Enrollment

Yes, if you are a full-time METRO employee or working under the supplemental collective bargaining agreement (the “New Service Agreement”), you may be eligible to opt out of coverage and receive a cash payment amount. You will need to provide proof that you have coverage from a source other than METRO. For more information on opting out of coverage, visit the "Election of Cash Payment/Waiver of Coverage" section on the Enrollment page.

You cannot add your boyfriend or girlfriend to the Plan unless they legally qualify as your domestic partner. To qualify as your domestic partner, they must meet criteria set forth by the Health & Welfare Plan and submit an “Affidavit of Domestic Partnership” to the Plan to receive benefits. For more information, visit Eligibility for Domestic Partners.

No, you can only add your spouse or eligible dependent children to the Plan. For more information, see the Eligibility section.

No. The parents need to decide which one of them will cover the child. In cases involving a Qualified Medical Child Support Order (QMCSO), the county Child Services Agency may need to be informed. See the Enrolling for Coverage page for more information.

The 2012 collective bargaining agreement permits employees to receive a credit of up to $1,200 if their spouse opts out of the Transit Employees’ Health & Welfare Plan’s health insurance program. It can only be used as a credit against medical and dental benefit expenses incurred as a Participant in the Plan. You must elect the spousal credit option each year.

Up to $100 per month will be applied to reduce the cost of your medical and dental insurance. It cannot be applied to reduce the cost of any supplemental life insurance you may have elected or of any other voluntary benefit.

Example

Your plan requires a monthly contribution of $80 toward single coverage and $208 toward family coverage. Here is how the credit will work:

  • For a family with only employee and spouse coverage, the spousal credit would change your plan from family to single (from $208 to $80) and the credit would further reduce the monthly contribution for single coverage ($80) to zero.
  • For a family with employee, spouse and children coverage, the spousal credit would not change your family plan coverage ($208), but it would reduce the $208 amount you pay to $108 (the maximum credit of $100 per month).

This credit is available to employees and retirees, but cannot be combined with the employee opt-out payment. This credit is available only if the employee or retiree remains covered in the Transit Employees Health and Welfare program.

You can only elect the spousal credit option during the annual open enrollment period, usually in May of each year. It will be effective for your premiums for the following July 1st. Download the Spousal Credit form here.

If you have more questions, please contact the Health and Welfare Plan Office.