South Central Top FAQ’s

What if I have coverage elsewhere and want to waive coverage under the fund?
You may waive your coverage under this Fund by selecting that option during the enrollment process. However, if you choose to waive coverage you will not have an opportunity to re-enroll for benefits during the Plan Year, unless you experience a Qualified Life Event.

What is a Qualified Life Event (QLE)?
A Qualified Life Event (QLE) is an occurrence that will allow a special enrollment period. Examples of QLEs are marriage, divorce, birth or adoption of a dependent child, or loss of other health insurance coverage. Please refer to the Fund’s Notice of Special Enrollment Rights for more details on QLEs and the required notification periods. Please refer to page 27 of your current Summary Plan Description.

What if I enroll for ‘EMPLOYEE-ONLY’ coverage and then get married?
Your marriage would be considered a Qualified Life Event (QLE) and if you are eligible for spousal coverage and you notify the Fund within 31 days of your marriage you will be given an opportunity to enroll your spouse.

Why do you need information regarding  my spouse’s employer-offered coverage if my spouse did not enroll for that coverage?
The Fund has implemented a ‘Working Spouse Fee’. If your spouse is employed and declines coverage under a health care plan sponsored by his/her employer, you must pay a ‘Working Spouse Fee’ of $150.00 per month to obtain primary coverage for your spouse under this Fund. If the ‘Working Spouse Fee’ is not paid, this Fund will provide secondary coverage for your spouse and will estimate that the other coverage would have paid 80% of allowed charges. Please note, the ‘Working Spouse Fee’ is not required if both you and your spouse are both employed by the Kroger Co. and have coverage through this Fund provided you both enroll and elect coverage.

Can I add my dependent child(ren) up to age 26?
If you are eligible for dependent coverage, the Plan will provide coverage for dependent child(ren) unmarried/married, up to age 26.

If my employment terminates, when will my insurance benefits terminate?
The last day of the month in which your employment terminates provided you achieved eligibility for benefits that month by hours worked. Please refer to the current Summary Plan Description Booklet for more details.