Common use of Continuation of Coverage Clause in Contracts

Continuation of Coverage. Unless cancellation of this Certificate is made for reasons specified in IV. A. 1. (a), (b), (c), or (d), Subscribers who continue to pay appropriate Contributions and Copayments will have their Certificates automatically renewed at the expiration of the first twelve (12) months. The following conditions also will apply: A. At the attainment of the applicable age, coverage as a Dependent shall be extended if the individual is and continues to be both: 1. Incapable of self-sustaining employment by reason of mental retardation or physical handicap; and 2. Chiefly dependent upon the Subscriber for support and maintenance, provided proof of such incapacity and dependency is furnished to Company by the Subscriber within thirty-one (31) days of the Dependent’s attainment of the limiting age and subsequently as may be required by Company, but not more frequently than annually after the two-year period following the Dependent’s attainment of the limiting age. B. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that certain employers maintaining group medical and dental plans offer employees and their Dependents the opportunity to continue their coverage when such coverage ends under certain conditions. It is possible that a given employer is exempt from COBRA, particularly if there are less than 20 employees at all times during the calendar year. More information about COBRA continuation can be obtained from a Subscriber’s employer. COBRA does not apply to coverage maintained on any basis other than that through an employer-employee relationship.

Appears in 5 contracts

Samples: Dental Plan Agreement, Dental Plan Agreement, Dental Plan Agreement

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Continuation of Coverage. Unless cancellation of this Certificate is made for reasons specified in IV. A. 1. (a), (b), (c), or (d), Subscribers who continue to pay appropriate Contributions and Copayments will have their Certificates automatically renewed at the expiration of the first twelve (12) months. The following conditions also will apply: A. At the attainment of the applicable age, coverage as a Dependent shall be extended if the individual is and continues to be both: 1. Incapable of self-sustaining employment by reason of mental retardation or physical handicap; and 2. Chiefly dependent upon the Subscriber for support and maintenance, provided proof of such incapacity and dependency is furnished to Company by the Subscriber within thirty-one (31) days of the Dependent’s 's attainment of the limiting age and subsequently as may be required by Company, but not more frequently than annually after the two-year period following the Dependent’s 's attainment of the limiting age. B. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that certain employers maintaining group medical and dental plans offer employees and their Dependents the opportunity to continue their coverage when such coverage ends under certain conditions. It is possible that a given employer is exempt from COBRA, particularly if there are less than 20 employees at all times during the calendar year. More information about COBRA continuation can be obtained from a Subscriber’s 's employer. COBRA does not apply to coverage maintained on any basis other than that through an employer-employee relationship.

Appears in 2 contracts

Samples: Agreement and Certificate of Benefits, Agreement and Certificate of Benefits

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Continuation of Coverage. Unless cancellation of this Certificate is made for reasons specified in IV. A. 1. (a), (b), (c), or (d), Subscribers who continue to pay appropriate Contributions and Copayments will have their Certificates automatically renewed at the expiration of the first twelve (12) months. The following conditions also will apply: A. At the attainment of the applicable age, coverage as a Dependent shall be extended if the individual is and continues to be both: 1. Incapable of self-sustaining employment by reason of mental retardation or physical handicap; and 2. Chiefly dependent upon the Subscriber for support and maintenance, provided proof of such incapacity and dependency is furnished to Company by the Subscriber within thirty-one (31) days of the Dependent’s attainment of the limiting age and subsequently as may be OHGNCERT04 3 required by Company, but not more frequently than annually after the two-year period following the Dependent’s attainment of the limiting age. B. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that certain employers maintaining group medical and dental plans offer employees and their Dependents the opportunity to continue their coverage when such coverage ends under certain conditions. It is possible that a given employer is exempt from COBRA, particularly if there are less than 20 employees at all times during the calendar year. More information about COBRA continuation can be obtained from a Subscriber’s employer. COBRA does not apply to coverage maintained on any basis other than that through an employer-employee relationship.

Appears in 1 contract

Samples: Dental Plan Agreement

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