For the purpose of this Article, a benefits-eligible appointment must be confirmed by the appointing department.  

Section A. Definition of “Other Qualified Adult” [and 3/24/08 MOU on CRITERIA #6] 
An “Other Qualified Adult” is a person who:  

1. Shares the same primary residence as the Employee and has shared a residence with the Employee for at least 6 months. 
2. Is not eligible to inherit from the Employee under the laws of intestate succession in the state of Michigan.* 
3. Is not legally married in Michigan to another individual. 
4. At least one of the following is true: 
a. Shares a joint checking account with the Employee 
b. Shares a joint credit account with the Employee 
5. At least one of the following is true: 
a.  The Employee and the OQA have durable 
power of attorney for health care for each 
other 
b.  The Employee and the OQA have durable power of attorney for financial management for each other 
6. The Employee has designated as his or her primary beneficiary for at least one of the following: 
a. A life insurance contract held by the Employee; or 
b. A retirement contract (including IRA, 401(k), 403(b), or pension plan) held by the Employee 
7. The Employee cannot legally marry in Michigan 

*The following individuals do not fall within the eligibility criteria for OQA under the laws of intestate succession in the State of Michigan:  
• Spouse 
• Children and their descendents (i.e., children, grandchildren) 
• Parents 
• Parents' descendents (i.e., siblings, nieces, nephews) 
• Grandparents and their descendents (i.e., aunts, uncles, cousins) 

Section B. Plan Year 2008 through Term of Agreement
1. Eligibility (.25 or Greater Appointment Fraction Eligibility) Effective January  1, 2008 and through the term of this Agreement, and consistent with the terms of each program or plan, Employees with a one-quarter (.25) or greater employment fraction in a term are eligible to participate in the University’s Health Care programs (medical and prescription drugs); Group Dental Plan (Options I, II and III); University, Optional and Dependent Life Insurance; Vision Plan; Legal Plan; Flexible Spending Accounts (Health and Dependent Care); and Travel Accident Insurance. 
2. Group Health Insurance Plan Structure The Group Health Insurance Plan (medical and prescription drug) as of January 1, 2008 will contain a 4-tier rate structure consisting of: 
a. One adult; 
b. One adult plus any number of children; 
c. One adult plus one adult dependent (including an OQA); 
d. One adult plus one adult dependent (including an OQA) plus any number of children. 
3. Employer Contribution to Group Health Insurance Premium 
a. As of January  1, 2008  and throughout the term of this Agreement, for individual Employee coverage (Tier I: one adult) in any plan, the Employer contribution toward the cost of the group health insurance plan premium will be 95% of the average premium cost of the two lowest-cost comprehensive plans available to all University employees. The Employer contribution toward the cost of group health insurance plan premiums for other tiers of coverage (those that include dependents, including OQAs) shall be the same contribution for the coverage for the Employee plus an additional contribution for covered dependents, calculated such that the Employer pays 85% of the aggregate premium cost for all covered individuals. The Employee will be responsible for any additional premium cost above the base Employer contribution rate toward the Employee’s plan of choice. 
b. The University agrees that the co-pays in effect for Plan Year 2008 for the GradCare health insurance plan will not increase more than three dollars ($3.00) for each co-pay during the life of the Agreement. 
c. Effective January 1, 2009, through the end date of this Agreement, co-pays for the prescription drug plan shall be no more than: 

Tier 1: $5.00      Tier 2:  $15.00   Tier 3: $30.00 

d.  In the event of any changes in the coverage from any of the programs or plans, the Union will be notified sixty (60) days prior to the effective date of the change. The University and the Union will meet and discuss in Special Conference any substantial change to any benefit, including but not limited to, changes in co-pays, deductibles, out-of pocket expenses, and eligibility of dependents. 
e. University contributions (except as noted in Section E below) toward all plans other than health insurance under this Article shall be in the same amount as that provided to the University’s regular non-bargained-for instructional staff for the coverage selected.  
4. Initiation of Coverage 
a. Application Procedure: Application for Group Benefit programs must be made within thirty (30) days of the effective date of employment or the date of notification described in Section B(4)(c) below, whichever is later. Applicants enrolling past 30 days of their eligibility date for the University Life and Optional Insurance plan must provide the Group Life Insurance Company with proof of insurability in order to be considered for coverage. Dependent Life Insurance for a spouse or OQA may be applied for any time and requires proof of insurability. 
b. Newly hired eligible Employees who do not either enroll in or waive medical insurance will be immediately enrolled in the GradCare medical insurance plan at the Tier I Level (one adult). Such newly-hired Employees will have thirty (30) days after employment begins to choose an alternative coverage and/or level if applicable. 
c. Not later than the 30th day after employment begins, the University will notify an Employee of the provisions of this Article including a reference to the time period requirement for application. In cases where an Employee misses the application deadline due to a lack of such notification, the University will enable the Employee to enroll in the benefits plan of his/her choice. 

Section C. Dental Coverage
Newly hired eligible Employees who do not either enroll in or waive dental insurance will be immediately enrolled in Dental Option I at the Tier I Level (one adult).  

The Employer will pay 100% of the premium for Dental Plan Option I for all Employees with employment fractions at one -quarter (.25) or greater. The Employer contribution for all other Options shall be in the same amount as that provided to the University’s non-bargained-for instructional staff for the coverage selected. For all other Employees, the Employer will make no contribution towards the cost of any other Option.

Section D. Summer Coverage
An Employee who is participating in the University Benefit plans during Term II, whether or not employed for IIIA and/ or IIIB, and either:  

a. has been re-employed under the terms of this Agreement for the following Term I or 
b. was employed during the previous Term I 

may continue coverage during the months of May, June, July, and August, between Term II and Term I by ensuring that the employing department has delivered confirmation of the Term I employment status to the Benefits Office by April 10. 

An Employee who is not employed for Term II but is employed for Term IIIA and re-employed for the following Term I may continue coverage during the months of July an August between Term IIIA and Term I by making arrangements through the Benefits Office by June 30, provided the initial employment and re-employment occur no later than the first day of Term IIIA. If employee contributions are required, the Employee will be billed monthly for the employee contributions for the months of May, June, July, and August. It is the Employee’s responsibility to provide current address information for billing purposes, if payment is not timely coverage will be cancelled.  

Section E. Less than .25 Appointment Fraction Eligibility
In conjunction with the above listed provisions, but specific to the Employee with an appointment fraction of less than one quarter (.25) the following provisions apply:  

Any Employee who is appointed with an employment fraction of below one quarter (.25) throughout not less than a whole term, may purchase GradCare medical insurance plan (Employee only, Employee + Adult, Employee + Adult + Children, Employee + Child, Employee + Children) for 0% of the total premium cost and Dental Option I at 50% of the total premium cost. The University will fund 100% of the premium cost for the GradCare medical insurance and 50% of the premium cost for Dental Option I. The Employee contribution will be made through payroll deduction; however, if payroll deduction cannot be taken due to insufficient pay, the Employee must make arrangements to pay any billed charges on a timely basis. In either case, coverage begins in the first month in which:  
1. Both an appointment notification is issued and the Benefits Office receives a completed application for the benefit from the Employee, and 
2. The Employee makes appropriate payment arrangements with the University.

Section F. Scope of Review
No matter concerning the above group benefit plans shall be subject to the Grievance and Arbitration Procedures, except for questions concerning compliance with the specific provision of this Article, and whether or not the Employee has coverage in accordance with the terms of the Plan. If, during the term of this Agreement, a federal or state law is enacted which requires the payment of taxes or premiums to either the federal or state government or another entity for hospital or medical benefits for Employees, the University may make such adjustments in the schedule of benefits provided by this Article to avoid duplication of benefits. In addition, any such taxes or premiums paid by the University shall be included in the total dollar limitations provided in this Article.