Reso 2010-1529 - Laserfiche WebLink

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") ) VI. EFFECTIVE DATE OF MEMBERSHIP ) Subject to the payment of applicable monthly premium charges set forth in Part VII and to the provisions of this Contract, coverage under this Plan shall become effective on the following dates: 6.0 I Eligible employees, Subscribers and Dependents who enroll during the open enrollment period will be covered Members as of the effective date of this Contract or subsequent anniversary thereof. 6.02 If a Subscriber acquires an eligible Dependent through birth, adoption, placement for adoption or rnarriage, such Dependent shall be treated as covered under the Plan if, within 31 days (or as otherwise provided for newborns in Part IV) of acquiring the new Dependent, you complete and submit an enrollment form on behalf of such Dependent. If received by AvMed within the 31 day time period (or 60 days as permitted for newborns), the enrollment for such Dependent shall become effective on the date of the birth, adoption or placement for adoption, or in the case of marriage, on the first day of the month following the date of marriage. During this period, you and your eligible spouse may also enroll for rnedical coverage under the Plan if not already covered. However, if an enrollment request is not received by AvMed within the required time frame, you and your eligible Dependents will be required to wait until the next open enrollment period to apply for coverage. 6.03 Coverage for the newborn child of the Subscriber or the newborn child of the Subscriber's covered Dependent is effective at birth if Subsection 4.02.02(i) and Section 6.02 are complied with. 6.04 If you or your Dependents originally declined medical coverage under the Plan due to other health coverage, and that coverage is subsequently terminated as a result of either a loss of eligibility for such coverage or the termination of any employer contributions for such coverage, you and your Dependents will be eligible to enroll in the Plan. To enroll, you must complete and submit an Enrollment form within 31 days of the loss of such other coverage or the termination of employer contributions. The effective date of any coverage provided by AvMed will be the first day of the month following the date you euroll. If you fail to enroll within 31 days after the loss of other coverage, you and your eligible Dependents must wait until the next open enrollment period to apply for coverage. 6.05 If you or your Dependents are eligible for coverage but not enrolled, and experience a termination of coverage under Medicaid or CHIP due to loss of eligibility, or are determined to be eligible for premium assistance under Medicaid or CIDP, you and your Dependents will be eligible to enroll in the Plan. To enroll, you must complete and submit an enrollment form within 60 days ofthe loss of such coverage or the determination of such eligibility. The effective date of any coverage provided by AvMed will be the first day of the month following the date you enroll. If you fail to enroll within 60 days after the loss of such coverage or the determination of such eligibility, you and your eligible Dependents must wait until the next open enrollment period to apply for coverage. o VII. MONTHLY PAYMENTS AND CO-PAYMENTS 7.0 I On or before the fIrst day of each month for which coverage is sought, Subscribing Group or its designated agent shall remit to AvMed, on behalf of each Subscriber and his Dependents, the monthly premium based on the rate letter and Master Application. Only Members for whom the stipulated payrnent is actually received by AvMed shall be entitled to the health services covered under this Contract and then only for the period for which such payment is applicable. Failure of the Subscribing Group to pay the premium due by the first of the month and not later than the end of the grace period (as provided in Section 7.02) shall result in retroactive termination of the Subscribing Group, effective at 12:00 a.m. (midnight) on the last day of the month for which the premium was paid, unless the payment of premiums has otherwise been contractually adjusted and specified by the parties in a fully executed 12 A V-GI00-2009 MP-53 19 (10/09)