When Your Coverage Begins Your coverage will begin on the first day of the month following your eligibility date as long as we receive required enrollment information within the first thirty (30) days following your eligibility date and the premium is paid. If you or your dependents fail to enroll at this time, you cannot enroll in the plan unless you do so through an Open Enrollment Period or a Special Enrollment Period.
When Your Coverage Ends Coverage under this plan is guaranteed renewable. It can only be canceled by us for the following reasons: • if you leave your place of employment; • if you decide to discontinue coverage. Inform your employer prior to the requested date of cancellation and your employer will notify us. If we do not receive your notice prior to the requested date of cancellation, you or your employer may be responsible for paying another month’s premium; • if the required premium is not paid within one month of the due date. We will mail you a notice of discontinuance along with information about enrolling in an individual healthcare plan; • if you or a covered dependent no longer qualifies as an eligible person; • if we no longer offer this type of coverage; • if your employer contracts with another insurer or entity to provide or administer benefits for the covered healthcare services provided by this agreement; • if fraud is determined by us. See Rescission of Coverage section below for additional details; If your healthcare coverage is terminated for one of the reasons listed above, we will send you a termination notice thirty (30) days before the termination date. The notice will indicate the reason why your healthcare coverage has ended. When your coverage ends, you may apply for individual healthcare coverage directly from BCBSRI or through HSRI. You must meet the eligibility requirements and we must receive required enrollment information within sixty (60) days from the date your group coverage ended along with required premium. If you do not reside in Rhode Island, you are not eligible to enroll in an individual plan from BCBSRI or HSRI. You may be able to obtain coverage through an insurance company in the state in which you reside. Rescission is a cancellation or discontinuance of coverage that has a retroactive effect. A cancellation is not a rescission if it: • only has a prospective effect (as described above); or • is due to non-payment of premiums, which can have a retroactive cancellation effect. We may rescind your coverage if you or your dependents commit fraud. Fraud includes, but is not limited to, intentional misuse of your identification card (ID card) or intentional misrepresentation of a material fact. Any benefit paid in the past will be voided. You will be responsible to reimburse us for all costs and claims paid by us. We must provide you a written notice of a rescission at least thirty (30) days in advance. Except for non-payment, we will not contest this policy after it has been in force for a period of two (2) years from the later of the effective date of this agreement or the latest reinstatement date.
ELIGIBILITY FOR COVERAGE Any employee and the dependents of an employee who meet and continue to meet the eligibility requirements described in this Contract, will be entitled to apply for coverage under this Contract. These eligibility requirements are binding upon you and your eligible dependents. We may require acceptable documentation that an individual meets and continues to meet the eligibility requirements (e.g. proof of residency, copies of a court order naming the Subscriber as legal guardian, or appropriate adoption documentation, as described in Part IV. ENROLLMENT AND EFFECTIVE DATE OF COVERAGE).
Coverage Selection Prior to Retirement An employee who retires and is eligible to continue insurance coverage as a retiree may change his/her health or dental plan during the sixty (60) calendar day period immediately preceding the date of retirement. The employee may not add dependent coverage during this period. The change takes effect on the first day of the month following the date of retirement.
Short-term Disability Coverage Days Payable at 90% Wages Permanent Employees
Continuing Coverage If a letter of assurance is obtained from any insurer under a Hazard Insurance policy or a Flood Insurance policy that the insurance coverage shall continue in full force and effect, the Servicer shall deposit such letter in the appropriate Servicer Mortgage Loan File.
Long-term Disability Coverage New employees may enroll in long-term disability insurance by their initial effective date of coverage. Employees who become eligible for insurance may enroll in long-term disability insurance within thirty (30) days of their initial effective date as defined in this Article, Section 5C. An employee who is insurance eligible and moves from a temporary position to a permanent position will be allowed to enroll in long-term disability coverage within thirty (30) days of the event without providing evidence of insurability. The terms are the same as for employees who wish to add/increase during the annual open enrollment. During open enrollment only, an employee may purchase long-term disability coverage that provides benefits of from three hundred dollars ($300) to seven thousand dollars ($7,000) per month, based on the employee's salary, commencing on the 181st calendar day of total disability, and not subject to evidence of insurability but with a limited term pre-existing condition exclusion. Employees should be aware that other wage replacement benefits, as described in the certificate of coverage (i.e., Social Security Disability, Minnesota State Retirement Disability, etc.), may result in a reduction of the monthly benefit levels purchased. In any event, the minimum is the greater of three hundred dollars ($300) or fifteen (15) percent of the amount purchased. The minimum benefit will not be reduced by any other wage replacement benefit. In the event that the employee becomes totally disabled before age seventy (70), the premiums on this benefit shall be waived.
Exclusions from Coverage The Long-Term Disability Plan does not cover total disabilities resulting from:
A) war, insurrection, rebellion, or service in the armed forces of any country;
B) voluntary participation in a riot or civil commotion, except while an employee is in the course of performing the duties of her regular occupation; C) intentionally self-inflicted injuries or illness.
Disability Coverage In the event a State employee goes on an extended medical disability, or is receiving Workers’ Compensation benefits, the Employer-policyholder shall continue at no cost to the employee the coverage of the group life insurance for such employee for the period of such extended leave, but not beyond two (2) years.
Basic Life and Accidental Death and Dismemberment Coverage The Employer agrees to provide and pay for the following term life coverage and accidental death and dismemberment coverage for all employees eligible for an Employer Contribution, as described in Section 3. Any premium paid by the State in excess of fifty thousand dollars ($50,000) coverage is subject to a tax liability in accord with Internal Revenue Service regulations. An employee may decline coverage in excess of fifty thousand dollars ($50,000) by filing a waiver in accord with Minnesota Management & Budget procedures. The basic life insurance policy will include an accelerated benefits agreement providing for payment of benefits prior to death if the insured has a terminal condition. $10,000 - $15,000 $15,000 $15,000 $15,001 - $20,000 $20,000 $20,000 $20,001 - $25,000 $25,000 $25,000 $25,001 - $30,000 $30,000 $30,000 $30,001 - $35,000 $35,000 $35,000 $35,001 - $40,000 $40,000 $40,000 $40,001 - $45,000 $45,000 $45,000 $45,001 - $50,000 $50,000 $50,000 $50,001 - $55,000 $55,000 $55,000 $55,001 - $60,000 $60,000 $60,000 $60,001 - $65,000 $65,000 $65,000 $65,001 - $70,000 $70,000 $70,000 $70,001 - $75,000 $75,000 $75,000 $75,001 - $80,000 $80,000 $80,000 $80,001 - $85,000 $85,000 $85,000 $85,001 - $90,000 $90,000 $90,000 Over $90,000 $95,000 $95,000
