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DELTA DENTAL
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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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5. The Individual first obtains coverage for dental benefits, after the date of the election <br />of continued coverage, under another group health plan (as an employee, or <br />dependent) which does not contain or apply any exclusion or limitation with respect to <br />any pre-existing condition of such person, If that pre-existing condition is covered <br />under this plan; <br />6. Entitlement to Medicare. <br />The employer or Primary Enrollee shall notlfy Delta Dental or the administrator within 30 days <br />of the occurrence of any of the above events. Once continued coverage terminates, It cannot <br />be reinstated. <br />10.8 TERMINATION OF THE EMPLOYER'S DENTAL CONTRACT <br />If the dental contract between the employer and Delta Dental terminates prior to the time <br />that the continuation coverage would otherwise terminate, the employer shall notify a <br />Qualified Beneficiary (either 30 days prior to the termination or when all Enrollees are notlfied <br />whichever Is later) of that person's ability to elect continuation coverage under the employer's <br />subsequent dental plan, If any. The employer must notify the successor plan of the Qualified <br />Beneficiaries receiving continuation coverage so they may be notlfied of how to continue <br />coverage under that plan. <br />The continuation coverage will be provided only for the balance of thea that a Qualified <br />Beneficiary would have remalned covered under the Delta Dental plan had such plan with the <br />former employer not terminated. The continuation coverage will terminate if a Qualified <br />Beneficiary falls to comply with the requirements pertaining to enrollment In, and payment of <br />Premium to the new group benefit plan within 30 days of receiving notice of the termination <br />of the Delta Dental plan. <br />10.9 OPEN ENROLLMENT CHANGE OF COVERAGE <br />A Qualified Beneficiary may elect to change continuation coverage during any subsequent <br />open enrollment period, If the employer has contracted with. another plan to provide coverage <br />to Its active employees, The continuation coverage under the other plan will be provided only <br />for the balance of the period that a Qualified Beneficiary would have remained covered under <br />the Dalte Dental plan. <br />ARTICLE 11- GENERAL PROVISIONS <br />11.1 No agent has authority to change this Contract or waive any of Its provisions, Delta Dental <br />may not change Premium rates, copayments or deductibles, If any, during any of the <br />following time periods: <br />(a) after the Contractholder has delivered written acceptance of the Contract, <br />(b) after the start of an annual open enrollment period, and; <br />(c) after receipt of the Premium for the first month of the contract term. <br />Premiums may be changed under the following exceptions: <br />(a) when authorized or required In the Contract, <br />(b) when Premiums are subject to execution of a def7nitive agreement, and; <br />(c) when Delta Dental and the Contractholder mutually agree In writing. <br />No change In this Contract is valid unless.approved by an executive officer of Delta Dental <br />and Included In this Contract by written amendment. <br />zn <br />25C-72 <br />
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