not be legally married, under federal law, to each other or anyone else or part of another domestic partnership during the previous 12 months currently be in an exclusive, committed relationship with each other that has existed for at least 12 months and is intended to be permanent currently reside together, and have resided together for at least the previous 12 months, and intend to do so permanently Benefits Handbook Date July 1,

6 have agreed to share responsibility for each other s common welfare and basic financial obligations not be related by blood to a degree of closeness that would prohibit marriage under applicable state law. Marsh & McLennan Companies reserves the right to require documentary proof of your domestic partnership or marriage at any time, for the purpose of determining benefits eligibility. If requested, you must provide documents verifying the registration of your domestic partnership with a state or local authority, your cohabitation and/or mutual commitment, or a marriage license that has been approved by a state or local government authority. In order to cover the child(ren) of a spouse or domestic partner, you will be required to complete an Affidavit of Eligible Family Member. Go to Colleague Connect ( click Career & Rewards and select Mercer Marketplace benefits enrollment website under Resources. My spouse or domestic partner also works for the Company; can I still cover my spouse or domestic partner under my healthcare plans? You can cover your spouse or domestic partner as a family member under your healthcare plans, or your spouse or domestic partner can elect separate employee coverage. You or your spouse or domestic partner can t be covered as both an employee and a family member under the same Company healthcare plans. Children If you are enrolled for coverage, you can cover: your biological child the child of an approved domestic partner your stepchild a child for whom you or your spouse are the legally appointed guardian with full financial responsibility your legally adopted child or child placed with you for adoption. Note: Any child that meets one of these eligibility requirements and who is incapable of self support by reason of a total physical or mental disability as determined by the Claims Administrator, may be covered beyond the end of the calendar year in which the child attains age 26. Benefits Handbook Date July 1,

7 Eligibility for Children Dependent children are eligible for healthcare coverage until the end of the calendar year in which they attain age 26. This eligibility provision applies even if your child is married, has access to coverage through his or her employer, doesn t attend school full-time or live with you, and is not your tax dependent. Notes: While married children are eligible for healthcare coverage under your plan until the end of the calendar year in which they attain age 26, this provision does not apply to your child s spouse and/or child(ren), unless you or your spouse is the child s legally appointed guardian with full financial responsibility. The Company has the right to require documentation to verify the relationship (such as a copy of the court order appointing legal guardianship). Company healthcare plan coverage does not cover foster children or other children living with you, including your grandchildren, unless you are their legal guardian with full financial responsibility that is, you or your spouse claims them as a dependent on your annual tax return. How long can I cover my child? Generally, you can cover your child through the end of the calendar year in which the child attains age 26. You may be able to extend coverage for your child beyond the end of the calendar year in which the child attains age 26, if your child is disabled. Your child s coverage will stop upon the earlier of: When Children Become Ineligible If your covered child no longer meets the eligibility requirements, you must remove your child from coverage by going to Colleague Connect ( ect. mmc.com). No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the Plan for these claims. reaching the maximum age for coverage (the end of the calendar year in which the child attains age 26), or no longer meeting the plan s eligibility requirements. If your child continues to be disabled over the age limit for coverage, your child may still be eligible to continue coverage. Otherwise, if your child reaches the age limit for coverage (the end of the calendar year in which the child attains age 26) or no longer meets the eligibility requirements, you must remove your child from coverage. Go to Colleague Connect ( click Career & Rewards and select Mercer Marketplace benefits enrollment website under Resources. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the plan for these claims. Failure to timely remove your child may also result in missing the child s opportunity for COBRA continuation coverage. Benefits Handbook Date July 1,

8 My spouse or domestic partner also works for the Company; can we both cover our child? Your child can be covered under either your coverage or your spouse s or domestic partner s coverage, but not both. To be covered, your child has to meet the dependent child eligibility requirements. I am divorced and do not have sole custody of my child; can I still cover my child under the healthcare plans? You can still cover your child until the end of the calendar year in which the child attains age 26. Can I continue covering my disabled child once my child reaches the age limit for coverage? You can cover your disabled child over the limiting age. To be eligible for coverage, your child has to be incapable of self support by reason of a total mental or physical disability, as determined by the Claims Administrator. In order to register a child as disabled, you must fill out the applicable medical plan provider form (contact your medical plan provider for the appropriate form) for continuing coverage beyond the limiting age and return the form to the Claims Administrator no later than 30 calendar days after the disabled child s coverage would otherwise end. The Claims Administrator will review the request for disabled status and will notify the Company and the employee whether the child is determined as disabled. If approved, eligibility records will be adjusted to allow for coverage beyond the end of the calendar year in which your child attains age 26, as long as the child meets the remaining eligibility requirements. Your child s disability has to begin before the date eligibility would otherwise end. In addition, to be covered beyond the limiting age, your child must already be covered or have current continuous coverage under one of the Company healthcare plans prior to reaching the limiting age. If approved, eligibility records will be adjusted to allow for coverage beyond the limiting age as long as the child meets the remaining eligibility requirements. Can I cover my grandchild? You cannot cover your grandchild unless you are the legally appointed guardian or you have legally adopted the child, and the child resides with you. Benefits Handbook Date July 1,

9 My dependent child is having a baby; what will be covered? If your daughter is covered under a Company medical plan, she is covered for maternity benefits, which include delivery of the baby. Unless the newborn meets the definition of an eligible child and is covered under the Company healthcare plan, medical care for the newborn, whether in or out of the hospital is not covered. Can I cover my child who is not attending school, is temporarily out of school (as a student on leave or for medical reasons) or changes to a part-time status? As long as your child meets the eligibility requirements, coverage will continue through the end of the calendar year in which your child attains age 26, whether or not a full- or part-time student. This provision also applies if your child is married, has access to coverage through his or her employer, doesn t live with you and is not your tax dependent. When your child reaches the age limit for coverage (the end of the calendar year in which your child attains age 26) or no longer meets the eligibility requirements, you must remove your child from coverage. Go to Colleague Connect ( click Career & Rewards and select Mercer Marketplace benefits enrollment website under Resources. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the Plan for these claims. Can I cover my married child who is still dependent on me? Yes, you can cover a married child up to the end of the calendar year in which your child attains age 26. Note: While married children are eligible for healthcare coverage under your plan until the end of the calendar year in which they attain age 26, this provision does not apply to your child s spouse and/or child(ren), unless you or your spouse is the child s legally appointed guardian with full financial responsibility. Once your child reaches the age limit for coverage (the end of the calendar year in which your child attains age 26), you must remove your child from coverage. Go to Colleague Connect ( click Career & Rewards and select Marketplace benefits enrollment website under Resources. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the Plan for these claims. Failure to timely remove your child may also result in missing the child s opportunity for COBRA continuation coverage. Benefits Handbook Date July 1,

10 Can I cover my child when a Qualified Medical Child Support Order (QMCSO) is in effect? In order to add a child as required by a Qualified Medical Child Support Order, submit the QMCSO to the Global Benefits Department for validation. If the QMCSO is determined to be complete and valid, you will be notified and your child will be added to your coverage. Retiree Plan Participation Retiree Eligibility Requirements You are eligible to participate if you: are a US regular employee of Marsh & McLennan Companies or any subsidiary or affiliate of Marsh & McLennan Companies, (other than (i) Marsh & McLennan Agency, LLC and any of its subsidiaries and generally, either (ii) Marsh ClearSight LLC (formerly CS STARS, LLC) (iii) Mercer Services (which consists of Mercer HR Services LLC, Mercer Trust Company, and Mercer Health and Benefits Administration LLC, and was formerly known as Mercer Outsourcing or Mercer Human Resources Services) (iv) Mercer PeoplePro who terminates employment at age 55 or older with at least five years of vesting service, and are a current retiree under age 65, or are the non-medicare eligible dependent of a Medicare eligible retiree. When you or a covered family member reach age 65 or are covered by Medicare, those Medicare eligible family members are no longer eligible for coverage under the pre-65 retiree medical plans. You may be eligible for coverage under the post-65 Retiree Reimbursement Account (RRA) Plan. See the Retiree Reimbursement Account (RRA) Plan section for information. Note: Although you may be eligible to participate in retiree medical coverage, the opportunity to defer your retiree medical coverage election only applies to employees that terminate employment on or after April 1, As an example, if you are under age 65 and terminated employment prior to April 1, 2010, the rules regarding the deferral of your retiree medical coverage election do not apply to you. Does eligibility to participate in retiree medical coverage impact any benefits other than active employee medical coverage? Yes, if you are eligible to participate in retiree medical coverage, your active employee medical, dental, vision care plan, and/or EAP coverage, whichever plans you are enrolled in, will be continued through the end of the month in which you terminate. Benefits Handbook Date July 1,

11 If I am not enrolled in active employee medical coverage at the time of my termination, am I eligible to participate in retiree medical coverage? Yes, if you meet the retiree eligibility requirements you are eligible to participate in retiree medical coverage. You will be given an opportunity to immediately elect or defer retiree medical coverage following your termination of employment. Since you were not enrolled in Company s active medical coverage, you will not have the option to elect COBRA medical coverage. What happens to my active employee medical coverage upon termination of employment if I am not eligible to participate in retiree medical coverage? If you (and your eligible family members) are enrolled in active employee medical coverage but you are not eligible to participate in retiree medical coverage, coverage for you and your eligible family members ends on your last day of employment. COBRA medical coverage will automatically be offered to you. You will have 60 calendar days from the date of the COBRA notice to elect COBRA continuation. Your COBRA premium will be due 45 days from your election date. The COBRA medical coverage effective date will be the day following your last day of employment. Should I elect to participate in retiree medical coverage immediately following my termination date? This is an individual decision that you must make based on your personal facts and circumstances. Note though, if you defer your retiree medical coverage enrollment election beyond 60 calendar days of your termination, additional rules and documentation requirements apply. Transfers/Status Changes/Rehires Will I retain my eligibility for retiree medical coverage if I transfer from a participating to a non-participating company? Yes, if you met the retiree eligibility requirements prior to your transfer to the nonparticipating company, you will retain the opportunity to immediately elect or defer retiree medical coverage participation when you subsequently terminate from employment. Will I retain my eligibility for retiree medical coverage if my status changes from a regular to a temporary employee within a participating company? Yes, if you met the retiree eligibility requirements prior to your change in status within a participating company, you will retain the opportunity to immediately elect or defer retiree medical coverage participation when you subsequently terminate from employment. Benefits Handbook Date July 1,

12 If I am rehired by a participating company after I terminate from a non-participating company, am I eligible for retiree medical coverage? Yes, if you met the retirement eligibility requirements at a participating company, you are eligible for the opportunity to immediately elect or defer participation in retiree medical coverage upon subsequent termination from employment. Am I eligible to participate in retiree medical coverage if I terminate after transferring from a participating company to a non-participating company? Yes, if you met the retiree eligibility requirements prior to your transfer to the nonparticipating company, you will be eligible to elect to participate in retiree medical coverage. Eligibility provides you with an opportunity to immediately elect or defer retiree medical coverage following termination. If I am rehired by a non-participating company after I terminate from a participating company, am I eligible for retiree medical coverage? Yes, if you met the retirement eligibility requirements when you terminated from the participating company, you are eligible for the opportunity to immediately elect or defer participation in retiree medical coverage. Enrollment For all of the Company healthcare benefits, you must formally enroll to participate. You can enroll for coverage by going to Colleague Connect ( You must enroll within 30 calendar days of the date you become eligible or during Annual Enrollment. You may be able to make changes to your elections during the plan year if you have a qualified family status change. Enrolling/Terminating Retiree Medical Plan Coverage What are the available Retiree Medical Plan options? If eligible, you can elect retiree medical coverage. If you elect this coverage, retiree medical coverage is considered an alternative to continuing Company medical coverage through COBRA. You can elect any of the medical plan options that are available to active employees in the state in which you reside regardless of whether you were enrolled in active employee medical coverage. However, if you are deemed to be Medicare eligible (generally age 65 or over as of your retirement date), you may be eligible for the Retiree Reimbursement Account (RRA) Plan. If your covered dependent is deemed to be Medicare eligible (generally age 65 or over as of your retirement date), he/she may be eligible for the Retiree Reimbursement Account (RRA) Plan. Benefits Handbook Date July 1,

13 When you or a covered family member reach age 65 or are covered by Medicare, those Medicare eligible family members are no longer eligible for coverage under the pre-65 retiree medical plans. You may be eligible for coverage under the post-65 Retiree Reimbursement Account (RRA) Plan. See the Retiree Reimbursement Account (RRA) Plan section for information. How do I enroll in retiree medical coverage? In order to initiate your retiree medical coverage election, you must call the Employee Service Center at least 30 calendar days prior to your Retiree Medical Coverage Participation Date. Contact the Employee Service Center at , any business day, from 8:00 a.m. to 8:00 p.m. Eastern time, to make your election. The requirement to contact the Employee Service Center at least 30 calendar days prior to your Retiree Medical Coverage Participation Date will be waived if you elect to participate in retiree medical coverage within 60 calendar days following your termination from the Company. If you are eligible to participate in retiree medical coverage and you elect to participate, your Retiree Medical Coverage Participation Date will be reflected as the 1 st of the month following your termination date, or if you defer your election and elect coverage at a later date, the 1 st of any month, but no later than the 1 st of the month following your attainment of age 65 (retiree medical coverage participation dates always are on the 1 st of a month). If you defer your retiree medical coverage participation election date beyond 60 calendar days of your termination date, you can elect to participate at a later date (no later than the 1 st of the month following your attainment of age 65). Your retiree medical coverage will take effect the 1 st of the month following the earlier of your Retiree Medical Coverage Participation Date or the 1 st of the month following attainment of age 65. If you do not contact the Employee Service Center at least 30 calendar days prior to your participation date, your coverage will begin the 1 st of the next month following notification. When should I contact the Employee Service Center to elect my retiree medical coverage? To elect retiree medical coverage, you must contact the Employee Service Center at , any business day, from 8:00 a.m. to 8:00 p.m. Eastern time, at least 30 calendar days prior to your Retiree Medical Coverage Participation Date. The requirement to contact the Employee Service Center at least 30 calendar days prior to your Retiree Medical Coverage Participation Date will be waived if you elect to participate in retiree medical coverage within 60 calendar days of your termination from the Company. Benefits Handbook Date July 1,

14 For example: If you terminate on June 30 th, you can contact the Employee Service Center on August 15 th to elect Retiree Medical Coverage effective July 1 st. This election is valid since it is within 60 calendar days of the loss of your active medical coverage. If you terminate on June 30 th, you cannot contact the Employee Service Center on September 15 th to elect Retiree Medical Coverage effective July 1 st. This election is beyond the 60 calendar days. Can I enroll my spouse in a Company retiree medical plan coverage option upon termination of COBRA coverage? Yes, if you choose to elect COBRA for your spouse at retirement, once COBRA coverage is exhausted, you can enroll your spouse in any applicable Company retiree medical plan option within 30 calendar days of the event provided you met eligibility requirements upon termination of employment. Termination of COBRA is considered a HIPAA qualifying event. If I elect COBRA for my spouse, can my spouse elect retiree medical if I die during my retiree medical deferral period? No. If your spouse is not covered under your retiree medical (COBRA coverage is not retiree medical coverage) at the time of your death, your spouse will not have the option to elect retiree medical coverage. If I participate in retiree medical coverage or defer retiree medical coverage and then die, can my spouse elect retiree medical coverage? No. If your spouse is not covered under your retiree medical at the time of your death, your spouse will not have the option to elect retiree medical coverage. Can I terminate my retiree medical coverage? Yes, you can terminate your retiree medical coverage at any time by calling the Employee Service Center at , any business day, from 8:00 a.m. to 8:00 p.m. Eastern time. Alternatively, you can send a letter requesting the discontinuance of your retiree medical coverage to: Employee Service Center P.O. Box 9740 Providence, RI Whether you terminate coverage via the phone or in writing, you must submit a termination of coverage request 30 calendar days prior to your coverage end date (always the last day of a month). Benefits Handbook Date July 1,

15 Retiree medical coverage cannot be terminated on a retroactive basis, nor can paid premiums be refunded. Also remember, terminated retiree medical coverage cannot be reinstated. You have a one-time opportunity to elect retiree medical coverage. Can I elect COBRA coverage if I terminate my Retiree Medical Plan coverage? No. Your request to discontinue your Retiree Medical Plan coverage is not considered a qualifying event. COBRA coverage is not an available option following your termination of Retiree Medical Plan coverage. Deferring Retiree Medical Plan Coverage If I defer my retiree medical coverage election, will I remain eligible for the present medical plan design and coverage? No, if you defer your retiree medical coverage election, you will be eligible for the benefit plans and options available at the time of your election to participate. If I defer retiree medical coverage beyond 60 calendar days of my termination date, will I retain the employer subsidy enhanced severance benefit under the severance plan? No, if you are eligible for Enhanced Severance Benefits under the Company Severance Pay Plan and choose to defer your retiree medical coverage beyond 60 calendar days of your termination date, you will forfeit the Company contribution towards the premium cost of retiree medical coverage. Can the Company change the medical post-termination eligibility rules? Yes, Marsh & McLennan Companies reserves the right to make changes to plan design including eligibility rules, etc. How do I defer my retiree medical coverage participation election? No action is required to defer your retiree medical coverage participation election. Once you decide to initiate your retiree medical coverage participation election, contact the Employee Service Center at , any business day, from 8:00 a.m. to 8:00 p.m. Eastern time, to make your election. If I defer retiree medical coverage, will I automatically receive a COBRA package? Yes, upon termination, Trion will automatically mail a package, including a COBRA election form and an explanation of your COBRA rights to your home address on file. If you wish to elect COBRA coverage, complete your election form and return it to Trion within your 60-day COBRA election period. Benefits Handbook Date July 1,

16 Costs The cost of your coverage under each of the healthcare plans is listed in the sections that describe each plan. If you or your spouse are under age 65 and eligible for Retiree Medical Plan coverage, see Paying for Coverage in the Participating in Pre-65 Retiree Medical Coverage section. Refer to the Retiree Reimbursement Account (RRA) Plan section for information if you (or your spouse) is 65 or over and eligible for the RRA Plan. Will my costs change? Your costs for coverage may change. Generally, these changes occur each January 1. The Company reserves the right to change the amount you are required to contribute at any time. If you (or your spouse) is 65 or over you may be eligible for the RRA Plan. Taxes Do I pay for my healthcare coverage with before-tax or after-tax dollars? You pay for your coverage (other than coverage for a domestic partner and his/her approved dependent child(ren)) with before-tax dollars. What effect does paying for coverage on a before-tax basis have on my other benefits? None. Your annual base salary will be used to calculate all salary related benefits. What effect does paying for coverage on a before-tax basis have on my paycheck? Paying for coverage on a before-tax basis means that the amount you pay toward your healthcare coverage comes out of your pay before taxes are withheld, so you are paying taxes on a lower amount of salary. Your take-home pay is higher than it would be if you paid for your coverage on an after-tax basis. What effect does paying for my coverage on a before-tax basis have on my Social Security benefit? Your Social Security benefits may be slightly reduced because you pay for coverage on a before- tax basis. This is because your Social Security is based on your taxable pay, and your taxable pay is reduced by the amount you pay for healthcare coverage. Are contributions for an approved domestic partner and child(ren) of an approved domestic partner made on a before-tax basis? Your contribution to cover a domestic partner and the dependent child(ren) of a domestic partner is the same as the cost to cover other eligible family members. However, because of IRS requirements, these contributions will be made on an after-tax basis Benefits Handbook Date July 1,

17 even for coverage that would in most cases be paid on a before-tax basis. Additionally, the difference between the cost of coverage and your contributions could be imputed as taxable income to you. An exception applies if your domestic partner and the child(ren) of a domestic partner are your tax dependents. If your partner (or his or her child(ren)) qualifies as a dependent under IRS Section 152 and IRS Publication 501, your contributions for domestic partner coverage will be on a before-tax basis, and imputed income would not apply. What is imputed income and why am I taxed on it for domestic partner coverage? Under current tax laws, the Company s cost for providing healthcare coverage to domestic partners results in imputed income to you; you must pay tax on this income. The full cost of domestic partner coverage (both the employee and employer contributions to coverage) is subject to federal, Social Security (FICA) and if applicable, state and local income taxes. Your amount of imputed income equals the full cost to cover your partner (and/or partner s child(ren)) less your after-tax contribution to cover that person. Your dollar amount of imputed income is calculated every payroll cycle and is reflected on your semi-monthly electronic pay check. It is also reported on your year-end W-2 Form as a component of taxable income from the Company. Tables in each of the sections describing an affected healthcare plan show the imputed income amounts. If your domestic partner (or his or her child(ren)) qualifies as a dependent under Internal Revenue Code Section 152 and IRS Publication 501 (that is, are your tax dependents), imputed income does not apply. If my approved domestic partner qualifies as a tax dependent, how can I begin making contributions on a before-tax basis and have imputed income stopped? You must complete the Declaration of Domestic Partner s Tax Status form and return it as the form instructs. You can obtain a form by going to Colleague Connect ( Click Career & Rewards, select Career & Rewards Forms/Documents and click Declaration of Domestic Partner Tax Status under Domestic Partners. You will be notified by Mercer if additional information is required or if you qualify. When Coverage Starts Existing Employees If you are an existing employee and you experience a qualified family status change (such as marriage), your family member s coverage will become effective on the date of the event, if you enroll the family member within 30 calendar days of the qualified family Benefits Handbook Date July 1,

18 status change (60 calendar days of the qualified family status change for medical plan changes). Marsh & McLennan Companies New Hire (other than Marsh and MMA) Your coverage will be effective on the first day you are ACTIVELY-AT-WORK on or after your date of hire, as long as you complete enrollment within 30 days of your eligibility date. Marsh New Hire Your coverage will be effective on the first day you are Actively-At-Work on or after your date of hire, as long as you complete enrollment within 30 days of your eligibility date. MMA New Hire Your coverage will be effective on the first day you are Actively-At-Work on or after your date of hire, as long as you complete enrollment within 30 days of your eligibility date. What happens if I am not at work on the day my coverage is supposed to start? As a new hire, if you are eligible for coverage and enroll, your coverage will be effective on the first day that you begin fulfilling your job responsibilities with the Company at a Company-approved location. If you are absent for any reason on your scheduled first day of work, your coverage will not begin on that date. For example, if you are scheduled to begin work on August 3 rd, but are unable to begin work on that day (e.g., because of illness, jury duty, bereavement or otherwise), your coverage will not begin on August 3 rd. Thereafter, if you report for your first day of work on August 4 th, your coverage will be effective on August 4 th. If you are an existing employee and you are not Actively-At-Work on the day your coverage is supposed to begin, your coverage will be effective on the day it is supposed to begin. If you are hospitalized on the day your coverage is supposed to begin and you had prior coverage, your prior plan would pay for the confinement and ancillary charges until discharge. What happens if my family member is in the hospital when coverage is supposed to start? If your family member is confined to a health care facility or home under a physician s care on the date coverage would otherwise become effective, your family member s medical coverage will be effective on the day it is supposed to begin. Your prior plan coverage would pay for the confinement and ancillary charges until discharged. Benefits Handbook Date July 1,

19 When does my child s coverage start? A newborn natural child is eligible for coverage at birth. An adopted child is eligible for coverage on the day the child is placed for adoption or the date the adoption is finalized. A stepchild is eligible for coverage upon your marriage to his or her parent. You must enroll your child within 30 calendar days of the event that made the child eligible for coverage (within 60 calendar days of the event for medical coverage). If you do not enroll the child within that period, you must wait until the next Annual Enrollment period to enroll your child. When will my retiree medical coverage be effective? If you decide to elect to participate, your Retiree Medical Coverage Participation Date will be reflected as the 1 st of the month following your termination date, or if you defer your election and elect coverage at a later date, the 1 st of any month, but no later than the 1 st of the month following your attainment of age 65 (retiree medical coverage participation dates always are on the 1 st of a month). If You Have Other Coverage If you or an eligible family member has coverage under the Company healthcare benefits plans and coverage under another healthcare plan (such as a plan sponsored by your spouse s employer), the Company s benefits are coordinated with those provided by the other plan. In addition to having your benefits coordinated with other group health plans, benefits from the Company healthcare plans are coordinated with no fault automobile insurance and any payments recoverable under any workers compensation law, occupational disease law or similar legislation. What is coordination of benefits? Coordination of benefits is what happens when a person is covered under more than one group plan. You or a covered family member may be entitled to benefits under another group health plan (such as a plan sponsored by your spouse s employer) that pays part or all of your health treatment costs. If this is the case, benefits from the Company healthcare plan will be coordinated with the benefits from the other plan. In addition to having your benefits coordinated with other group health plans, benefits from the Company healthcare plan are coordinated with no fault automobile insurance and any payments recoverable under any worker s compensation law, occupational disease law or similar legislation. When the Company healthcare plan is primary, it pays benefits first without consideration of the other plan. After you receive payment from the Company healthcare plan, you may then submit a claim to your secondary plan and possibly receive additional reimbursement. Reimbursement from your secondary plan depends on that plan s coverage levels and coordination of benefits rules. Reimbursements by both plans cannot exceed the full amount of covered expenses. Benefits Handbook Date July 1,

20 How does coordination of benefits work when my spouse and I are covered under two plans? When you or your spouse is covered under two plans, there are certain rules that determine which plan pays its benefits first. The plan that covers you or your spouse as the employee pays its benefits before the plan that covers you or your spouse as a family member. If it is determined that the other plan will pay first, the benefits payable under your Company healthcare plan will be reduced by the amount or value of the services paid by the other plan. You should submit your claims to the primary plan first. When you receive a payment from the primary plan, you should submit a claim form and a copy of the Explanation of Benefits to the secondary payer, for any additional benefit. How does coordination of benefits work when children are covered under two plans, and the parents are not divorced or separated? The benefit plan of the parent whose birthday falls earlier in the calendar year pays first. If both parents have the same birthday, the plan that has covered the child(ren) longer pays first. If the other plan does not have the parent birthday rule, the other plan s coordination of benefits rule applies. You should submit your claims to the primary plan first. When you receive a payment from the primary plan, you should submit a claim form and a copy of the Explanation of Benefits to the secondary payer, for any additional benefit. How does coordination of benefits work when children of divorced parents? The plan that pays first is decided in this order: If a court decree has established financial responsibility for the child s health care expenses, and the plan of that parent has actual knowledge of those terms, the plan of the parent with this responsibility pays first. Next, the plan of the parent with custody of the child pays. Then, the plan of the spouse of the parent with custody of the child pays (if applicable). Then, the plan of the natural parent not having custody of the child pays. Then, the plan of the spouse of the parent not having custody of your child pays. In the case of joint custody where there is no financial responsibility for a child s health care has been established by the court order, the plan of the parent whose birthday falls earlier in the year will pay first. Benefits Handbook Date July 1,

21 You should submit your claims to the primary plan first. When you receive a payment from the primary plan, you should submit a claim form and a copy of the Explanation of Benefits to the secondary payer, for any additional benefit. How does coordination of coverage work when one person is covered as the employee under two plans? If you are covered as the employee under two separate medical plans, the medical plan that has covered you for the longest time will be the primary plan and will pay its benefits first. You should submit your claims to the primary plan first. When you receive a payment from the primary plan, you should submit a claim form and a copy of the Explanation of Benefits to the secondary payer, for any additional benefit. If I become disabled and I am eligible for coverage through Medicare, can I remain in my current Company medical plan? If you become disabled and qualify for Medicare while on long term disability, you must sign up for Medicare Parts A and B. If you are enrolled in a Company medical plan, Medicare will be the primary plan and your Company medical plan coverage will be the secondary plan. The Company plan will pay as if it is secondary even if you fail to sign up for Medicare. You should submit your claims to the primary plan first. When you receive a payment from the primary plan, you should submit a claim form and a copy of the Explanation of Benefits to the secondary payer, for any additional benefit. If I am disabled and eligible for coverage through Medicare, how are my family member s benefits impacted? If you are disabled and qualify for Medicare, your family member(s) will continue their primary plan coverage under the Company medical plan. If I am disabled and eligible for coverage through Medicare, how are my family member s benefits impacted if they are deemed to be Medicare-eligible? If you are disabled and qualify for Medicare and your family member is deemed to be Medicare-eligible (e.g., disabled, attains age 65) your family member(s) must sign up for Medicare Parts A and B. If a covered family member becomes disabled and eligible for coverage through Medicare, but I m still an active employee, can he/she remain covered by my Company medical plan? While you are in active employment, your Company medical plan is your primary plan, even if your family member is eligible for Medicare. If your family member is enrolled in Medicare, Medicare becomes the secondary plan for that family member. Benefits Handbook Date July 1,

22 Dental Coverage In general, Medicare doesn t provide dental coverage. But if there is an expense that both the Dental Plan and Medicare cover, the Dental Plan will pay benefits before Medicare. If I become injured or ill as a result of an accident caused by a third party, what happens to any payment I may receive ( subrogation )? To the maximum extent permitted by law, the Plan is entitled to equitable or other permitted remedies, including a lien or constructive trust, to recover any amounts received as a result of a judgment, settlement or other means of compensation for conditions or injuries which have resulted in the payment of benefits under this Plan. This will include, but is not limited to, damages for pain and suffering and lost income. The Plan is entitled to recover these amounts from you, as the employee, any covered family member or beneficiary, or any other person holding them, up to the amount of all payments made or payable in the future plus the costs of recovery. The Plan has a priority interest in any and all funds recovered in any full or partial recovery, including funds intended to compensate for attorney s fees and other expenses. As a condition of receiving benefits under this Plan, you agree that: You will promptly notify the Claims Administrator of any settlement negotiations, settlement, or judgment in any litigation related to an event or condition for which you have received, or expect to receive, benefits under this Plan; and Future benefits (even for an unrelated event or condition) may be reduced by the amount of any judgment or settlement, or similar compensation which the Plan would be entitled to under the rules above but is unable to recover. Changing Levels of Coverage You can change your level of coverage: during Annual Enrollment for coverage effective January 1 within 30 calendar days of certain qualified family status changes (60 calendar days of the qualified family status change for medical plan changes) within 30 calendar days of losing other coverage See the Life Events section in the Handbook to determine whether your qualified family status change allows you to enroll, increase, decrease or discontinue coverage. Benefits Handbook Date July 1,

23 Changes Must Be Consistent Any changes you make in your Company benefits following a qualifying change in status or losing other coverage must be consistent with that change in status. When Coverage Ends Company healthcare coverage ends on the first of the following to occur: the date you discontinue coverage the last date you ve paid contributions (if you do not make the required contributions) the date you no longer meet the eligibility requirements the date you terminate your employment the date of your death the date the Plan is terminated. What happens to my active employee medical coverage upon termination of employment if I am eligible to participate in retiree medical coverage? If you (and your eligible family members) are enrolled in active employee medical coverage, active employee medical coverage for you and your eligible family members ends on the last day of the month in which you terminate employment. If you are eligible to participate in retiree medical coverage, you will be given an opportunity to enroll immediately following your termination of employment or defer your Company retiree medical coverage enrollment to some time in the future. If you defer, no immediate action is required at termination unless you which to elect COBRA. Can I continue coverage through COBRA? Yes, you can continue coverage under the Company-sponsored plans if you experience a COBRA qualifying event and register your event within the legally allowable time frame. If you terminate and are eligible to retire, Trion will automatically mail a package, including a COBRA election form and an explanation of your COBRA rights to your home address on file. If you wish to elect COBRA coverage, you must complete your election form and return it to Trion within your 60-day COBRA election period. Can my domestic partner (or the child(ren) of my domestic partner) continue coverage through COBRA? Although not legally required to do so, Marsh & McLennan Companies extends COBRA continuation coverage to domestic partners of Marsh & McLennan Companies Benefits Handbook Date July 1,