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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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SUNNYISLES <br />1703779 <br />City of Sunny Isles Beach <br />SPECIFIED INJURIES OR SICKNESSES LIMITATION: Benefits for disability due to certain disorders will be <br />40 imited to 24 months. The following conditions contain this limitation: <br />Plan <br />Mental Disorders <br />Substance Abuse <br />Environmental Sicknesses (e.g. sick building syndrome) <br />Musculoskeletal or Connective Tissue Disorders <br />Premier Plan <br />Value Plan <br />24 Month Limitation 24 Month Limitation <br />24 Month Limitation 24 Month Limitation <br />Maximum Benefit Duration 24 Month Limitation <br />Maximum Benefit Duration 24 Month Limitation <br />If the claimant is confined to a hospital or other appropriate treatment facility at the end of the first 24 months of <br />receiving total and /or partial disability benefits for one of these conditions, the monthly benefit will continue to <br />be paid until discharge. The monthly benefit will not be payable beyond the policy's Maximum Benefit Period. <br />PRIOR INSURANCE CREDIT UPON TRANSFER OF INSURANCE CARRIERS: Option 1.00 <br />To prevent loss of coverage for an employee because of a transfer of insurance carriers, this policy will provide <br />prior insurance credit for employees insured under the prior carriers' policy on its termination date as follows: <br />Disability Due To A Pre - Existing Condition: <br />Benefits may be payable for a disability due to a pre- existing condition for an employee who: <br />1. was insured by the prior carrier at the time of transfer; and <br />2. was actively -at -work and insured under this policy on its effective date. <br />Whe level of benefits will be the lesser of as follows: <br />1. If the employee is eligible for benefits under this policy, such employee will be paid according to this <br />policy's benefit schedule. <br />2. If the employee is not eligible for benefits under this policy, such employee will be paid according to the <br />prior carrier's benefit schedule, if eligible for benefits under that plan; or <br />3. If the employee is not eligible for benefits under this policy or the prior carrier's plan, no benefit will be <br />paid. <br />Failure To Be Active -At -Work Due To Injury Or Sickness: <br />Subject to premium payments, the policy will provide coverage to any employee: <br />1. who was insured by the carrier's policy at the time of transfer; and <br />2. who was not actively -at -work due to injury or sickness on the policy's effective date. <br />The coverage will be that provided by the prior carrier's policy, had it remained inforce. The Company will pay: <br />1. the benefit that the prior carrier would have paid; minus <br />2. any amount for which the prior carrier is liable. <br />EXCLUSIONS: Disabilities which arise from intentionally self - inflicted injuries, war or participation in a riot, <br />committing a felony, any type of assault or battery or during which the employee is not under the regular care <br />of a Physician, or is incarcerated, are excluded from coverage. <br />n <br />LJ <br />Jefferson Pilot Financial Insurance Company <br />FL 23 11/02/01 <br />
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