Reso 98-109 - Laserfiche WebLink

Home Browse Search

Ronda Municipal Insurance Trust Medical Master Plan of Benefits application is not received on or before the expiration of 30 days following the effective date of the Participation Agreement of the employer, any application for coverage by an employee, or his eligible dependents, will be governed by the provisions set forth in Enrollment Paragraph (4). (2) In the event an employee, or eligible dependents, were validly covered under a group health insurance plan issued to the employer and in effect immediately prior to the effective date of this Plan and such plan is discontinued and replaced with this Plan, all such employees and eligible dependents actually covered under such prior plan shall be eligible to participate in this Plan, without interruption of coverage and without proof of insurability, unless such employee or dependent is entitled to any extension of benefits in accordance with S. 627.667, F,S., under the terms of the prior plan, and provided the Trust receives a properly and accurately completed and executed enrollment form, and any required medical statement application, no later than 30 days following the effective date of the Participation Agreement of the employer. In the event such employee or dependent is entitled to an extension of benefits in accordance with S. 627.667, F.S., under the terms of the prior plan, such employee or participant shall be entitled to participate in this Plan without interruption of coverage and without proof of insurability provided the Trust receives an accurately completed and executed enrollment form, and any required medical statement application, no later than 30 days following the effective date of the Participation Agreement of the employer; however, the level of benefits under this Plan shall be no more than the applicable level of benefits under this plan reduced by any benefits payable under the prior Plan. Upon request, the employer, employee and dependent shall provide the Trust , such information as is reasonably necessary, including the prior plan, to coordinate the level of benefits payable under this Plan and the prior plan, for the Trust to verify the level of benefits provided under the prior plan, and to determine each employee and dependent who was validly covered under the prior plan on the date of discontinuance of the prior plan. If application is not received on or before the expiration of 30 days following the effective date of ~e Participation Agreement of the employer, any application for coverage by an employee, or his eligible dependents, will be governed by the provisions set . forth in Enrollment Paragraph (4). EHe:ibllity - Employees and eligible dependents shall be eligible for coverage on or after the effective date of this Plan if: (1) They fall within the classification set forth in the Employer's Participation Agreement; and (2) They have completed the period of continuous employment with the employer as set forth in such classification. An employee shall not be eligible as a dependent under the same employer group except when both spouses are eligible employees and desire dependent child(ren) coverage. In that case, one employee may cover the spouse and children as dependents for health benefits and the spouse may be covered as a single employee for other employee coverage(s). Enrollment - Employees and eligible dependents may enroll for coverage under the Plan by completing and submitting to the employer an accurately completed and executed enrollment form provided by the Trust, as specified below: