Enrolling for Coverage!
As a full-time employee, you are automatically enrolled in the default Health and Welfare medical and dental plan. However, it is important for you to select the specific medical/vision and dental plans that best suit your needs. The Fund offers a selection of three medical plans and two dental plans for you to choose from:
- Kaiser/NVA Vision
- Blue Choice HMO Medical/Davis Vision
- CareFirst POS Medical/Davis Vision
- CareFirst Dental
- CIGNA DMO
If you fail to select a medical plan, you will be automatically enrolled for single coverage under the default HMO and dental plans. To enroll family members, you must complete and submit forms during your initial enrollment or the open enrollment period (outlined below).
Open Enrollment
Open Enrollment presents an annual opportunity for making changes to your benefits, unless a change in status occurs. Each October, you will receive an Enrollment Guide designed to assist you in making informed decisions regarding your selections.
To make changes, please complete an Enrollment Form and submit it to the Fund Office within the designated open enrollment period. Your requested modifications will take effect on the subsequent January 1st.
2024 OPEN ENROLLMENT: OCTOBER 28th – NOVEMBER 17th, 2024
In October 2024, you will receive an enrollment guide containing updated rates, as well as summary books detailing benefits and coverage options.
Change in Status
Outside of Open Enrollment, you are not allowed to modify your benefits unless you experience a “qualified status change.” These changes are limited to certain circumstances, which include:
- Marriage or divorce.
- Birth, adoption, or placement for adoption of a child.
- Death of a dependent.
- Change in work status; and
- Change in your spouse’s health insurance coverage.
Depending on the status change, you will have either 30 or 90 days from the event date to make changes to your healthcare elections. Your Plan coverage will generally commence on the first day of the month following the completion of the enrollment process.
If you’re enrolling a newborn, coverage will begin on the date of the child’s birth provided, you enroll your child within 30 days of their birth date. For an adopted child, coverage will start from the date of adoption or placement, as long as you enroll the child within 30 days.
| 30 days to Make a Change | 90 Days to Make a Change |
|---|---|
| To enroll for Plan coverage if you or a dependent loses other healthcare coverage | To add a new dependent |
| To enroll a newborn, to be effective from the date of birth, or to enroll a child adopted or placed for adoption, to be effective from the date of adoption or placement for adoption. | To enroll a newborn, to be effective from the first of the following, or to enroll a child adopted or placed for adoption, to be effective from the date of adoption or placement for adoption. |
| To change from part-time to full-time or from full-time to part-time. |
Waiver of Coverage (Opt-Out)
If you have other medical and dental coverage and choose to decline coverage under TEHW, complete the Opt-Out form, and provide a copy of your insurance ID card (front and back) and your WMATA ID. You can opt-out of medical coverage when you are first hired. After that, you can elect to opt-out only during the Open Enrollment period each year. You must provide proof of other coverage during each subsequent open enrollment period; otherwise, you will be re-enrolled in the last plan you selected or the default plan in which you never made an election.
Please note: Chip & State Medicaid health insurances are not eligible for the MONETARY compensation according to the Terms of the Collective Bargaining Agreement and IRS code Section 125.
Spousal Credit
If you have a spouse, your spouse can opt-out of coverage under the Transit Health & Welfare Plan. Complete the Spousal Credit form (and provide a copy of your marriage certificate & spouse insurance ID card). You will receive a monthly credit toward your contribution for Transit Coverage. The credit will be up to $100, but no more than your monthly contribution toward the coverage.
For a family that consists of the employee, spouse, and one or more children, the spousal credit would not eliminate the contribution for family coverage ($208). Still, it would reduce the $208 contribution to $108 (the maximum credit of $100 per month).
Dual Eligibility
If one Participant in this Plan is married to another Participant, one of the Participants must carry family coverage, and the other will be dependent on that Participant’s plan. A spouse or adult child employed by METRO and enrolled as a dependent on the plan of another METRO employee is NOT eligible for opt-out or spousal credit.
Documents must be returned to Health & Welfare at or our office.
If you have additional questions, you can contact our office by via phone Monday through Friday, from 8:30 am to 5:00 pm.
Links to some important documents below:
