当地的22名消防/护理

/ 22

第五大街415号. 费城., PA 19123.

受养人资格和登记

谁是合格的  – (添加受养人的表格可在主页-表格中找到)

You and your dependents are eligible for coverage beginning with your first day of employment with the Fire Department.

i. 员工

如果你受雇于由IAFF地方22工会代表的消防部门,你就有资格享受福利. 如果你受雇于与IAFF当地第22健康计划签订了参与协议的雇主,或者受雇于IAFF当地第22联盟或IAFF当地第22健康计划,你也有资格享受福利.

ii. 退休人员

在退休, you are eligible for certain benefits for five (5) years provided you meet the age and service requirements described below:

  1. you have reached age 45 and are eligible to participate in Plan X; or
  2. you have reached age 50 and are eligible to participate in Plan 87 (Plan A); or
  3. you have satisfied the minimum requirements to qualify for a pension benefit through the City uniformed pension plan; or
  4. you were a participant in the City of 费城 pension fund for a least ten (10) years; or
  5. 你是受雇于当地22健康计划或当地22联盟至少每周35小时连续至少十(10)年之前立即退休,你至少55岁当你离开就业与健康计划或联盟
    1. any Health Plan or Union employee (or their eligible dependent) who is eligible to enroll in Medicare, 必须参加医疗保险A部分和B部分才能有资格享受城市资助的五(5)年城市资助的健康覆盖仅限于这五(5)年, regardless of whether you would qualify for a pension under more than one of the requirements listed above. 如果你死了, 您的合格家属有权继续享受该计划在您死亡时剩余五年的保险余额, 只要他们继续满足“合格家属”的定义.”

延迟退休福利 

You may elect to defer your eligibility for five years of City-funded coverage until a later date. This election to defer coverage must be made when you retire and you can only re-enter coverage status one time. 如果你退休后有其他的医疗保险, 及有意了解有关延迟投保本计划的额外信息, 请与计划办公室联系 之前 来讨论一下你的退休方案.

服务与残疾退休福利有关 

如果您有资格从费城领取与服务有关的伤残抚恤金,并且在退休前曾在该养老基金中参加过一天, 你有资格享受5年的退休人员健康保险.

非服务关联残疾退休福利 

如果你有资格获得费城市的非与服务有关的残疾养老金,并且在退休前连续至少10年参加该养老基金,你就有资格享受5年的退休人员健康保险.

Your City-sponsored retiree health coverage runs concurrently with your eligibility for continuation coverage under COBRA. This means that at the end of your five years of City-funded coverage you will NOT be offered a COBRA election. 详情请参阅“COBRA下的延续保险”.

3. 因公死亡雇员的合资格家属 

如果你因公殉职, 您的遗孀或鳏夫有资格从该计划中获得终身福利. Any other eligible dependents will be covered for as long as they meet the eligibility criteria of the Plan, e.g.在美国,受抚养的儿童将享受保险,直到他们年满26岁.

iv. 因服现役而非因公死亡的雇员的合资格家属 

如果你死于现役而不是因公殉职, your spouse and other eligible dependents will remain eligible for coverage 好像你已经退休了 在你死的那天.

v. 雇员在获准休假期间死亡的合资格受养人 

如果你在退休前去世, 在获准休假期间, your spouse and other eligible dependents will remain eligible for coverage 好像你已经退休了 在你死的那天.

vi. 退休雇员的合资格受养人 

如果你是一名退休人员,在符合健康保险条件的情况下死亡,你的配偶将在你的退休保险的剩余期间受到保护. Any other eligible dependents will be covered for as long as they meet the eligibility criteria of the Plan.

事件 谁都是 报道时间
成员退休后死亡 未亡配偶及合资格受抚养人 If you retire and die while eligible for health coverage your spouse will be covered for 退休保险的剩余期限, 包括金融城提供的5年保险,以及当你退休时通过未用病假时间转换而“购买”的额外几个月的保险. Any other eligible dependents will be covered as long as they meet the eligibility criteria of the Health Plan (e.g. 受抚养的子女在26岁的月底之前都可以享受保险
成员在服役期间在执行任务时死亡 未亡配偶及合资格受抚养人 如果你因公殉职,你的配偶可能有资格 一生 健康计划下的福利覆盖. Any other eligible dependents will be covered for as long as they meet the eligibility criteria of the health Plan (e.g. 受抚养的子女在26岁的月底之前都可以享受保险. 你的配偶将永远有资格享受你作为退休人员所享有的福利, 包括金融城提供的5年保险,以及你可以通过未用病假时间转换“购买”的任何额外月的保险.一生 如果你的配偶在你死后再婚,保险将停止.
成员在现役中死亡,但不是在执行任务 未亡配偶及合资格受抚养人 如果你死于现役而不是因公殉职 your spouse will be eligible for coverage 好像你已经退休了 在你死的那天. 这包括5年由城市提供的保险,加上任何额外的月的保险,你可以“购买”通过未使用的病假时间转换. Any other eligible dependents will be covered as long as they meet the eligibility criteria of the Heath Plan (e.g. 受抚养的子女在26岁之前都可以享受保险

Upon your initial eligibility, the Plan will provide you with enrollment cards and application forms. You will not be eligible for health benefits until you complete and return these documents.

加入“健康计划”不是自动的. 在你完成登记和申请表格之前,你和你符合条件的家属都不能享受健康福利

1. 健康计划涵盖了多少家属?

•合法结婚的配偶

•26岁以下的亲生和领养儿童

任何年龄的残疾儿童

•合格的医疗子女赡养令(QMCSO):根据QMCSO,您需要为26岁以下的儿童提供医疗保健

•26岁以下继子女(提供保险的费用为每个继子女每月65美元:有关详细情况,请与健康计划联系)

2. 我什么时候可以在健康计划中添加家属?

•如果你结婚了,你需要加上你的配偶 在你们结婚后的30天内
•如果你有一个新孩子,你需要加上这个孩子 出生后30天内
•如果你领养了一个孩子,你需要加上这个孩子 在孩子被送到你家供人收养的30天内

如果你在结婚/出生/安置的30天内没有添加一个新的从属关系, 你必须等到健康计划的年度开放登记, 每年的11月是哪一天.

异常:如果你的受扶养人参加了另一个健康计划,但失去了该保险, 你可以在一年中任何时候加上这个依赖项只要你在他们失去其他保险后的30天内这么做.

Coverage for you dependent will start on the 1st day of the month after we receive your documentation

3. 如何将受抚养人添加到健康计划中?

The Form and Instructions are on the “dafabet网页手机登录 Page” of this website – under the “FORMS Header” -“Dependent Forms Instructions”.
您需要致电健康计划办公室,添加一个依赖项,以指示如何通过电子方式提供适当的文档或亲自带着适当的文档前来. Your enrollment card needs to be updated by you and there is documentation that’s required (see below).

4. 我需要哪些文档才能添加一个新的依赖项?

•配偶-你的结婚证和配偶的社会保障号码的复印件(dafabet网页手机登录不需要看社会保障卡)
•亲生子女-孩子出生证明的复印件,上面显示您是亲生父母和孩子的社会保险号(dafabet网页手机登录不需要看社会保险卡)
o If you don’t have the state-issued birth certificate within 30 days of the baby’s birth, dafabet网页手机登录将接受医院出具的证明,直到您收到国家文件
•领养孩子-孩子的出生证明复印件, 社会安全号码, 还有法律文件表明孩子已经被你收养了
• Handicapped Dependent – you must provide medical or other documentation of the child’s handicap. Examples of documentation include a statement from a treating physician that the child is handicapped; or a determination from the Social Security Administration that the child is handicapped.
 the child must have been handicapped and an eligible dependent under the Plan 之前 to reaching their 26th 生日

5. 如果dafabet网页手机登录离婚,我配偶的保险怎么办?
It is your responsibility to notify the Health Plan immediately when you are divorced and to provide a copy of your divorce 法令. 如果你不告诉dafabet网页手机登录你离婚了, 而你的前配偶继续使用健康计划福利, it is YOUR responsibility to repay the Plan for benefits used by a non-eligible dependent.

 

你有资格家属 

保险范围是为你和你的合格家属. 合资格的受养人是你的:

  • 合法结婚的配偶
  • 26岁以下儿童
  • 主要依靠你供养,由于精神或身体残疾而无法谋生的任何年龄的残疾儿童

你的孩子就是你的亲生孩子, 从被安置在你家开始合法收养的孩子, 以及任何受你法律约束的孩子, 由法院命令确认的, 提供全面和永久的支持. A child may be covered until the end of the month in which he or she reaches the age limit of 26.

Your spouse or child is not eligible while they are on active duty in the armed forces of any country.

继子女 may be enrolled if you demonstrate that you stand in a parent-child relationship with the child. Your stepchildren are the children of a person to whom you are legally married where you are not the biological parent. 你可以向孩子的父母提供你的结婚证明,以及孩子的出生证明副本,以证明父母与孩子之间的关系. 让继子女参加健康计划,每个孩子每月要交65美元的费用,在每年由董事会审查时,这一数额可能会有所改变. 此费用应于保险月的第一天或之前缴交 failure to provide timely payment will result in a late fee of $25 per child for each month that your payment is delinquent. Continued delinquency in remitting this fee may result in termination of the stepchild’s health coverage. Coverage will also terminate in the event you and your step child’s biological parent divorce.

免除费用 

You may apply for an annual waiver of the fee to enroll your stepchild if you furnish the following documentation to the Plan 每年:

  • 如果孩子未满18岁, a current child support order that substantiates that neither you nor your spouse is receiving any financial support on behalf of the child; and
  • Evidence that the child’s biological parents cannot provide health benefit coverage; and
  • 一份你的报税表,上面显示你, 或你的配偶,如果单独提交, 要求这孩子为受抚养人. The child must be claimed as a dependent within your household; and
  • “继子女宣誓书”,确认你符合资格的所有要求, 如果继子不符合条件,说明你的责任, and also affirms that neither you nor your spouse receive any financial support from any source for the child

孙子 

如果您向该计划提供一份有管辖权的法院授予您永久居住权的正式命令副本,您可以为您的孙辈登记, 孩子的合法和唯一的身体监护权.

26岁以上残疾儿童 

该计划将继续为智力或身体残疾和在26岁以后没有能力养活自己的儿童提供健康保险th 生日 for as long as the child remains handicapped and unmarried and the following requirements are met:

  • the child must have been handicapped and an eligible dependent under the Plan 之前 to reaching their 26th 生日
  • you must provide medical or other documentation of the child’s Examples of documentation include a statement from a treating physician that the child is handicapped; or a determination from the Social Security Administration that the child is handicapped.

保管委员会将作出最终决定, 根据提交的文档, 关于残疾儿童是否可以继续享受这项规定的保险.

合资格医疗子女赡养令 

您的子女还包括26岁以下的子女,根据《dafacasino网页版》(QMCSO),您需要为他们提供医疗保险, 不管孩子们住在哪里. QMCSO是一种判断, 法令, or order issued by a court requiring you to provide child support or health care coverage for a child.

资格证明 

作为通过本计划获得保险和福利的条件, you must comply with reasonable requests for verification of initial and continuing eligibility. 已婚参加者须提供婚姻状况证明. 如果你的孩子是残疾人, you must provide written evidence of the child’s handicap within 31 days after his or her attainment of age 26. When required, you must provide proof of the continuation of your child’s handicap to the Plan.

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