Pechanga 2013-2014 Benefits Guide

Eligibility

Part-Time : Team Members in a part time status and scheduled to work less than 30 hours a week are eligible to enroll in the benefit options summarized in the table on page 4. Full-Time : Team Members in a full time status and scheduled to work 30 or more hours a week are eligible to enroll in the benefit options summarized in the table on page 4. As a newly eligible Team Member, benefits, unless stated otherwise, will begin the first of the month following your 90- day waiting period (for example, if you started work November 15, coverage could begin on March 1). You will receive communication from the Benefits Department prior to your effective date. Your eligible dependents may also enroll in medical, dental, vision, and dependent life insurance benefits. To add a dependent to your PR&C benefits, you must provide acceptable verification documentation Documentation Includes: Spouse - A copy of your marriage certificate or most recent tax return Same-sex or Opposite-sex Domestic Partner – A copy of your domestic partner affidavit and two documents indicating financial interdependence. For example: joint bank accounts, joint credit cards, joint ownership of residence, sharing of household expenses, designation of power of attorney, designation of one another as sole beneficiary/executor. Child less than 26 years of age – A copy of the child’s birth certificate or most recent tax return form indicating son or daughter is a dependent and if applicable, a copy of the divorce decree, copy of the court-issued qualified medical child support order, if the dependent is not a natural born child we will require custodial or adoption papers. Disabled child over age 26 – A copy of the Social Security letter deeming child disabled. Eligible dependents include: • Your legally married spouse • Your dependent children up to age 26 • Your disabled child(ren) of any age who is incapable of self-support due to mental or physical handicap, either of which commenced prior to age 26. • Your domestic partner (same and opposite sex) and the domestic partner's eligible children can be covered under the medical, dental, and vision plans. A completed affidavit must be on file with HR Benefits Department and benefits are subject to federal income tax per IRS guidelines. Contact HR Benefits Department for additional details.

Changing Your Coverage Generally, you may only change your PR&C benefit elections during the annual Open Enrollment period. However, you can change your benefit elections during the year if you experience a Qualifying Life Event. If you experience a Qualifying Life Event, you must notify your Benefits Specialist within 30 days of the event. Depending on the type of change, you may need to provide proof. If you do not contact your Benefits Specialist within 30 days, you will have to wait until the next annual Open Enrollment period to make changes, unless you have another Qualifying Life Event.

Qualifying Life Events may include: • Marriage • Divorce or legal separation • Birth of your child • Death of your spouse or dependent child • Adoption or placement for adoption, of a child • Termination or commencement of your spouse’s employment • Change of employment status by you or your spouse • A significant change in your or your spouse’s health coverage due to your spouse’s employment • Qualification by the Plan Administrator of a Medical Child Support Order • Entitlement to Medicare or Medicaid

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