5.3. ERMUSR 02-09-2010 - Laserfiche WebLink

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(2) Gain of Coverage Eligibility Under Another Employer's Plan. For a Change in Status in which a Participant, a Participant's Spouse, or a Participant's gains eligibility for coverage under another employer's cafeteria plan Deleted: Dependent (or another employer's qualified benefit plan) as a result of a change in marital status or a change in employment status, a Participant may elect to cease or decrease coverage only if that coverage becomes effective or is increased under the other employer's plan. (3) Dependent Care Expense Reimbursement Plan. With respect to the Dependent Care Expense Reimbursement Plan, a Participant may change or terminate his or her Election only if (i) such a change or termination is made on account of and corresponds with a Change in Status that affects eligibility for coverage under or (ii) the Election change is on account of and Deleted: an employer's plan; corresponds with a Change in Status that affects eligibility of dependent care expenses for the tax exclusion available under the Code. Deleted: code § tz9 of (b) HIPAA Special Enrollment Rights. If a Participant's Spouse or a Participant's is to special enrollment rights by Code § 9801(f), the may make a new corresponds with the special enrollment For purposes of this provision (1) an Election to add previously eligible as a result of the acquisition of a new Spouse or child shall be considered consistent with the special enrollment right and (2) a HIPAA special enrollment Election attributable to the birth or adoption of a new child may be effective retroactive (up to thirty (30) (c) Certain Judgments, Decrees and Orders. If a judgment, decree, or order (an "Order") resulting from a divorce, legal separation, annulment or change in legal custody (including a qualified medical child support order) requires accident or health coverage for a Participant's child (including a foster child who is a of the Participant), a Participant may: (1) change his or her Election to provide coverage for the child (provided that the Order requires the Participant to provide coverage and subject to the provisions of the underlying group health plan); or (2) change his or her Election to revoke coverage for the child if the Order requires that another individual (including the Participant's Spouse or former Spouse) provide coverage under that individual's plan. (d) Medicare and Medicaid. If a Participant, a Participant's Spouse, or a Participant's who is enrolled in a health or accident benefit under this Plan becomes entitled to Medicare or Medicaid (other than coverage consisting solely of benefits under Section 1928 of the Social Security Act providing for pediatric vaccines), the Participant may prospectively reduce or cancel the health or accident coverage of the person becoming entitled to Medicare or Medicaid. Further, if a Participant, a Participant's Spouse, or a Participant's who has been entitled to Medicare or Medicaid loses eligibility for such coverage, then the Participant may prospectively elect to commence or increase the health or accident coverage Deleted: Deleted: Dependent Deleted: entitled Deleted: under a group health plan, as required Deleted: medical coverage was declined under the group health plan because of outside medical coverage, and eligibility for Deleted: outside medical coverage is subsequently lost due to legal separation, divorce, death, termination of employment, reduction in hours, or exhaustion of the maximum COBRA period, then a Participant Deleted: revoke a prior Election for health or accident coverage and Deleted: Election (including salary reduction Election), provided that the Election Deleted: exercise of such Deleted: right. Deleted: Dependents Deleted: Dependent Deleted: ,subject to the provisions of the underlying group health plan, Deleted: (a/k/a the Tag-along Rule); Deleted: Dependent Deleted: ,subject to the provisions of the underlying group health plan, Deleted: days). Deleted: Dependent Deleted: Dependent Deleted: Dependent Deleted: Dependent Deleted: Dependent Deleted: Dependent Deleted:. ©2009 Hitesman & Associates, P.A. 10 EIk River Municipal Utilities Flexible Benefits Plan (NO. 8.0.0.0)