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 medical and prescription coverage as a regular full-time employee for the immediately following 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 are credited with an average of at least 30 hours per week during the standard measurement period, you will be eligible for medical and prescription drug coverage 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 period 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 medical benefits 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 part-time rates 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 as the result of marriage who is recognized in the state of Hawaii.
- 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.
- In general, you may enroll a child who meets the following requirements:
- The child is your son, daughter, stepson or stepdaughter, your legally adopted child or a child placed with you for adoption, a child for whom you are the court-appointed guardian, or your eligible foster child defined as an individual who is placed with you by an authorized placement agency or by judgement, decree or other court order).
- Your domestic partner's children.
- The child is under 26 year of age.
- You may enroll your disabled child by providing documentation demonstrating that:
- Your child is incapable of self-sustaining support because of a mental disability.
- Your child's disability existed before the child turned age 26.
- Your child relies primarily on you for support and maintenance as a result of the disability.
- Your child is enrolled under this coverage or another HMSA plan and has had continuous health care coverage with HMSA since before the child's 26th birthday.
The required documentation must be provided to HMSA within 31 days of the child's 26th birthday and subsequently at the plan's request, but not more frequently than annually.
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 HMSA plan. 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 on your date of hire. If you are re-hired after a break in service, coverage begins on the date of rehire. If you are hired as a result of an acquisition, coverage will begin on the first day you become eligible for Stryker benefits.
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.
You may enroll a newborn or adopted child according to the following requirements:
- The birth date of a newborn, providing you comply with the usual enrollment process within 31 days of the birth.
- The date of adoption, providing you comply with the usual enrollment process within 31 days of adoption.
- The birth date of a newborn adopted child, if you provide notice of your intent to adopt the child within 31 days of the child's birth.
- The date the child is placed with you for adoption, if you provide notice of the placement within 31 days of the placement. Placement occurs when you assume a legal obligation for total or partial support of the child in anticipation of adoption.
Coverage for you and your dependents under the Stryker Corporation's Welfare Benefits Plan ends on the following dates:
- The date on which your employment ends, you fail to pay required coverage contributions or otherwise become an ineligible employee. (NOTE: In compliance with the Hawaii Prepaid Health Care Act, if you live in Hawaii when you leave Stryker, your coverage ends on the date on which your employment ends.)
- The date of the 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 (unless he or she is mentally or physically disabled and primarily depends on you for support)
- On the date your dependent ceases to qualify as a dependent under the plan
- In the case of your spouse, on the date of divorce
- In the case of your domestic partner, on the date the domestic partnership terminates.
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.
COBRA continuation coverage can become available to you, your spouse and dependent children who are covered under the Stryker Corporation Welfare Benefits Plan when coverage might otherwise be lost. For more information, see "COBRA: Continuing Healthcare Coverage" in the Participating in Healthcare Benefits section of this Stryker Benefits Summary. However, keep in mind that the HMSA plan does not provide COBRA coverage for domestic partners.
For specific and detailed information about the medical benefits offered under the HMSA plan, refer to the HMSA Summary of Benefits and Coverage, available at https://totalrewards.stryker.com/spd/2023-sbc-hmsa.pdf.
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.