11 Eligibility for Retiree Coverage To be eligible for Retiree coverage where provided, you must retire from active employment with a participating Employer while you are eligible for benefits under this Plan, and your Employer must continue to make the required monthly contributions to the Plan. Retiree coverage is only available where the collective bargaining agreement and/or particip ation agreement provide for Retiree health care coverage, and the covered Employee meets the eligibility rules for Retiree coverage under the terms of such agreements. Please be sure that you and your Medicare - eligible dependents are enrolled for Medicare before your retirement, or as soon as you become entitled to Medicare after retirement. This Plan has a Medicare enrollment provision for Retirees (and certain disabled persons) which requires that you enroll for Medicare when you become entitled. If a par ticipant could enroll for Medicare but neglects to do so, the Plan will administer benefits as the secondary payer, i.e., Medicare as primary, and will reduce medical benefit payments by the amount Medicare would have paid if the person had enrolled (See C oordination of Benefits). Eligibility Pursuant to a Qualified Medical Child Support Orders The Plan is required to recognize Qualified Medical Child Support Orders (QMCSOs). QMCSOs require health plans to recognize state court orders that the Plan finds to be Qualified Medical Child Support Orders, as defined in the Social Security Act, directing a participant to provide health care coverage for dependent children, even if the participant does not have custody of the children. The Plan will honor any medica l child support order, which it finds to be a Qualified Medical Child Support Order (QMCSO) under the procedures set forth under the Plan, and as set forth in ERISA. Under federal law, a QMCSO is a child support order of a court or state administrative ag ency that has been received by the Fund Office, and that: • Designates one parent to pay for a child’s health plan coverage; • Indicates the name and last known address of the parent required to pay for the coverage and the name and mailing address of each chi ld covered by QMCSO; • Contains a reasonable description of the type of coverage to be provided under the designated parent’s health care plan or the manner in which such type of coverage is determined; and • States the period for which the QMCSO applies. An o rder is not a QMCSO if it requires the Plan to provide any type or form of benefit or any option that the Plan does not otherwise provide. For a state administrative agency order to be a QMCSO state law must provide that such an order will have the force a nd effect of law, and the order must be issued through an administrative process established by state law. If a court or state administrative agency has issued an order with respect to health care coverage for any of your dependent children, the Plan Admin istrator will determine if that order is a QMCSO as defined by ERISA, and under the terms of the Plan. The Plan Administrator’s determination will be binding on you, the other parent, the child and any other party acting on behalf on the child. If an order is determined to be a QMCSO, the Plan Administrator will notify the parents of each child, and advise them of the Fund’s procedures that must be followed to provide coverage to the dependent children. Coverage of the dependent children will be subject to all terms and provisions of the Plan, including any limits on the selection of providers, and requirement for authorization of services, insofar as is permitted by applicable law. No coverage will be provided for any dependent child under a QMCSO unless al l of the Plan’s requirements for coverage of that dependent child have been satisfied. Coverage of a dependent child
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