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Important Information about this Guide <br />This guide describes the Employee Benefits Program for eligible employees of the City of Louisville. <br />This guide does not constitute the Summary Plan Description as required by the Employee Retirement Income <br />Security Act of 1974 (ERISA). If any conflict should arise between this guide and the pertinent provisions of <br />any insurance policy or master plan document, or if any provision is not explained or only partially explained in <br />this guide, your rights will always be determined under the provisions of the plan documents (and any rules not <br />yet written into the plan documents) and insurance contracts. <br />While the City of Louisville intends to maintain the Employee Benefits Program, it retains the right to amend or <br />terminate any of the benefit plans at any time, as it deems advisable, as to any or all of the employees <br />covered. In fact, as a matter of prudent business planning, the City routinely evaluates the benefits program it <br />offers to employees and their dependents. <br />Eligibility and Enrollment <br />Who is Eligible: You are eligible to participate in the City of Louisville's benefits program if your position is <br />designated as `Regular' as defined below: <br />• Tier 1: The level of benefits a Full -Time employee is eligible to receive who is authorized to work 36 — 40 <br />hours per week on a regular basis. <br />• Tier 2: The level of benefits a Benefited Part -Time employee is eligible to receive who is authorized to work <br />30 — 35 hours per week on a regular basis. <br />Eligible Family Members (Dependents): You may cover your eligible family members under the City's plans. <br />Eligible family members include: <br />• Your spouse, or <br />• Your Common Law Spouse (Affidavit of Common Law Marriage required.), or <br />• Your Same Sex Domestic Partner - An exclusive committed relationship between two (2) unmarried adult <br />persons, of the same sex, who are unrelated by blood, maintain a mutual residence, and share basic living <br />expenses. (Affidavit of Same -Sex Domestic Partnership required.) <br />• Your child(ren): Up to 26 years of age <br />When Your Coverage is Effective: If you enroll during the Annual Open Enrollment period, the coverage you <br />select will be effective January 1, 2017 provided you have met the eligibility requirements. If you are a newly <br />hired employee or are newly eligible for the plans, your effective date is the first day of the month following <br />your date of hire. <br />If you choose not to enroll during Open Enrollment or your eligibility period, you will be required to wait until the <br />next Annual Open Enrollment unless you have a qualifying change of status as defined by the IRS, listed <br />below. Please note that some coverages are not subject to Annual Open Enrollment. <br />QUALIFYING EVENTS — MID -YEAR CHANGES: <br />You may only enroll, add family members, or cancel your elections during the Annual Enrollment <br />period, or within 31 days of experiencing a qualifying life status change, including: <br />• Marriage, death of spouse, divorce or legal separation. <br />• Birth, adoption, placement for adoption or death of a dependent. <br />• Termination or commencement of employment for you, spouse, or dependent. <br />• Relocation or increase in hours of employment by you or your spouse. <br />• Your dependent child satisfies or ceases to satisfy the requirements for coverage because of age. <br />• A change in the place of residence or work (>35 miles) for you, your spouse, or dependent. <br />• You or your spouse/domestic partner experience an open enrollment event. <br />4 <br />