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Last modified
3/27/2018 10:28:51 AM
Creation date
3/27/2018 10:16:23 AM
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Contracts
Company Name
DELTA DENTAL
Contract #
A-2018-021
Agency
PERSONNEL SERVICES
Council Approval Date
2/6/2018
Expiration Date
12/31/2019
Destruction Year
2024
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This 18 -month period can be extended for a total of 29 months, provided; <br />1. A determination Is made under Title II or Title XVI of the Social Security Act that an <br />Individual is disabled on the date of the Qualifying Event or became disabled at any <br />time during the first 60 days of continued coverage; and <br />2. Notice of the determination Is given to the employer during the initial 18 months of <br />continued coverage and within 60 days of the date of the determination. <br />This period of coverage will end on the first of the month that begins more than 30 days after <br />the date of the final determination that the disabled individual is no longer disabled. The <br />Primary Enrollee must notify, the employer/administrator within 30 days of any such <br />determination. <br />If, during the 18 month continuation period resulting from Qualifying Event 1, the Primary <br />Enrollee's dependents experience Qualifying Events 2, 3, 4 or 5, they may choose to extend <br />coverage for up to a total of 36 months (inclusive of the period continued under Qualifying <br />Event 1). <br />The Primary Enrollee's dependents may continue coverage for.36 months following the month <br />In which Qualifying Events 2, 3, 4 or 5 occur. <br />Under federal COBRA law only, when an employer has filed for bankruptcy under Title II, <br />United States Code, beneflts may be substantially reduced or eliminated for retired <br />employees and their dependents, or the surviving spouse of a deceased retired employee. If <br />this benefit reduction or elimination occurs within one year before or one year after the filing, <br />It Is considered a Qualifying Event. If the Primary Enrollee Is a retiree, and has lost coverage <br />because of this Qualifying Event, he or she may choose to continue coverage until his or her <br />death. The Primary Enrollee's dependents who have lost coverage because of this Qualifying <br />Event may choose to continue coverage for up to 36 months following the Primary Enrollee's <br />death. <br />10.4 PERIODS OF CONTINUED COVERAGE UNDER CAL -COBRA (groups of 2 - 19) <br />In the case of Cal -COBRA, Delta Dental will act as the administrator. Notification and <br />Premium payments should be made directly to Delta Dental. Notifications and payments <br />should be delivered by first-class mail, certified mail, or other reliable means of delivery, <br />Individuals who are eligible for coverage under the federal COBRA law are not eligible for <br />coverage under Cal -COBRA. The employer must notify Delta Dental In writing within 30 days <br />of the date when the Enrollee becomes subject to COBRA. <br />Qualified Beneficiaries may continue coverage for 36 months following the month In which <br />Qualifying Events 1, 2, 3, 4 or 5 occur. <br />If, during the 36 -month continuation period resulting from Qualifying Event 1, the Qualified <br />Beneficiary is determined under Title II or Title XVT of the Social Security Act to be disabled <br />on the date of the Qualifying Event or became disabled at any time during the first 60 days of <br />continuation coverage; and notice of the determination Is given to the employer during the <br />initial period of continuation coverage and within 60 days or the date of the social security <br />determination letter, the Qualified Beneficiary may continue coverage for a total of 36 months <br />following the month in which Qualifying Event 1 occurs. <br />18 <br />25C-70 <br />
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