Using the Plan FAQs

IF A MEMBER SATISFIES THE ANNUAL DEDUCTIBLE OR OOP MAXIMUM UNDER THE LMHW PLAN FOR ACTIVES, THEN SWITCHES TO THE RETIREE LMHW PLAN MID-YEAR, DO THEY START FRESH UNDER THE RETIREE LMHW PLAN, WOULD THEY NEED TO SATISFY THE DEDUCTIBLE AND OOP MAXIMUM AS IF STARTING FROM SCRATCH?

If a member satisfies the annual deductible or OOP maximum under the LMHW Plan for actives, then switches to the retiree LMHW Plan mid-year, they do not start fresh under the retiree LMHW Plan.  The satisfied amount of deductible and out of pocket maximum would carry over to the retiree LMHW Plan (this assumes the member changed from the active plan to the retiree plan in the same plan year) .

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