Who can be excluded from the plan?
Union employees covered by a collective bargaining agreement can be excluded, as well as any specific group of employees, provided that the minimum coverage and minimum participation requirements are satisfied. In addition, the conditions for participation may not discriminate in favor of Highly Compensated Employees (HCE). Officers or owners may voluntarily opt out.
Related Questions
- If a procedure or service is excluded from a members plan benefits, can we obtain authorization if we are able to establish medical necessity?
- If I am enrolled in a Medicare Part D drug plan, can I use the discount card for drugs excluded from Part D coverage?
- Student employees are excluded from the Plan. How are students being defined for the purpose of this exemption?
