How does the Spousal Credit work?

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.

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Do my spouse and I need to sign up for Medicare?

When you or your spouse becomes eligible for Medi­care, you should enroll in Medicare Parts A and B. For most people, enrollment in Medicare Part A is automatic (there is no premium) when you start receiving benefits from Social Security. You should sign up for Medicare Part B with the Social Security office three months before turning 65. Your monthly premium to Medicare for Part B will be deducted from your Social Security check.

When you become eligible, you are not required to enroll in Medicare Part B, but benefits will be paid by the Plan as if you are enrolled. This means that, if you do not enroll, you or your spouse will have higher expenses because you will be responsible for paying for the benefits Medicare Part B would have covered. After you submit evidence of your Part B enrollment for yourself or your dependent, your HEALTH & WELFARE Plan premium will be reduced. For more information, visit the "If You Become Eligible for Medicare" section on the Life Events page.

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