Common use of Health Insurance Plan Clause in Contracts

Health Insurance Plan. Provisions applicable to the modular plan 4.2.1 Description of the modules The health insurance plan offers the following three modules: - Bronze module; - Silver module; - Gold module. 4.2.2 Minimum period of participation This modular plan stipulates a minimum period of participation of 24 months before the participant can switch to a lower-level module, whether or not she has a life event leading to a change in her family situation. Participants may switch to a higher-level module at any time. However, the 24-month minimum period of participation is considered to be completed on this contract’s effective date for participants who had the basic prescription drug plan and the extended plan III under the previous contract and who are maintaining equivalent coverage, i.e. the Silver module, under this contract. 4.2.3 Participants who are totally disabled or temporarily absent from work A participant who is totally disabled or temporarily absent from work on this contract’s effective date will automatically be assigned one of the following modules, depending on her situation: - Bronze module, if the participant only had the basic prescription drug plan under the previous contract; or - Silver module, if the participant had the basic prescription drug plan and the extended health III under the previous contract. If the participant wants to switch modules at the end of her period of total disability or temporary absence from work, she must fill out a request to that effect within 30 days from the date of her effective return to work. In that case, the change in module takes effect on the date of her effective return to work. If the request is not submitted within the required time frame, the change in module takes effect on the date the request is signed. 4.2.4 Effective date of a change in module at the end of a minimum period of participation If the participant wants to switch to a lower-level module at the end of a minimum period of participation, she must fill out a request to that effect within 30 days of the period’s end date. In that case, the change in module takes effect on the end date of the minimum period of participation. If the request is not submitted within the required time frame, the change in module takes effect on the date the request is signed. If the participant wants to switch to a higher-level module, the change takes effect on the date the request submitted by the participant to that effect is signed.