ELIGIBILITY AND EFFECTIVE DATE OF COVERAGE

PARTICIPANT COVERAGE

Participant Eligibility

A participant establishes initial eligibility for benefits on the day following the date he or she completes 90 days of covered employment within a period of any 182 consecutive days. A participant who then loses eligibility will re-establish eligibility for benefits on the day following the date he or she completes thirty 30 days of covered employment within a period of 182 consecutive days. Please note: Eligibility for Administrative, Union and certain other employees is established on the date the participant completes 90 days of covered employment.

Covered Employment

Covered employment includes the following:

• Days of actual employment with companies signatory to the AMO Medical Plan;
• Days of paid vacation from the AMO Vacation Plan when taken provided 30 or more days of actual shipboard employment are completed within the immediately preceding six consecutive months, unless as provided in item 7 of this section;
• Days the participant receives unearned wages from a Deep Sea company and for which the company makes contributions to this plan;
• Days of disability for which the participant receives Disability Benefits (Accident and Sickness Benefits) from this plan;
• Days of participation as an observer under the Observer Training Program sponsored by the American Maritime Officers Safety and Education Plan;
• Days of company paid sick leave as reported to the AMO Medical Plan by Great Lakes Area contributing Employers and for which the company makes contributions to this plan;
• Days of family leave for Great Lakes employment under an AMO contract which provides family leave and under which the company makes family leave contributions to this plan;
• For Inland Waters and Great Lakes Tugboat employees who are scheduled for a specified number of days on and off a covered vessel, ninety (90) days of covered employment for initial eligibility purposes will include scheduled days off provided the participant returns to a covered vessel at the conclusion of the scheduled days off.

For those Inland Waters employees who are considered permanent relief employees, 1½ days of eligibility will be granted for each day of actual shipboard employment.

Duration of Eligibility

Unless terminated earlier:

• Group 1 Deep Sea, Great Lakes and Inland Water participants remain eligible for benefits for 182 consecutive days following their last date of covered employment;
• Administrative, Union, and certain other participants remain eligible for 30 days following their last date of covered employment (or as otherwise provided in the applicable Collective Bargaining Agreement);
• Pensioners who return to covered employment and meet the eligibility requirements for active benefits will terminate active eligibility on their last date of covered employment;
• Coverage will begin at 12:01 AM, Standard Time, on your effective date.

DEPENDENT COVERAGE

Dependent Eligibility

A dependent is eligible to be covered on the later of:

• The date the participant is covered;
• The date of the participant's marriage for a dependent acquired on that date;
• The child's date of birth;
• The date a court order places a child in the participant's home. The child must be under the participant's legal guardianship;
• The date a child is legally adopted; or
• The date a valid court order is issued which, by federal law or plan provision, requires the plan to provide coverage;
• Dependents may only be covered if the participant is covered. Check with the plan on how to enroll for dependent coverage. When both parents are participants, each may enroll for dependent coverage.

Dependent Effective Date:

Each dependent’s effective date of coverage is determined by the plan administrator: Coverage will begin at 12:01 AM, Standard Time, on the dependent’s effective date.

A dependent child that becomes a participant must apply for coverage as a participant to remain covered by the plan. The dependent child will no longer continue to be eligible as your dependent.

PENSIONER COVERAGE

You will be eligible for pensioner coverage if you meet the eligibility requirements as defined in the AMO Medical Plan Rules and Regulations, which are contained in a separate document. If you meet the requirements, coverage will include any of your eligible dependents.

Please Note: If you are Medicare eligible, you must have both Part A and Part B Medicare coverage. Claims must be submitted to Medicare first. After Medicare has processed your claim, the claim and the Medicare EOB should be submitted to this plan.