Reso 2010-1529 - Laserfiche WebLink

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1 administer this Contract or to arrange for the delivery of health care services to the Member or other Members after AvMed has attempted to resolve the Member's problem. e) At the effective date of such termination, premium payments received by AvMed on account of such termination shall be refunded on a pro rata basis, and AvMed shall have no further liability or responsibility for the Member under this Contract. 9.02 Notification requirements: ) Loss of eligihility of Subscriber. It is the responsibility of Subscribing Group to notifY AvMed in writing within 31 days from the effective date of termination regarding any Subscriber and/or Dependent who becomes ineligible to participate in the Plan. Failure of the Subscribing Group to provide timely written notice as described above may lead to retroactive termination of the Subscriber and/or Dependent. The effective date for such retroactive termination will be the last day of the month for which the premiwn was paid and during which the Subscriber and/or Dependent was eligible for coverage. See Section 7.06. 9.02.02 Loss of eligibility of Dependent. When a Dependent becomes ineligible for Dependent coverage, the Subscriber is required to notifY AvMed in writing within 31 days of the Dependent becoming ineligible. 9.02.01 'I 9.02.03 Contract termination. In the event this Contract is terminated, the Subscribing Group agrees that it shall provide 45 days prior written notification of the date of such termination to its employees who are Subscribers under this Contract. . a) In no event will any retroactive termination of a Member be made beyond 60 days from notification of the terminating event. Certificates of Coverage. If your coverage under the Plan ends, you will autornatically receive a Certificate of Group Health Plan Coverage. You rnay take this certificate to another health care plan to receive credit for your coverage under the Plan. You will only need to do this if the other health care plan has a pre-existing condition limit. You can request a Certificate of Group Health Plan Coverage anytime during the 24-month period after the date your coverage under the Plan has ended. 9.04 Continuation Coverage under COBRA. Under certain provisions of COBRA, the Subscriber or his Dependents may elect continued coverage under the Plan if coverage is lost due to a qualifYing event. 9.03 9.04.01 A V-OIOO-2009 MP-53 19 (10/09) ) Eligibility. You or your covered Dependents will become eligible for continuation coverage under COBRA after any of the following qualifYing events result in the loss of Plan coverage: a) Loss of benefits due to a reduction in your hours of employment; b) Termination of your ernployment, including retirement but excluding termination for gross misconduct; c) Termination of employment following leave under the Family and Medical Leave Act of 1993 (FMLA), in which case the qualifYing event will occur on the earlier of the date you indicated you were not returning to work or the last day of the FMLA leave; or d) You or a Dependent frrst become entitled to Medicare or covered under another group health plan prior to your loss of coverage due to termination of employment or reduction in hours. e) In addition, your Dependents will become eligible for COBRA continuation coverage after any of the following qualifYing events occur to cause a loss of Plan coverage, 17