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25C - AGMT GROUP INSURANCE
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25C - AGMT GROUP INSURANCE
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Last modified
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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2.12 A Primary Enrollee absent from work due to a leave of absence governed by the "Family and <br />Medical Leave Act of 1993" (P.L. 103-3) will not be subject to Section 2,11. <br />2.13 A Primary Enrollee absent from work due to a leave of absence governed by the "Uniformed <br />Services Employment and Re-employment Rights Act of 1994" (P.L. 103-353) will not be <br />subject to Section 2.11. Such Primary Enrollee shall have the right to continue coverage for <br />up to 24 months while he or she Is on military leave. If the Primary Enrollee elects this <br />continued coverage, he or she must submit the Premiums necessary to the Contractholder. <br />2.14 A Primary Enrollee's eligibility ends on the last day of the month in which his or her full-time <br />employment ends, unless he or she chooses to continue coverage under Article lo. A <br />Dependent's eligibility ends along with the Primary Enrollee's, or sooner if the Dependent <br />loses his or her Dependent status, unless continued coverage Is chosen in a timely fashion by <br />or on behalf of the Dependent(s) under Article 10. Eligibility for such continued coverage will <br />continue for the period required by the Option. In any event, eligibility ends immediately <br />when this Contract ends. <br />2.15 The Contractholder agrees to permit Delta Dental, by its auditors or other authorized <br />representatives, on reasonable advance written notice, to inspect the Contractholder's records <br />in order to verify the accuracy of lists of Primary Enrollees prepared by the Contractholder <br />and submitted to Delta Dental and to verify the Contractholder's compliance with Article 3 of <br />this Contract. <br />ARTICLE 3 — PREMIUM PAYMENTS <br />3.1 Within ten days after receipt of Delta Dental's Invoice, except for the month of January 2018, <br />the Contractholder agrees to pay the following monthly, billed Premiums to Delta Dental, at the <br />address shown on the first page of this Contract, for all of Contractholder's Primary Enrollees <br />and their Dependents who are "Enrollees" as set forth in ArtIcIe2 of this Contract: <br />$52.56 for each Primary Enrollee without enrolled Dependents; and <br />$129.44 for each Primary Enrollee with one or more enrolled Dependents. <br />Contractholder agrees to pay the invoiced amount. Eligibility adjustments reported to Delta <br />Dental after the date the invoice is prepared will be reflected on the subsequent month's <br />invoice. Such adjustments are limited to the three-month period prior to the most current <br />month for which the Contractholder provides eligibility data. <br />Contractholder agrees to bear the cost of such Premiums without withholding or otherwise <br />charging Primary Enrollees for their coverage. Primary Enrollees agree to bear the cost of <br />coverage for their enrolled Dependents. <br />3.2 The Premium for each person electing continued coverage under the Continued Coverage <br />Option in Article 10 for himself or herself will be the same as that for a single Primary <br />Enrollee. The Premium for a person who also elects continued coverage for his or her <br />Dependents is the same as that for a Primary Enrollee with the same number of Dependents. <br />The Contractholder may charge persons choosing coverage under Article 10 such amounts as <br />are permitted by law. <br />3.3 This Contract is not in effect until Delta Dental receives the initial Premiums from the <br />Contractholder. <br />3.4 If this Contract terminates for any reason, the Contractholder agrees to pay all Premiums <br />earned by Delta Dental but unpaid by the Contractholder. <br />256-57 <br />
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