The MEBA Medical and Benefits Plan (“Medical Plan” or “Plan”) provides medical, prescription drug, dental, mental health, disability, life, and accidental death and dismemberment benefits. The pages on this website only provide a high-level overview of how the Plan works and the benefits it provides. For more detailed information, please refer to your Summary Plan Description, Summaries of Material Modifications and the Plan’s Rules and Regulations. Nothing in this overview should be construed to replace or override anything that is in the Medical Plan’s Rules and Regulations.
The Trustees believe the Plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the “Affordable Care Act”). As permitted by the Affordable Care Act, a grandfathered health plan can preserve basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health care services without any cost sharing. However, grandfathered health plans must comply with certain consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.
If you are a new MEBA member, you become covered under the Medical Plan on the date you complete 30 days of Covered Employment in any six consecutive calendar months.
“Covered Employment” is employment with a Participating Employer and vacation time for which you receive benefits from the MEBA Vacation Plan. A “Participating Employer” is any Employer who is obligated under a collective bargaining agreement with the Union or a participation agreement to make contributions to the Medical and Benefits Plan.
You will maintain your eligibility under the Medical Plan if you complete a second period of 30 days of Covered Employment within a period of six consecutive calendar months as long as this second period of Covered Employment falls within your first year of participation.
After that, in order to maintain eligibility, you must complete 60 days on the payroll in Covered Employment within any period of six consecutive calendar months.
Your Medical Plan coverage continues for six months following the last day of Covered Employment that was used to earn your eligibility.
Under COBRA, you may be eligible to extend coverage for yourself and your dependents following the end of coverage. If you choose to do so, you’ll have to pay the full cost of coverage yourself. Details about electing COBRA coverage are provided in your Summary Plan Description.
While you are covered by the Plan, your qualified dependents are also covered for medical and dental benefits. Your qualified dependents are:
The age limits for dependent children do not apply to an unmarried child who is incapable of self-sustaining employment by reason of mental or physical disability, provided the child became so incapable before the age limit was reached.
To have Medical Plan coverage, you must submit a Permanent Data Form to the Plan Office in Baltimore, MD. Your dependents’ coverage will begin at the same time as your coverage or as soon as a dependent becomes qualified, whichever occurs later.
Your qualified dependents are not covered under the Medical Plan unless a Permanent Data Form has been completed, signed and submitted to the Plan Office and they are listed on the Permanent Data Form. If there is any change to your dependents’ status (e.g., birth, death, change in marital status, etc.), you need to submit a new Permanent Data Form.
The Permanent Data Form also collects information the Plan needs to administer other benefits in addition to your medical coverage (e.g., dental coverage, life insurance, and accidental death and dismemberment insurance).
If you continue to work in Covered Employment beyond age 65, coverage under the Plan will continue for you and your qualified dependents.
While you are in Covered Employment with coverage under the Plan, you have the option of enrolling in Medicare Part A and rejecting Medicare Part B.
While you are in Covered Employment, Medicare coverage (Parts A and B) is secondary to the coverage provided by the Plan. However, because Medicare will become your primary coverage when you retire, if you don’t enroll in Part B when you are first eligible, there may be a gap between your retirement and the date your Part B coverage becomes effective.
Under Medicare Part D, if you enroll in any Part D Medicare Prescription Plan in any year, prescription coverage under the MEBA Medical Plan will terminate for that year. You will have an opportunity to regain prescription coverage under the MEBA Medical Plan should you terminate the Medicare Part D coverage.
If you’re a pensioner, your Plan coverage will be different from the coverage for active employees and their dependents. The differences take effect on your effective date of pension, not when your active coverage would otherwise run out if you did not choose pensioner medical coverage. You must also make contributions toward the cost of medical coverage under the Plan.
You may choose pensioner medical coverage for you and your qualified dependents under the Plan if you are entitled to pension benefits from the MEBA Pension Trust (including benefits payable under the MEBA Inland Pension Plan). Pensioners must generally have at least 15 years of pension credit to maintain medical coverage. (See the Plan Rules and Regulations and the MEBA Pension Trust Regulations for more information.) Pensioner medical coverage under the Plan is only available if you waive COBRA coverage or elect COBRA coverage and comply with the Plan requirements with respect to COBRA continuation coverage.
If your Employer was obligated to contribute to the Medical and Benefits Plan and to the Money Purchase Benefit Plan, but not to the Defined Benefit Plan, your employment will be treated as though credit was earned under the Defined Benefit Plan. This applies only for establishing pensioner medical eligibility.
If you retire from the MEBA Pension Trust on or after January 1, 1997, your eligibility for pensioner medical coverage depends on the years of pension credit you have. You must have at least 15 years of pension credit to qualify for pensioner medical coverage under the Plan (unless you retire on a disability pension, in which case you must have at least 10 years of pension credit).
The level of benefits available to you and your qualified dependents is also based on the number of years of pension credit you have. One level of benefits is available if you have at least 15 but less than 20 years of pension credit; another level is available if you have at least 20 years of pension credit.
The Plan provides benefits for non-collectively bargained employees of the Plan Office, the Union, the Calhoon MEBA Engineering School and certain other employers that contribute to the Plan. If you are one of these employees, your coverage starts the day you complete one month of continuous employment and ends on the last day of the month during which your employment terminates. You may be eligible to continue coverage at your own cost under COBRA when your regular coverage ends. The Plan also provides retiree benefits for these employees and their dependents.
In order to have your Pre-Employment drug test covered by the plan, you are required to have worked in Covered Employment for at least 60 days in the six-month period immediately preceding your drug test; and such Covered Employment must be with Employers that participate in the Federal Drug Testing Program.
New Entrants in the Plan, or employees who have not previously participated in the plan, will become eligible after completing 30 days of Covered Employment within any period of six consecutive calendar months.
You would need to complete a Change of Address Form, which can be found under Forms & Documents, Medical Forms. We cannot take address changes over the phone; the form must be submitted in writing, signed and dated by the member.