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| MEDICAL |
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| Other
Information |
Non-duplication of Benefits
You or members of your family may be covered under another group medical
plan, such as a plan provided by your spouse’s employer. Through
a non-duplication of benefits provision, the Valassis medical plans
are designed to coordinate with other coverage you might have.
How Non-duplication of Benefits Works
When you or a covered dependent have dual coverage, a coordination of
benefits (COB) provision will apply. The purpose of this provision is
to avoid duplicate payment of benefits in the event an individual is
covered by more than one health plan.
The plan that pays the expenses first depends on which plan is primary
and which is secondary. The primary plan pays first. Usually, an associate’s
plan pays first for the associate and second for the spouse, if the
spouse has coverage elsewhere.
For your children, the "birthday" rule determines which plan
(yours or your spouse's is primary. The plan covering the spouse whose
birth date (excluding the year) falls earlier in the year is primary
for the children. If you and your spouse have the same birth date (excluding
the year), the plan covering you or your spouse for the longer period
of time is primary. If the other plan does not have the birthday rule,
the father's plan is primary.
If you are divorced or legally separated and have children, the plan
covering the parent who has financial responsibility for the children's
medical expenses according to a court decree is primary. If there is
no court decree, the plan covering the parent with legal custody is
primary. If the parent with custody is remarried, the new spouse's plan
is secondary, followed by the plan of the parent without custody. In
case of joint custody, the birthday rule applies.
Right of Recovery
If the amount of the payments made under the medical plans is
more than those plans should have paid under the non-duplication of
benefits provision, the company may recover the excess from one or more
of the persons it has paid or for whom it has paid, or any other person
or organization that may be responsible for the benefits or services
provided.
Release of Information
The plans reserve the right to release
information to or obtain information from any insurance company,
or other organization or individual, for the purposes of administering
the non-duplication of benefits provision.
When Coverage Ends
Coverage under the medical plan terminates on the last day of the month
following the earliest of the following dates:
- The date your employment ends,
- The date any of these plans is terminated,
- The date you are no longer in an eligible class (which may apply
to all or part of your coverage), or
- The date you fail to make any required contribution.
If you stop active work, contact the your Human Resources Representative
(Valassis Communications, Inc. and NCH associates paid through ADP)
or the Associate Resource Center (Valassis Direct Mail and Sales &
Marketing associates paid through PeopleSoft) to determine if any coverage
can be continued.
Dependent Coverage
A dependent’s coverage terminates at the earliest of:
- Termination of all dependents’ coverage under the plan,
- The end of the calendar month in which the dependent child reaches
age 19, or at age 25 if attending school on a full-time basis, or
- When the related associate’s coverage terminates.
Certification of Prior Medical Coverage
Under the Health Insurance Portability and Accountability Act of 1996
(HIPAA), you may need to provide certification of prior medical coverage.
You will need this certification if:
- You need to satisfy a plan’s preexisting condition limitation,
- You decline medical coverage for the calendar year and later lose
coverage under another company-provided plan (such as your spouse’s
medical plan), or
- Your COBRA coverage ends.
Your prior plan may simply state in writing:
- That you had at least 18 months of creditable coverage,
- That coverage was not interrupted by a significant break in service,
- The name and address of the former carrier and the plan number,
and
- The date coverage ended.
If coverage was lost as the result of divorce or the death of your
spouse, a copy of the divorce decree or death certificate may be required.
If coverage is requested as a result of a court order, a copy of the
court order may be requested.
With this certification, the time you were covered for medical benefits
will be credited toward any preexisting condition limitation, if any,
in your new plan, provided you are enrolled in the new plan within 63
days of losing your Valassis coverage.
If you were covered under another company’s medical plan prior
to joining Valassis, you should automatically receive a certification
of coverage from that plan.
 
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