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ELIGIBILITY,FUNDING,EFFECTIVE DATE <br /> AND TERNIINATION PROVISIONS <br /> ELIGIBILITY <br /> Eligible Classes of Employees.All Active and Retired Employees of the Employer. <br /> Eligibility Requirements for Employee Coverage.A person is eligible for Employee coverage from the tirst day <br /> that he or she: <br /> (1) is a Full-Time,Active Employee of the Employer.An Employee is considered to be Full-Time if he or <br /> she normally works at least 30 hours per week and is on the permanent payroll of the Employer for that <br /> work. <br /> (2) is a Retired Employee of the Employer,per the terms of the City Labor Agreement or Administrative <br /> policy. <br /> (3) is in a class eligible for coverage. <br /> Medicare Eligible Covered Persons.If you meet the definition of an Eligible Person stated in the ELIGIBILITY <br /> Section above and you are eligible for Medicare and not affected by the"Medicare Secondary Payer"(MSP) laws as <br /> described below,the benefits described in the section of this benefit booklet entitled"Benefits for Medicare Eligible <br /> Covered Persons"will apply to you and to your Spouse and covered Dependent children (if he or she is also eligible <br /> for Medicare and not affected by the MSP laws). <br /> A series of federal laws collectively referred to as the"Medicare Secondary Payer"(MSP)laws regulate the manner <br /> in which certain employers may offer group health care coverage to Medicare Eligible employees,spouses and in <br /> some cases, dependent children. <br /> The statutory requirements and rules for MSP coverage vary depending on the basis for Medicare and employer <br /> group health Plan ("GHP")coverage,as well as certain other factors,including the size of the employers sponsoring <br /> the GHP. In general,Medicare pays secondary to the following: <br /> (1) GHPs that cover individuals with end-stage renal disease("ESRD")during the first 30 months of <br /> Medicare eligibility or entitlement.This is the case regardless of the number of employees employed by <br /> [he employer or whether the individual has"current employment status." <br /> (2) In the case of individuals age 65 or over,GHPs of employers that employ 20 or more employees if that <br /> individual or the individual's Spouse(of any age)has "current employment status."If the GHP is a <br /> multi-employer or multiple employer plan,which has at least one participating employer that employs 20 <br /> or more employees,the MSP rules apply even with respect to employers of fewer than 20 employees <br /> (unless the plan elects the small employer exception under the statute). <br /> (3) In the case of disabled individuals under age 65,GHPs of employers that employ 100 or more <br /> employees, if the individual or a member of the individual's family has "current employee status."If the <br /> GHP is a multi-employer or multiple employer plan, which has at least one participating employer that <br /> employs 100 or more employees, the MSP rules apply even with respect to employers of fewer than 100 <br /> employees. <br /> PLEASE NOTE: SEE YOUR EMPLOYER OR GROUP ADMINISTRATOR SHOULD YOU HAVE ANY <br /> QUESTIONS REGARDING THE ESRD PRIMARY PERIOD OR OTHER PROVISIONS OF MSP LAWS <br /> AND THEIR APPLICATION TO YOU,YOUR SPOUSE OR ANY DEPENDENTS. <br /> Your MSP Responsibilities.In order to assist your employer in complying with MSP laws, it is very important that <br /> you promptly and accurately complete any requests for information from the Claim Administrator and/or your <br /> Employer regarding the Medicare eligibility of you, your Spouse and covered Dependent children.In addition, if you, <br /> your Spouse or covered Dependent child becomes eligible for Medicare, or has Medicare eligibility terminated or <br /> 3 <br />