Reso 98-109 - Laserfiche WebLink

Home Browse Search

Ronda Municipal Insurance Trust Medical Master Plan of Beneflts (3) Soecial enrollment period - within 30 days of certain events or loss of coverage as ou tlined below: (a) An eligible employee andj or eligible dependent except a totally disabled dependent or a dependent exposed to the HIV infection or a specific sickness or medical condition derived from such exposure, was: <D covered under another health benefit plan as an employee or dependent, or COBRA continuation of coverage at the time of initial eligibility to enroll for coverage under this Plan, and a> When offered coverage under this Plan at the time of initial eligibility stated, in writing, that coverage under another health plan was the reason for declining enrollment, and a> Demonstrated that loss of coverage under an individual or group health benefit plan occurred within the past thirty (30) days as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment, and @ Requests enrollment within thirty (30) days after the termination of coverage under another health benefit plan. (b) An individual who loses coverage as a result of termination for failure to pay premiumsjprepayment fee on a timely basis, or the discontinuance of any contributions toward the health coverage plan by the employer, or for cause does not have the right to special enrollment under this Plan. Voluntary termination of coverage does not constitute loss of eligibility of coverage. (c) A newly eligible dependent, except a totally disabled dependent or a dependent exposed to the HIV infection or a specific sickness or medical condition derived from such exposure, as a result of marriage, birth, adoption or placement for adoption, legal guardianship or court order, without proof of insurability provided the Trust has received an accurately completed and executed enrollment form, within thirty (30) days of the event. Eligible dependents may only be enrolled if the eligible dependent is a dependent of an employee who is already participating in the Plan. If the employee fails to apply within the thirty (30) day period, any application for coverage will be governed by Paragraph (4) of this Section. <D In the event of marriage, the effective date of coverage shall be the frrst day of the month following receipt of notification by the Trust. a> In the event of a newborn, coverage will take effect on the date of birth and will continue for thirty (30) days. Coverage beyond this period requires the enrollment form as specified above. If application is not received during this time period, the Trust reserves the right to charge an additional premium for coverage of such newborn from date of birth to the date of receipt of application or the end of the thirty (30) day period. a> In the event of an adoption of a newborn child, if a written application to adopt. a newborn child has been entered into by the employee prior to the 1?irth of the child, such child shall be subject to the conditions and entitled to the benefits and services provided in this Plan applicable to newborn children provided the child is ultimately adopted pursuant to Ch. 63, F.S. As a condition of coverage, the written agreement shall