Enrolling for Coverage

Enrolling for Coverage!

You’re automatically enrolled in the Health and Welfare Plan if you’re a full-time employee. However, you should pick the medical/vision and dental plans you want to join. The Fund Offers a choice of three medical plans:

  • Kaiser/NVA Vision
  • Blue Choice HMO Medical/Davis Vision
  • CareFirst PPO Medical/Davis Vision

New employees may only select between the two HMOs during their first 39 months. And you can choose between the two dental plans (available if you elect medical/vision):

  • CareFirst
  • CIGNA DMO

If you don’t select a medical plan, you will automatically be 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 (see below).

 

Open Enrollment

Open Enrollment is your once-a-year opportunity to make changes to your benefits (unless you experience a change in status). Each October, you’ll receive an Enrollment Guide to help you make your choices.

To make changes, you’ll need to complete an Enrollment Form and submit it to the Fund Office during the open enrollment period. Your changes will be effective the following January 1.

If you add dependents, you must bring the documentation to the Health & Welfare Plan. If you miss the deadline, your next opportunity to make changes will be the next Open Enrollment Period.

OPEN ENROLLMENT: OCTOBER 24 – NOVEMBER 18, 2022

The time for the Local 689 Union members to change medical and dental plans and enroll in or increase supplemental life insurance is approaching. You will receive an enrollment guide, which includes the new rates and a summary of benefits and coverage books around October 18, 2022.

Change in Status

Outside of Open Enrollment, you are not permitted to change your benefits unless you experience a “qualified status change.” Qualified status changes 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 health care elections. Your Plan coverage will generally start the first of the month following completion of the enrollment process.

If you’re covering a newborn, coverage will be effective on the date of the child’s birth as long as you enroll your child within 30 days of the birth date. If you’re adding an adopted child, coverage will be effective as of the date of adoption or placement, as long as you enroll the child within 30 days.

30 days to Make a Change90 Days to Make a Change
To enroll for Plan coverage if you or a dependent loses other healthcare coverageTo 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.

You can contact Health & Welfare Specialist Monday through Friday from 8:30 am to 5:00 pm if you have questions. Call 301-568-2294.

Links to some important documents below:

 

Open Enrollment

Make a change

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