#5 – Amendment to Health Benefit Plan

IT IS UNDERSTOOD AND AGREED THAT THE FOLLOWING MODIFICATIONS SHALL BE MADE:

In the INITIAL REQUIREMENTS – DEPENDENT ELIGIBILITY section of the Plan document, the Special Eligibility Provision for Working Spouses and Domestic Partners subsection will be revised to read as follows:

Special Eligibility Provision for Working Spouses and Domestic Partners

A Participant’s spouse or domestic partner who is eligible for coverage under his or her own employer’s group health plan must enroll for that coverage at his or her next available enrollment opportunity where that coverage will begin on or after January 1, 2019. Coverage under the spouse or domestic partner’s own employer’s group health plan will be considered his or her primary coverage, and this Plan will be the secondary coverage. A Participant’s spouse or domestic partner who is eligible for coverage under his or her own employer’s group health plan for medical, dental, or vision benefits, but who declines to take that other coverage will not be eligible to enroll in or participate in the Plan for that benefit type.

The Participant is obligated to immediately report to the Plan Administrator any change that would affect his or her spouse or domestic partner’s eligibility under this Plan (e.g., the spouse or domestic partner changes employers or the spouse or domestic partner’s employer offers its employees a medical, dental, or vision plan for the first time). If it is found that a spouse or domestic partner who is eligible for coverage under his or her own employer’s group health plan has not enrolled for his or her own employer’s medical, dental, or vision coverage as required by this provision, benefits for the spouse or domestic partner may be terminated. Coverage may not be retroactively rescinded except as permitted by law (e.g., in cases of fraud or intentional misrepresentation). Notice that coverage will be retroactively rescinded must generally be provided 30 days before proceeding with the termination process. Otherwise, coverage will be terminated prospectively once the error is discovered.

The following exceptions to this provision shall apply:

  1. A Participant, spouse, or domestic partner who is an Employee of Kalamazoo College and who is married to or in a domestic partner relationship with an individual who is also an Employee of Kalamazoo College will not be penalized for declining to enroll separately as individual Participants in this Plan.
  2. A spouse or domestic partner who is required to pay at least 50% or more of the total cost for medical, dental, or vision coverage under his or her own employer’s group health plan will not be subject to this provision and can enroll for primary / sole coverage under this Plan for that benefit type.
  3. The spouse’s or domestic partner’s medical plan provides limited access to in- network inpatient hospitalization services by having no access to any in-network hospitals within a 50-mile radius of the spouse’s residence.

All other provisions of the Plan shall remain in effect and unchanged.

IN WITNESS WHEREOF, the undersigned has caused this amendment to be duly adopted and effective as of the August 1, 2020

Signatures on file in Human Resources.