Common use of Loss of Coverage – Qualified Employee and Dependents Clause in Contracts

Loss of Coverage – Qualified Employee and Dependents. A. A Qualified Employee or an eligible spouse or registered domestic partner and/or eligible child dependent may be added to coverage at a time other than at initial enrollment of the Qualified Employee or at each open enrollment period of GROUP if they experience a loss of Minimum Essential Coverage due to one of the events listed below. Receipt of the application for coverage and any supporting documents must be within 30 days of the event. Coverage will become effective on the first day of the month following the loss of coverage. a. Loss of eligibility for health insurance coverage due to: 1. legal separation; 2. divorce; 3. cessation of dependent status; 4. termination of employment; or 5. reduction in the number of hours of employment. b. Termination of qualified employer contributions toward the employee’s or dependent’s health insurance coverage. c. Exhaustion of COBRA or Cal-COBRA coverage. B. A Qualified Employee and/or an eligible spouse or registered domestic partner and/or eligible child dependent may be added to coverage at a time other than at initial enrollment of the Qualified Employee or at each open enrollment period of GROUP if they experience a loss of Minimum Essential Coverage due to the loss of coverage through Medicare or Medi-Cal or other government sponsored health care program. Receipt of the application for coverage and any supporting documents must be within 60 days of the event. Coverage will become effective on the first day of the month following the loss of coverage.

Loss of Coverage – Qualified Employee and Dependents. A. A Qualified Employee or an eligible spouse or registered domestic partner and/or eligible child dependent may be added to coverage at a time other than at initial enrollment of the Qualified Employee or at each open enrollment period of GROUP if they experience a loss of Minimum Essential Coverage due to one of the events listed below. Receipt of the application for coverage and any supporting documents must be within 30 days of the event. Coverage will become effective on the first day of the month following the loss of coverage.: a. Loss loss of eligibility for health insurance coverage due to: 1. legal separation; 2. divorce; 3. cessation of dependent status; 4. termination of employment; or 5. reduction in the number of hours of employment. b. Termination of qualified employer contributions toward the employee’s or dependent’s health insurance coverage. c. Exhaustion exhaustion of COBRA or Cal-COBRA coverage. B. A Qualified Employee and/or an eligible spouse or registered domestic partner and/or eligible child dependent may be added to coverage at a time other than at initial enrollment of the Qualified Employee or at each open enrollment period of GROUP if they experience a loss of Minimum Essential Coverage due to the loss of coverage through Medicare or Medi-Cal or other government sponsored health care program. Receipt of the application for coverage and any supporting documents must be within 60 days of the event. Coverage will become effective on the first day of the month following the loss of coverage.