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25C - AGMT GROUP INSURANCE
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25C - AGMT GROUP INSURANCE
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2/1/2018 7:02:12 PM
Creation date
2/1/2018 7:10:52 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Personnel Services
Item #
25C
Date
2/6/2018
Destruction Year
2023
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Dentist means: <br />• a person licensed to practice dentistry in the jurisdiction where such services are performed; or <br />• any other person whose services, according to applicable law, must be treated as Dentist's <br />services for purposes of the group contract. Each such person must be licensed in the <br />jurisdiction where the services are performed and must act within the scope of that license. The <br />person must also be certified and/or registered if required by such jurisdiction. <br />• For purposes of dental benefits, the term will include a physician who performs a Covered <br />Service. <br />The term does not include: <br />• You; <br />• Your spouse; or <br />• any member of Your immediate family including Your and/or Your spouse's parents; children <br />(natural, step or adopted); siblings; grandparents; or grandchildren. <br />Dentures means fixed partial dentures (bridgework), removable partial dentures and removable full dentures. <br />Directory of Participating Providers means the list of Selected General Dentists from whom You must <br />select to receive Covered Services. <br />Domestic Partner means each of two people, of the same or opposite sex, one of whom is an employee of <br />Your Organization, who represent themselves publicly as each other's domestic partner and have: <br />• registered as domestic partners with a government agency or office where such registration is <br />available; or <br />• submitted a domestic partner declaration to Your Organization. <br />The domestic partner declaration must establish that: <br />• each person is 18 years of age or older; <br />• neither person is married; <br />• neither person has had another domestic partner within 6 months prior to the date they enrolled for <br />insurance for the Domestic Partner under the Group Policy; <br />• they have shared the same residence for at least 6 months prior to the date they enrolled for <br />insurance for the Domestic Partner under the Group Policy; <br />• they are not related by blood in a manner that would bar their marriage in the jurisdiction in which <br />they reside; <br />• they have an exclusive mutual commitment to share the responsibility for each other's welfare and <br />financial obligations which commitment existed for at least 6 months prior to the date they enrolled for <br />insurance for the Domestic Partner under the Group Policy, and such commitment is expected to last <br />indefinitely; and <br />• 2 or more of the following exist as evidence of joint responsibility for basic financial obligations: <br />a joint mortgage or lease; <br />designation of the Domestic Partner as beneficiary for life insurance or retirement benefits; <br />joint wills or designation of the Domestic Partner as executor and/or primary beneficiary; <br />designation of the Domestic Partner as durable power of attorney or health care proxy; <br />ownership of a joint bank account, joint credit cards or other evidence of joint financial <br />responsibility; or <br />other evidence of economic interdependence. <br />Your Organization will review the declaration and determine whether to accept the request to insure the <br />Domestic Partner. <br />Your Organization will inform the employee of its decision. <br />GCERT2011-DHMO-EOC 2 <br />5C-34 <br />20 <br />
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