Conversion after Continuation Coverage Sample Clauses

Conversion after Continuation Coverage. Federal law provides for the guaranteed availability of coverage, when continuation coverage as provided under the provisions of the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) expires. Under these provisions, the Subscriber or Covered Dependent may be eligible for coverage under an AvMed Individual Contract, and may apply by completing a coverage application form. Coverage is subject to AvMed’s eligibility requirements and enrollment may be limited to annual open enrollment periods. To be considered for coverage outside of the annual open enrollment period, subject to the rules of special enrollment listed in Section 4.3, the required Premium payment, along with proof of a qualifying event and completed enrollment application form must be submitted to: AvMed Individual Sales Accounts Receivable 0000 Xxxxx Xxxxxxxx Xxxx Xxxxx 000 Miami, Florida 33156 VI. 5B ONTHLY PREMIUM PAYMENTS, COPAYMENTS, COINSURANCE AND DEDUCTIBLES This Part explains the Premium payment responsibilities of the Subscribing Group under this Contract, and Members’ monetary responsibility for expenses for Covered Services received. Members are responsible and will be liable for applicable Deductibles, Copayments or Coinsurance amounts which must be paid to Health Care Providers for certain services at the time services are rendered, as shown in the Schedule of Benefits. In addition to the information explained in this Part, it is important that you refer to your Schedule of Benefits to determine your share of the cost for Covered Services.
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Related to Conversion after Continuation Coverage

  • Continuation Coverage Consistent with state and federal laws, certain employees, former employees, dependents, and former dependents may continue group health, dental, and/or life coverage at their own expense for a fixed length of time. As of the date of this Agreement, state and federal laws allow certain group coverages to be continued if they would otherwise terminate due to:

  • COBRA or State Continuation Coverage If a Member whose coverage is provided under COBRA or under a right of continuation provided by state or other federal law is covered under another plan, the plan covering the Member as an employee, member, Subscriber or retiree or covering the Member as a Dependent of an employee, member, Subscriber or retiree is the primary plan and the COBRA or state or other federal continuation coverage is the secondary plan. If the other plan does not have this rule, and as a result, the plans do not agree on the order of benefits, this rule is ignored. This rule does not apply if the rule under Section D.1. can determine the order of benefits.

  • Spousal Coverage Any new Participants to the COG, after June 30, 2015, with working spouses who have the ability to be covered under an insurance plan through his/her place of employment, will be required to take his/her plan as their primary plan. This provision does not apply to a participant who had insurance with one COG employer and immediately thereafter, moved to another COG employer. If the spouse is required to pay forty (40%) percent or more of the premium with his/her employer, the requirements of this section shall not apply.

  • Dental Coverage 206. Each employee covered by this agreement shall be eligible to participate in the City's dental program.

  • Continuation of Optional Coverages During Unpaid Leave or Layoff An employee who takes an unpaid leave of absence or who is laid off may discontinue premium payments on optional policies during the period of leave or layoff. If the employee returns within one (1) year, the employee shall be permitted to pick up all optionals held prior to the leave or layoff. For purposes of reinstating such optional coverages, the following limitations shall be applicable. For the first twenty-four (24) months of long-term disability coverage after such a period of leave or layoff during which long-term disability coverage was discontinued, any such disability coverage shall exclude coverage for pre-existing conditions. For disability purposes, a pre-existing condition is defined as any disability which is caused by, or results from, any injury, sickness or pregnancy which occurred, was diagnosed, or for which medical care was received during the period of leave or layoff. In addition, any pre-existing condition limitations that would have been in effect under the policy but for the discontinuance of coverage shall continue to apply as provided in the policy. The limitations set forth above do not apply to leaves that qualify under the Family Medical Leave Act (FMLA).

  • Retiree Coverage Pre-Medicare: Employees who retire on or after January 1, 2011, will be provided the same health care benefits, including but not limited to, cost sharing, that it provides to its active employees until the retiree becomes eligible for Medicare. In the event health care benefits for active employees are eliminated in their entirety, which shall include a change to a one-hundred (100%) percent employee contributory health savings plan, the last health care benefits plan in effect for retirees preceding the elimination of the plan shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides a health care benefits plan to active employees. Medicare: Retirees must enroll in the Part B Medicare program commencing on the date they first become eligible to participate in the program. Retirees shall be responsible for the cost of such coverage. The Employer shall make available to those retirees who are properly enrolled in the Part B Medicare Program as above provided, a Supplemental Plan, with a $100 deductible. Such Plan will have the same Rx drug benefits the County provides its active employees. In the event Rx drug benefits for active employees are eliminated in their entirety, which shall include a change to a one-hundred (100%) percent employee contributory health savings plan, the Rx drug benefits last in effect for retirees preceding the elimination of the Rx drug benefits for active employees shall remain in effect (absent a contrary order from a Court of competent jurisdiction) until the Employer again provides Rx drug benefits to active employees.

  • Contribution Formula Dental Coverage a. Faculty Member Coverage. For faculty member dental coverage, the Employer contributes an amount equal to the lesser of ninety percent (90%) of the faculty member premium of the State Dental Plan, or the actual faculty member premium of the dental plan chosen by the faculty member. However, for calendar years beginning January 1, 2014, and January 1, 2015, the minimum employee contribution shall be five dollars ($5.00) per month.

  • Insurance Continuation The Board shall continue to pay the Board contribution necessary to continue all medical, dental, and life insurance plans for the employee while he/she is on leave under this article.

  • Continuation of Coverage If your coverage is terminated, you may be eligible to continue your coverage in accordance with state or federal law. Continuation of Coverage According to State Law In accordance with R.I. General Laws §. 27-19.1, if your employment is terminated due to one of the following reason, your healthcare coverage may be continued, provided that you continue to pay the applicable premiums. • Involuntary layoff or death; • The workplace ceasing to exist; or • Permanent reduction in size of the workforce. The period of this continuation will be for up to eighteen (18) months from your termination date, but not to exceed the period of continuous employment preceding termination with your employer. The continuation period will end for any person covered under your policy on the date the person becomes employed by another group and is eligible for benefits under that group’s plan.

  • Continuation of Insurance Benefits Notwithstanding any other provision in this Agreement to the contrary, the Bank and/or its successor shall maintain in full force and effect for Employee's continued benefit, for the two (2) year period beginning upon a Change in Control, all life insurance, medical, health and accident and disability policies, plans, programs or arrangements which were in effect immediately prior to the Change in Control.

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