Glossary
Active Work Status
You must be actively-at-work during your approved scheduled work week and not on any type of leave.
Actively at Work
You are "actively at work" if you are fulfilling your job responsibilities at a Company-approved location on the day coverage is supposed to begin (e.g., you are not out ill or on a leave of absence).
After-tax (Post-tax) Contributions
Contributions taken from your paycheck after taxes are withheld.
Approved Spouse and Domestic Partner
Adding a spouse or same gender or opposite gender domestic partner to certain benefits coverage is permitted upon employment or during the Annual Enrollment period for coverage effective the following January 1st if you satisfy the plans' criteria, or immediately upon satisfying the plans' criteria if you previously did not qualify. To obtain spousal or domestic partner coverage, you will need to complete an Affidavit of Eligible Family Membership via PeopleLink (www.mmcpeoplelink.com), declaring that:
Spouse / Domestic Partner
  • You have already received a marriage license from a U.S. state or local authority, or registered your domestic partnership with a U.S. state or local authority.
Spouse Only
  • Although not registered with a U.S. state or local authority, your relationship constitutes a marriage under U.S. state or local law (e.g. common law marriage or a marriage outside the U.S. that is honored under U.S. state or local law).
Domestic Partner Only
  • Although not registered with a U.S. state or local authority, your relationship constitutes an eligible domestic partnership. To establish that your relationship constitutes an eligible domestic partnership you and your domestic partner must:
    • be at least 18 years old
    • not be legally married, under federal law, to each other or anyone else or part of another domestic partnership during the previous 12 months
    • currently be in an exclusive, committed relationship with each other that has existed for at least 12 months and is intended to be permanent
    • currently reside together, and have resided together for at least the previous 12 months, and intend to do so permanently
    • have agreed to share responsibility for each other's common welfare and basic financial obligations
    • not be related by blood to a degree of closeness that would prohibit marriage under applicable state law.
Marsh & McLennan Companies reserves the right to require documentary proof of your domestic partnership or marriage at any time, for the purpose of determining benefits eligibility. If requested, you must provide documents verifying the registration of your domestic partnership with a state or local authority, your cohabitation and/or mutual commitment, or a marriage license that has been approved by a state or local government authority.
Once your Affidavit of Eligible Family Membership is completed and processed, you may cover the dependent child(ren) of your spouse or domestic partner.
Complete your affidavit, via PeopleLink (www.mmcpeoplelink.com). Select the Health tab and under Vision, click Vision Care Plan. Then go to Take Action in the right navigation bar and select Enroll, view, change benefits.
Before-tax (Pre-tax) Contributions
Contributions taken from your paycheck generally before Social Security (FICA and Medicare) and federal unemployment insurance (FUTA) taxes and other applicable federal, state, and other income taxes are withheld.
Claims Administrator
Vendor that administers the Plan and processes claims; the vendor's decisions are final and binding.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
A Federal law that lets you and your eligible family members covered by a group health plan extend group health coverage temporarily, at their own expense, at group rates plus an administrative fee, in certain circumstances when their coverage would otherwise end due to a "qualifying event", as defined under COBRA.
A "qualifying event" under COBRA includes loss of coverage as a result of your leaving the Company (other than for gross misconduct); a reduction in hours, your death, divorce or legal separation; your eligibility for Medicare, or a dependent child's loss of dependent status; or, if you are a retiree, loss of coverage due to the Company filing for bankruptcy.
Coordination of Benefits
You or a covered family member may be entitled to benefits under another group health plan (such as a plan sponsored by your spouse's employer) that pays part or all of your health treatment costs. If this is the case, benefits from this plan will be "coordinated" with the benefits from the other plan. In addition to having your benefits coordinated with other group health plans, benefits from this plan are coordinated with "no fault" automobile insurance and any payments recoverable under any workers' compensation law, occupational disease law or similar legislation.
Covered Service(s)
See the detailed list of covered vision services covered under the plan.
Covered vision services must be provided:
  • when the plan is in effect
  • prior to the effective date of any of the individual termination conditions set forth in this Summary Plan Description
  • only when the person who receives services is a covered person and meets all eligibility requirements specified in the plan.
Decisions about whether to cover new technologies, procedures and treatments will be consistent with conclusions of prevailing medical research based on well-conducted randomized trials or group studies.
The Claims Administrator determines only the extent to which a service or supply is covered under the plan and not whether the service or supply should be rendered. The coverage determination is made using the descriptions of covered charges included in this section and the Claims Administrator's own internal guidelines. The decision to accept a service or obtain a supply is yours.
Disability
A physical or mental impairment that substantially limits one or more of an individual's major life activities.
Eligible Family Members
Child/Dependent Child means:
  • your biological child 
  • a child for whom you or your spouse are the legally appointed guardian with full financial responsibility
  • the child of an approved domestic partner
  • your stepchild
  • your legally adopted child or a child or child placed with you for adoption.
Note: Any child that meets one of these eligibility requirements and who is incapable of self support by reason of a total physical or mental disability as determined by the Claims Administrator, may be covered beyond the end of the calendar year in which the child attains age 26.
Dependent children are eligible for healthcare coverage until the end of the calendar year in which they attain age 26. This eligibility provision applies even if your child is married, has access to coverage through his or her employer, doesn't attend school full-time or doesn't live with you, and is not your tax dependent.
Note: While married children are eligible for healthcare coverage under your plan until the end of the calendar year in which they attain age 26, this provision does not apply to your child's spouse and/or child(ren), unless you or your spouse is the child's legally appointed guardian with full financial responsibility.
The Company has the right to require documentation to verify dependency (such as a copy of the court order appointing legal guardianship). Company medical coverage does not cover foster children or other children living with you, including your grandchildren, unless you are their legal guardian with full financial responsibility—that is, you or your spouse claims them as a dependent on your annual tax return.
Eligible MMA Employees
As used throughout this document, "MMA Employees" are defined as employees classified on payroll as U.S. regular employees of MMA Corporate, Insurance Alliance, MMA-NIA or the MMA Anchorage office.
Eligible Marsh & McLennan Companies Employees (other than MMA)
As used throughout this document, "Marsh & McLennan Companies Employees (other than MMA)" are defined as employees classified on payroll as U.S. regular employees of Marsh & McLennan Companies or any subsidiary or affiliate of Marsh & McLennan Companies (other than MMA and any of its subsidiaries).
In-network Providers
Preferred health care providers who have agreed to charge reduced fees to members.
Out-of-network Providers
Health care providers who are not in-network providers. Except in an emergency or when needed for urgent care services, you do not receive benefits if you receive care outside the network.
Qualified Family Status Change (Status Change, Qualified Change in Family Status)
An event that changes your benefit eligibility. For example, getting married and having a child or your spouse or dependent lose other coverage. You can make certain changes to your before-tax benefit elections that are due to and consistent with the change in family status.
Qualifying Event
A "qualifying event" under COBRA includes loss of coverage as a result of your leaving the Company (other than for gross misconduct); a reduction in hours, your death, divorce or legal separation; your eligibility for Medicare, or a dependent child's loss of dependent status; or, if you are a retiree, loss of coverage due to the Company filing for bankruptcy.
Waiting Period/Elimination Period
The amount of time you must wait before being able to participate in a plan.