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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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9.9 All Benefits end for all Enrollees, when this Contract ends, and Delta Dental will not provide <br />any right to continuation, renewal or reinstatement of Benefits to such persons In that event. <br />9.10 Delta Dental must notify the Contractholder in writing of any termination by Delta Dental <br />under paragraph 9.1, and the Contractholder shall promptly mall a copy of such notice to <br />each Primary Enrollee and provide Delta Dental with proof of mailing and the date thereof. <br />ARTICLE 10 - OPTIONAL CONTINUATION OF COVERAGE (COBRA) <br />10.1 The federal Consolidated Omnibus Budget Reconciliation Act (or COBRA, pertaining to certain <br />employers having 20 or more employees) and the California Continuation Benefits <br />Replacement Act (or Cal -COBRA, pertaining to employers with two to 19 employees), both <br />require that continued health care coverage be made available to "Qualified Beneficiaries" <br />who lose health care coverage under the group plan as a result of a "Qualifying Event." <br />Enrollees may be entitled to continue coverage under this plan, at the Quallfied eeneficlary's <br />expense, If certain conditions are met. The period of continued coverage depends on the <br />Qualifying Event and whether the Enrollee is covered under federal COBRA or Cal -COBRA. <br />10.2 DEFINITIONS <br />The meaning of key terms used in this Article are shown below and apply to both federal and <br />Cal -COBRA. <br />Qualified Beneficiary means: <br />Enrollees who are enrolled In the Delta Dental plan on the day before the Qualifying <br />Event, or <br />A child who is born to or placed for adoption with the Primary Enrollee during the <br />period of continued coverage, provided such child is enrolled within 30 days of birth or <br />placement for adoption. <br />Qualifying Event means any of the following events which, except for the election of this <br />continued coverage, would result In a loss of coverage under the dental plan: <br />Event 1: The termination of employment (other than termination for gross misconduct), or <br />the reduction In work hours, by the Primary Enrollee's employer; <br />Event 2: The death of the Primary Enrollee; <br />Event 3: Divorce or legal separation from the Primary Enrollee; <br />Event 4: A dependent child ceasing to meet the description of dependent child; <br />Event 5: As to dependents only, a Primary Enrollee becoming entitled to Medicare. <br />10.3 PERIODS OF CONTINUED COVERAGE UNDER FEDERAL COBRA <br />Qualified Beneficiaries may continue coverage for 18 months following the occurrence <br />Qualifying Event 1. <br />25&-69 <br />
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