Ongoing eligibility
For each plan year (January 1 through December 31) there will be a 12-month standard measurement period before the year begins. The standard measurement period for each plan year will end on October 3 immediately preceding the first day of the plan year. For example, for the 2023 plan year, the standard measurement period will begin on October 4, 2021 and end on October 3, 2022.
If you are a regular part-time employee working at least 20 hours per week or a regular full-time employee working at least 40 hours per week, you will remain eligible for benefits as described in the Eligibility section of the SPD , except as described below if your scheduled hours are reduced during the stability period.
If you are a regular employee working less than 20 hours and are credited with at least 30 hours per week during the standard measurement period, you will be eligible for the UHC Basic HSA Plan (with no Stryker HSA contribution) for the next plan year and your cost will be based on part-time rates.
If you are a direct temporary employee, variable hours employee, or seasonal employee and you are credited with an average of at least 30 hours per week during the standard measurement period, you will be eligible for the UHC Basic HSA Plan (with no Stryker HSA contribution) for the immediately following plan year, and your cost will be based upon part-time rates unless you are regularly scheduled to work 40 hours per week. If you satisfy the minimum hour requirement during the standard measurement period, you will be notified after the measurement period ends and will be provided with the opportunity to enroll in coverage for the immediately following plan year.
If you transfer to a position or change working hours that causes you to become eligible for additional plan benefits or qualifies you for a lower medical cost, you will be offered the additional coverage and the more favorable cost immediately upon your status change. Conversely, if you transfer to a position or change working hours that would ordinarily no longer qualify you for certain benefits, you will continue to be eligible for the UHC Basic HSA Plan (with no Stryker HSA contribution) for the balance of the stability period if you are credited with at least 30 hours per week during the standard measurement period. However, your employee cost will adjust to the part-time rate if you drop below 40 hours.
If you have a break in service (for example, due to termination of employment or the taking of a non-FMLA leave) during which you are not credited with any hours of service for at least 13 weeks, you will be treated as a new hire upon resumption of service. If the break in service is less than 13 weeks and you were enrolled in coverage and return during the same stability period or plan year, the coverage will be offered as soon as administratively practicable upon resumption of service. Further, you will be treated as a continuing employee upon resumption of service for purposes of any applicable measurement period.
The applicable service area is described in the "Definitions" section of the Evidence of Coverage for your plan. Special rules apply if you live or move outside of the service area after you enroll as described in the "Premiums, Eligibility and Enrollment" section of the applicable Evidence of Coverage.
Eligible dependents include:
- Your spouse
- Your domestic partner. Note: registered domestic partnerships are not subject to any requirements for proof of relationship or waiting periods applied to domestic partnerships that are not also applied to marriages. For purposes of Stryker's benefit plans, a domestic partnership is defined as:
OR
- A domestic partnership that meets all of the following requirements for the immediately preceding 12 months:
- Is at least age 18 and mentally competent to enter into a legal contract when the domestic partnership began.
- Is your sole domestic partner in a committed relationship and intends to remain so indefinitely.
- Has not had another domestic partner within the prior 12 months.
- Has not been a party to a divorce or annulment proceeding in at least 12 months.
- Is not related to you in a way that would prohibit a legal marriage.
- Is not legally married to anyone else, and any prior marriages have been dissolved through death, divorce or nullity.
- Shares a household with you that is the primary residence of both of you (although you may live apart for reasons of education, healthcare, work, or military service).
- Shares joint responsibility with you for each other's basic living expenses incurred during the domestic partnership.
- Your or your spouse's (or domestic partner's) children through the end of the month in which they turn age 26
- Other dependent persons (but not including foster children) who meet all of the following requirements:
- They are under age 26
- They receive all of their support and maintenance from you, your spouse or your domestic partner
- They permanently reside with you
- You or your spouse (or domestic partner) is the court-appointed guardian (or was before the person reached age 18) or the person's parent is an enrolled dependent under your family coverage
Dependents who meet the dependent eligibility requirements except for the age limit may be eligible if they meet all the following requirements:
- They are incapable of self-sustaining employment because of a physically or mentally disabling injury, illness or condition that occurred prior to reaching the age limit for dependents;
- They receive 50% or more of their support and maintenance from you, your spouse or your domestic partner; and
- You provide proof of their incapacity and dependency within 60 days after such proof is requested.
For purposes of determining eligibility under the Kaiser HMO option, the term "child" includes your (or your spouse's or domestic partner's) biological child, legally adopted child, a child placed for adoption, a stepchild or a child who is required to be covered under the Stryker Corporation Welfare Benefits Plan by a qualified medical child support order (QMCSO). See Your Rights and Responsibilities in this Stryker Benefits Summary for more information regarding QMCSOs.
If both you and your spouse ,domestic partner, or dependent work for Stryker, you may not be covered under the plan both as an employee and a dependent nor may you be covered under any other Stryker-sponsored plan if you are enrolled in this plan. Any eligible children of two Stryker employees may be covered as dependents by only one parent.
Note: The dependent eligibility requirements and age limitations discussed here apply only to the Kaiser HMO option. Other options may have other requirements. Please see "Dependents" in the Participating in Healthcare Benefits section for those requirements.
If you enroll when you are first eligible, your coverage under the plan begins immediately as of your date of hire. If you are re-hired after a break in service, coverage begins immediately on your date of hire.
A newly eligible child, spouse or domestic partner will be covered immediately if you contact your Benefits representative and complete necessary paperwork to enroll him or her within 30 days of the date of birth or marriage or the date the child joined the family.
For a newborn child, coverage is effective from the moment of birth. However, if you do not enroll the newborn child within 30 days, the newborn is covered for only 31 days (including the date of birth).
Coverage for you and your dependents under the Stryker Corporation's Welfare Benefits Plan ends on the following dates:
- The date you leave Stryker, fail to pay required coverage contributions or otherwise become an ineligible employee.
- The date you drop coverage due to a qualifying life event
- If you elect to drop healthcare benefits during annual enrollment, coverage ends on the December 31 following the annual enrollment period
Dependent coverage ends:
- On the date your coverage ends
- On the last day of the month in which the dependent child turns age 26
- On the date your dependent ceases to qualify as a dependent under the plan
- In the case of your spouse, the date of divorce
- In the case of your domestic partner, the date you submit an affidavit terminating the partnership
If coverage under the plan ends, you or your dependents may be able to choose COBRA continuation coverage. For more information, see "COBRA: Continuing Healthcare Coverage" in the Participating in Healthcare Benefits section of this Stryker Benefits Summary.
Although not required by COBRA law, under the Stryker Plan, a covered domestic partner has the same COBRA rights as a spouse under the Kaiser Permanente HMO option. Termination of the domestic partner relationship is treated in the same manner as divorce. For more information about COBRA coverage, see "COBRA: Continuing Healthcare Coverage" in the Participating in Healthcare Benefits section of this Stryker Benefits Summary.
For specific and detailed information about the medical benefits offered under the Kaiser Permanente HMO option, refer to the Evidence of Coverage for your plan.
You may also refer to a Benefit Summary for an overview of your plan's benefits:
- If you live in Northern California, refer to the Benefit Summary for Kaiser Northern California, available at https://totalrewards.stryker.com/spd/2023-stryker-corp-eoc-dhmo-ncr.pdf
- If you live in Southern California, refer to the Benefit Summary for Kaiser Southern California, available at https://totalrewards.stryker.com/spd/2023-stryker-corp-eoc-dhmo-scr.pdf.
The Kaiser Permanente HMO option provides benefits for covered prescription drugs, including contraceptives, insulin and diabetic supplies. Specific information is set out in the "Outpatient Prescription Drugs, Supplies and Supplements" section of the Evidence of Coverage for your plan.
Information about filing claims for benefits is set out in the "Requests for Payment or Services" section of the Evidence of Coverage for your plan. Kaiser Permanente is the fiduciary for purposes of deciding claims for benefits under this healthcare option.