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| Questions and Answers | ||||
| PPO
deductible and coinsurance Q. I joined the PPO Plan May 1. When do I have to pay a copayment? When do the deductible and coinsurance apply? A. Usually, if a copay is required, the deductible and coinsurance don’t apply. And, if the deductible and coinsurance apply, the copay does not. See “When the deductible and coinsurance apply to PPO services” for examples. Q. What are some medical services the HMO and PPO plans offer at no cost to me? A. See "Medical service in HMO & PPO offered at no cost to members" for examples. Q. My wife and I are both city employees. The family is covered under my medical, dental and life insurance plans. I will soon retire. Do I still have to cover them under my retiree plans, or could my wife cover the family? A. Your wife may enroll as the covered “employee and family” within 31 days of your retirement. This qualifies as a change in family status for you, allowing her to enroll the family. There is no waiting period for coverage in this case, so you may drop your own coverage at that time. She should receive her forms before you retire. The paper work for you and your wife must come in to the Human Resources Department, 611 Walker, 4th floor, at the same time – that’s the only way to be sure that the status change will be properly recorded and your coverage will continue uninterrupted. It will go into effect the day after you retire. However, you must remain covered under your wife’s city-sponsored plan to preserve your coverage as a retiree. Should her later employment status change, your coverage would be affected as well. You would have 31 days to contact the HR Department to reinstate your retiree coverage. Your wife will also need to complete
the voluntary life insurance form to elect
first-time coverage or add dependents,
and the basic life insurance form to add
the family. Both forms require her to
designate a beneficiary.
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