My spouse and I both work at Caterpillar. Do we pay our own premiums and have our own deductibles and maximum out-of-pocket amounts?
Yes, you'll each enroll on your own. If you have dependents, you'll decide which spouse will enroll for employee + dependent(s) coverage.
Does the birthday rule apply when deciding who covers the children of a dual-Caterpillar couple?
No. It's up to the employee to decide which spouse should cover the dependents. The children can only be covered under one Caterpillar employee, so the birthday rule cannot apply to dual-Caterpillar couples. The birthday rule is used to coordinate benefits between Caterpillar and other employer coverage and would be used to determine whose coverage is primary if the non-Caterpillar spouse covers the children under his/her medical plan in addition to the Caterpillar plan.
If one spouse is on the PPO plan and the other spouse is on the EPO plan, can the couple coordinate benefits for secondary coverage?
No. Dual-Caterpillar couples cannot coordinate benefits for secondary coverage. Each employee is required to be on his/her own healthcare plan and cannot be considered as a dependent on the other.
In a family dual-Caterpillar couple situation in which they're enrolled in two different plans (one as an individual and the other as employee + dependents), will their deductibles and maximum out-of-pocket (MOOP) amounts be combined?
No. One employee would be enrolled for single coverage and be responsible for an individual deductible and MOOP. The other employee would enroll for employee + dependent(s) coverage and be responsible for the family deductible and MOOP.