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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I am on military leave. What happens to my family coverage?

If you are on military leave for 31 days or less, you and your family will continue to receive health care coverage for up to 31 days. Coverage continues until the end of the month, after the month in which you are deployed.

If you are on military leave for more than 31 days, the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) allows you to continue medical, prescription drug, vision, and dental coverage for you and your family at your own expense for up to 36 months. This continu­ation right is similar to COBRA. Your dependent(s) may also be eligible for health care coverage under TRICARE, the military health plan. For more information on your benefits if you go on military leave, visit the "If You Enter Military Service" on the Life Events page.

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