Reso 98-109 - Laserfiche WebLink

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Ronda Municipal Insurance Trust Medical Master Plan of Beneflts dependents who enroll in the Plan during the initial enrollment period, and (2) for a l2 month period beginning on the effective date for employees and their dependents who enroll in the Plan during the open enrollment period and the special enrollment period. All participants enrolled subsequent to the effective date of this Plan will be subject to this pre-existing condition limitation, except newborn or adopted dependents th'at are properly enrolled in accordance with this Plan. Credit will be given for the time an eligible participant was covered under previous coverage, if the previous coverage was similar to or exceeded the coverage provided under this Plan and the previous coverage was continuous to a date not more than 62 days prior to the participant's effective date of coverage under this Plan, exclusive of any waiting period under this Plan. The eligible participant may prove periods of prior health coverage by providing a certificate of creditable coverage, which includes periods of coverage and benefit coverage levels. No pre-existing limitation will apply for an eligible participant presenting a certificate of creditable coverage indicating continuous coverage similar to or exceeding the coverage provided under this Plan, if the previous coverage was more than 12 months with no more than a 62 break in coverage prior to the participant's effective date of coverage under this Plan, exclusive of any waiting period under this Plan. SECTION XI-TIME OF PAYMENT, GRACE PERIOD All contributions are due and payable on the fIrst day of each month for which coverage under this Plan is provided. If the employer fails to pay the contributions to the Trust within twenty (20) days after they become due and payable, the Plan is automatically terminated effective the fIrst day of the month in which such contributions were due and payable; no participant shall thereafter be entitled to any further benefits hereunder. In the event this Plan terminates for any reason, the employer shall be liable for all contributions due and unpaid as of the date of termination in the event that claims were paid after the contributions became due and payable. The Trust must give an employer forty-five (45) days written notice of any change in the monthly rate of contribution or any changes in this Plan's terms or benefits. SECTION XII - CONDITIONS FOR RENDERING SERVICE The participant shall present proper identification issued by the Trust when applying for hospital, physician,. pharmacy or other medical services covered under this Plan. The Plan does not cbnfer upon the Trust or any hospital any rights to select a physician for the participant. The participant shall be at liberty to elect his or her "Unless Qthp.rwI~ rtated In ltl" <;':t",<l"I" 'If q",""Ilk '7 IqA\ "..-.~"'..