2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 2
Table of Contents
GROUP HEALTH CARE PLAN ESTABLISHMENT OF THE GROUP HEALTH CARE PLAN .........................1
Grandfathered Plan Status .....................................................................................................................1
Purpose of the Plan ................................................................................................................................1
ELIGIBILITY AND ENROLLMENT ......................................................................................................................2
Employee Eligibility ................................................................................................................................2
Priests, Religious and Seminarians: .......................................................................................................2
Lay Employees .......................................................................................................................................2
Timely Enrollment...................................................................................................................................2
Re-hire Provision ....................................................................................................................................2
Dependent Eligibility ...............................................................................................................................3
When you and your Spouse are both Covered Employees ...................................................................3
Court Ordered Coverage for a Child ......................................................................................................4
Annual Enrollment Period.......................................................................................................................4
Late Enrollment ......................................................................................................................................4
Special Enrollment Event .......................................................................................................................4
TERMINATION OF COVERAGE ........................................................................................................................6
Termination of Employee Coverage .......................................................................................................6
Termination of Dependent Coverage .....................................................................................................6
Retroactive Termination of Coverage .....................................................................................................6
Continuation of Coverage under the Family and Medical Leave Act (FMLA) ........................................7
Continuation of Coverage under State Family and Medical Leave Laws ...............................................7
Continuation of Coverage under USERRA ............................................................................................7
BENEFITS EXTENSION PROGRAM .................................................................................................................9
COORDINATION OF BENEFITS......................................................................................................................11
REIMBURSEMENT RIGHTS ............................................................................................................................15
RIGHTS OF RECOVERY .................................................................................................................................17
Excess Insurance .................................................................................................................................17
Separation of Funds .............................................................................................................................17
Wrongful Death ....................................................................................................................................17
Obligations ...........................................................................................................................................17
Offset ....................................................................................................................................................18
Minor Status .........................................................................................................................................18
Language Interpretation .......................................................................................................................18
Severability ...........................................................................................................................................18
Right to Receive and Release Necessary Information .........................................................................18
HEALTH CARE PLAN ADMINISTRATION .......................................................................................................19
Delegation of Responsibility .................................................................................................................19
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