Eligibility

If you are a METRO employee and a member of ATU Local 689, you and your eligible dependents can enroll for coverage in the Transit Employees’ Health & Welfare Plan once you complete your probationary period.

Eligibility for your Spouse and Children

Your spouse and eligible dependent children may be covered under the plan. Eligible dependent children, whether married or unmarried, include:

  • Children under age 26, including natural children, stepchildren, legally adopted children, children placed with you for adoption, or children in a domestic partner relationship
  • Children as described above, age 26 or older, who have a mental or physical incapacity that began prior to age 26 that prevents them from engaging in any self-sustaining employment, have the same principal place of residence as you for the full year, are members of your household, and are dependent upon you for over one-half of their support.
  • Unmarried children for whom you are the court-appointed guardian up to age 19. Note: unmarried children for whom you are the court-appointed guardian are eligible to continue their coverage after age 19 until age 23 if they are full-time students.
 

You will need to submit proof of dependents’ documents to the Health and Welfare Plan, which may include one or more of the following:

  • Original marriage certificate
  • Tax forms
  • Original birth certificate or certificate of live birth for your children
  • Social Security Number or W9 number
  • Proof of guardianship
  • Proof of student status

Eligibility for Domestic Partner

You can include your domestic partner in the Health & Welfare Plan. Domestic partners refer to two adults, whether of the opposite or same sex, who share a spouse-like relationship marked by cohabitation, mutual care, and dependency.

An “Affidavit of Domestic Partnership” must be submitted to the Health & Welfare Plan for your partner to receive benefits.

In specific situations, the Participant may need to consider taxable income coverage for a domestic partner or children in a domestic partnership. Participants who receive coverage for their domestic partners will receive an annual income statement indicating the value of this coverage for tax purposes. Taxes will be withheld through payroll deduction. It’s important to note that some states may consider coverage of a same-sex spouse as taxable income.

Eligibility for Domestic Partners

The plan considers your domestic partner eligible for coverage if you:

  • Share a permanent residence and intend to continue doing so indefinitely.
  • Are at least 18 years of age.
  • Are jointly responsible for each other’s common welfare and living expenses, and are financially interdependent.
  • Have registered a declaration of domestic partnership with the appropriate government offices.

Eligibility While on Leave

If you are not currently employed but remain eligible for Health and Welfare Plan coverage according to the collective bargaining agreement, you can maintain coverage by paying monthly premiums.

Payments are due on the first of each month. It is your responsibility to ensure timely payment. The Plan does not issue reminders for late payments or invoices. Failure to make payments on time will result in termination of your coverage under the Plan. You may choose to have payments deducted directly from your bank account. For further information, please contact the Plan Office at 301-568-2294.

If you are on a leave of absence for military duty, you may continue to receive medical, dental, prescription drug, and vision benefits coverage for both yourself and your covered dependents. Please see “If you enter Military Service” for more information.

The Family and Medical Leave Act (FMLA)

If you need to take leave due to a serious illness, the birth of a child, or caring for a seriously ill parent or spouse, you may qualify for up to 12 weeks of leave under the Family and Medical Leave Act (FMLA). Additionally, if you’re faced with a situation related to the active military service of a child, spouse, or parent, you may also be entitled to 12 weeks of leave. In certain circumstances, such as caring for a family member who is a member of the Armed Forces and undergoing medical treatment for a severe injury or illness, you could qualify for up to 26 weeks of leave within a single year under FMLA. To apply for FMLA leave, please reach out to METRO.

As long as you remain eligible and continue to make your monthly premium payments for the Health & Welfare Plan, METRO will continue to contribute its portion towards your coverage.

Retiree Coverage

If you are enrolled in the Health and Welfare Plan and retire through the Transit Employees’ Retirement Plan, you qualify for life insurance, medical coverage, and the voluntary retiree dental plan. Should you opt out of continuing medical coverage, you have the option to re-enroll later in the event of a life-changing circumstance or during the next Open Enrollment period. However, if you were hired on or after January 1, 2010, you are ineligible for retiree medical coverage.

Your monthly Health and Welfare premium payments will be automatically deducted from your pension check.

Upon retirement, retirees have the flexibility to switch health plans and may do so during the regular Open Enrollment Period.

If you Work Part-Time

All part-time employees, with the exception of re-hired retired employees, are entitled to receive long-term disability and life insurance benefits. Additionally, part-time employees have the option to enroll and contribute to the Health & Welfare Plan, which provides coverage for medical, vision, and dental expenses.

When Coverage Ends

Your coverage under the Plan will end at the conclusion of the month in which any of the following events takes place:

  • You stop working as a Local 689 employee of METRO for reasons other than retirement.
  • You are no longer eligible under the terms of a collective bargaining agreement.
  • You do not make your monthly payments (if required) on time.
  • The Plan is terminated or modified to end your coverage.

When your coverage ends, coverage for your dependents also ends unless your termination of coverage is due to your death. (Refer to the “If You Die While a Participant” section on the Life Events Page).

Your spouse’s coverage ceases upon divorce or annulment of your marriage. However, if you are separated but still legally married, your spouse remains covered. Your domestic partner loses coverage when your relationship no longer meets the criteria for a domestic partner relationship.

Coverage for dependent children terminates on the final day of the month in which they no longer meet the Plan’s definition of dependent.

Open Enrollment

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