"Mental health practitioner" means a medical doctor, clinical psychologist, nurse, social worker or other appropriately trained and qualified person with specific skills relevant to mental health care "Mental health facility" means any establishment, or any unit of an establishment, which as its primary function provides mental health care "Mental health care" includes analysis and diagnosis of a person's mental condition, and treatment, care and rehabilitation for a mental illness or suspected mental illness "Independent authority" means a competent and independent authority prescribed by domestic law "Counsel" means a legal or other qualified representative When you are entitled to the payment of healthcare expenses under automobile insurance, including no-fault insurance and other insurance that pays without regard to fault, your automobile insurance is the primary payor and we are the secondary payor.These Principles shall be applied without discrimination of any kind such as on grounds of disability, race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, legal or social status, age, property or birth.If you are an annuitant under our Plan and also are actively employed, any group health insurance you have from your employer will pay primary and we will pay secondary.If you are covered under our Plan as a dependent, any group health insurance you have from your employer will pay primary and we will pay secondary.
We, like other insurers, determine which coverage is primary according to the National Association of Insurance Commissioners’ (NAIC) guidelines.
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When you have double coverage, one plan normally pays its benefits in full as the primary payor and the other plan pays a reduced benefit as the secondary payor. You must tell us if you or a covered family member has coverage under any other group health plan, including a Medicare plan, or has automobile insurance that pays healthcare expenses without regard to fault. To verify eligibility and enroll, members electing TCC or Spouse Equity must contact their or the contract holder’s employing agency (or OPM for annuitants). Former spouses who currently receive, or have future title to receive a portion of the annuity payable to the employee upon retirement.Former spouses who were enrolled as a dependent any time during the 18 months preceding the divorce.Former spouses who do not remarry before age 55.Former spouses are responsible for both the employee and employer share of the premium with no administrative fee. Coverage remains in effect as long as the former spouse is eligible.
Unlike TCC, there is no time limit on the length of enrollment. Spouse Equity allows certain former spouses of civil service employees, former employees and annuitants to continue coverage.
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Members enrolling in TCC are responsible for both the employee and employer share of the premium, plus an additional 2% administrative fee. Temporary Continuation of Coverage (TCC) allows former employees to continue their healthcare coverage for up to 18 months and eligible family members to continue their healthcare coverage for up to 36 months.
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