In order to comply with the COBRA (p. 1. 99-272) changes to Medicare, effective 5/1/86, the following will be the intent of any wording in this Plan Document regarding coverage for Employees and Dependents who are eligible for Medicare benefits:

Active Employees and their Dependents, age sixty-five (65) or older, may choose to participate in this Plan as their primary coverage (in the absence of any other Plan which would be primary under the Coordination of Benefits Provision of this Plan) and Plan benefits will be the same as for active Employees and their Dependents under age sixty-five (65), with Medicare being secondary. Or, they may choose Medicare as their primary coverage, in which case there will be no coverage under this Plan. For such participating Employees and Dependents, the Third Party Administrator will assume that this Plan is primary unless written election of Medicare as primary is received.

If this Plan covers Retirees and you are a Retiree age sixty-five (65) or older, this Plan's benefits provide coverage after Medicare. Claims must be sent to Medicare for processing first, then the itemized billing and the Medicare Explanation of Benefits can be submitted to the Third Party Administrator for processing.

If an active Employee or a Covered Dependent of an active Employee is receiving Medicare on account of permanent and total disability, this Plan will be the primary payor, with Medicare as supplementary payor to this Plan's benefits. However, if you or a Dependent is eligible for Medicare solely because of End Stage Renal Disease, this Plan may be primary for up to eighteen (18) months which begins:

1. with the month in which the renal dialysis treatment starts for that person; or
2. in the case of a kidney transplant, with the first month you or your Dependent is entitled to enroll for Medicare.

If you or a family member has Medicare coverage which is based on a disability, and COBRA continuation coverage, Medicare is the primary coverage. Claims must be sent to Medicare for processing first, then the itemized billing and the Medicare Explanation of Benefits can be submitted to the Third Party Administrator for processing.

For all other active Employees and their Dependents, Medicare will pay last to the extent permitted by law.

If Medicaid is an option, this Plan is always primary and will pay first before Medicaid. This Plan will comply with all Federal updates to the Medicare regulations.

Table of Contents | Home Page