Page 84 - Avatar 2022 Flipbook
P. 84

MLB League-Wide Insurance Program
                                                                     Plan and Summary Plan Description

                   which Participants need not be the same Participants who made contributions under the policy
                   that issued the rebate.  Any portion of the rebate that is not treated as plan assets will be
                   allocated among one or more of Participating Employer(s) as the Plan Sponsor in its sole
                   discretion determines appropriate.

                   Termination Of Coverage.  Generally, if you terminate your employment with your Employer
                   you will remain covered through the end of the month in which such termination occurs.
                   Dependent coverage generally ends on the first day of the month following the month in which
                   they turn 26.  Please note that your Employer may have established different rules regarding
                   termination  of benefits.  Please see Appendix A for the specific rules applicable to your
                   Employer.

                   In addition, under federal law, you and your dependents may be entitled to continuation of
                   medical coverage.  The section of this booklet entitled CONTINUATION OF COVERAGE UNDER
                   COBRA describes certain circumstances under which medical coverage may be continued after
                   the date coverage would otherwise end.

                   Dental Coverage

                   This section briefly summarizes the dental benefits that may be available to you under the Plan
                   and describes some important rules regarding your annual elections under the Plan.  For a more
                   complete description of the benefits available under each coverage option, please refer to the
                   separate descriptive booklets that you have received from the Board, your Employer, insurance
                   companies, and other organizations with which the Board has contracted to provide benefits.

                   Your Employer may provide dental benefits, and if so, the available coverage options are listed
                   on Appendix A.  You are responsible for making decisions regarding the coverage option you
                   choose (if more than one option is available to you) and your selection of dentists and other
                   dental providers.  You also have the option to waive the dental coverage provided by your
                   Employer.

                   In addition, you and your dentist are responsible for choosing the course of treatment for (or
                   for choosing not to treat) any illness, injury or other dental condition.  The Board and/or your
                   Employer are not in any way responsible for the outcome of any dental treatment or care (or
                   lack of such treatment or care).

                   You should refer to the benefit booklets distributed to you to answer  specific coverage
                   questions and to help you decide which options (if more than one option is available to you)
                   are right for you and your family.  Copies of these benefit booklets are also available from your
                   Employer.

               CLAIMS PROCEDURE

                   Please refer to the booklets and other descriptive materials you have received from the Board,
                   your Employer and insurance companies for the Plan’s claims procedures.  These booklets and
                   other materials that describe a particular benefit under the Plan will contain a specific set of
                   claims and appeals procedures that you must follow to make a claim to receive that particular
                   benefit and/or to appeal a denied claim for that particular benefit.  Although these separate



              DB1/ 116860387.5                                                                       Page 10
   79   80   81   82   83   84   85   86   87   88   89