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Jefferson Pilot Life Ins.#1
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RFP No. 01-10-01 Employee Dental, Life, Insurance
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Jefferson Pilot Life Ins.#1
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Last modified
6/18/2012 10:02:26 PM
Creation date
12/28/2010 3:46:06 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Employee Insurance
Bid No. (xx-xx-xx)
01-10-01
Project Type (Bid, RFP, RFQ)
RFP
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ELIGIBILITY FOR <br />DEPENDENT DENTAL COVERAGE <br />OFFECTIVE DATES. Except as provided in the NEW DEPENDENTS section, Dependent Dental Coverage will become effective <br />on the latest of: <br />(1) the first day of the Coverage Month coinciding with or next following the date the Covered Employee becomes <br />eligible for Dependent Dental Coverage; <br />(2) the first day of the Coverage Month coinciding with or next following the date the Covered Employee makes <br />written application for Dependent Dental Coverage; and, if additional premium is required, the Employee signs: <br />(a) a payroll deduction order, if the Covered Employee pays any part of the premium for Dependent <br />Dental Coverage; or <br />(b) an order to pay premiums from the Employee's Section 125 Plan account, if any contributions for <br />Dependent Dental Coverage are paid through a Section 125 Plan account; or <br />(3) the first day of the Coverage Month coinciding with or next following the date the Company approves a Late <br />Entrant application for each Dependent applying for Dependent Dental Coverage. <br />COURT ORDERED COVERAGE. If coverage is provided to a child based on a court order which requires the Covered Employee to <br />provide dental benefits for the child, the coverage will become effective on the date stated in the court order; subject to payment of <br />any additional premium. <br />NEW DEPENDENTS. If a Covered Employee acquires a new Dependent while covered under this Policy, coverage will become <br />effective for the Covered Employee's Spouse or stepchild on the date the Covered Employee is married or takes custody of the child. <br />If additional premium is required, a written application, and a payroll deduction order or Section 125 Plan election, must be made <br />within 31 days of the date the Dependent is acquired. <br />Coverage for a Covered Employee's newborn child will be effective from the moment of birth. <br />9overage for a newborn child born to any family member while this Policy is in force will be effective from the moment of birth and <br />11 terminate 18 months after the birth of the child. <br />Coverage for a Covered Employee's adopted child, foster child or other child in court- ordered custody, placed in compliance with <br />Chapter 63, will be effective from the moment of placement in the Covered Employee's home. In the case of a newborn child, <br />coverage will be effective from the moment of birth if the Covered Employee has entered into such a written agreement to adopt prior <br />to the birth, whether or not such agreement is enforceable. However, coverage for such child shall not be required in the event that <br />the child is not ultimately placed in the Covered Employee's home. <br />Written notice of a newly acquired Dependent may be given to the Company within 31 days of the birth or placement of a child. If <br />timely notice is given, additional premium will not be charged for the notice period. If timely notice is not given, any applicable <br />additional premium will be charged from the date of birth for newborns or the date of placement in the home for an adopted child. <br />Coverage will not be denied for a child due to the Covered Employee failing to notify the Company, within the 31 -day notice period, <br />of the birth of the child. <br />r1 <br />U <br />GL11 -8 -ELD FL <br />14 09/01/01 <br />
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