Page 41 - IPsoft 2018 Benefits Guide

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Special Enrollment
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in the plan, provided that your request enrollment within 30 days after your other coverage ends (COBRA or state continuation coverage ends, divorce, legal separation, death, termination of employment or reduction in hours worked; or because the employer contributions cease). In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption or placement for adoption. If you or your dependent lose coverage under a Medicaid
Plan or Children’s Health Insurance Program (CHIP), or become eligible for group health plan premium assistance under a Medicaid Plan or under the CHIP, you may request enrollment within 60 days after coverage under the Medicaid or CHIP ends or within 60 after you or your dependent is determined to be eligible for state premium assistance under CHIP.
HIPAA Notice of Privacy Practices
Health Insurance Portability and Accountability Act (HIPAA) privacy rules require that Health Plans distribute a notice to participants of their privacy rights. This notice was provided to you upon your enrollment in the plan.
You may also request a hard copy by contacting our Bene ts Administrator, Yuan Chen at yuan.chen@ipsoft.com
This Enrollment Guide represents a Summary of Material Modi cations to the existing Summary Plan Descriptions available by contacting the Associate Director – Head of HR Operations, Yuan Chen at Yuan.chen@ipsoft.com. In addition, this Guide highlights certain provisions of the welfare bene t plans available to eligible IPsoft employees (and dependents and/or bene ciaries) effective January 1, 2018. Complete details are in the respective Summary Plan Descriptions and plan documents. In case of a con ict between the information in this Enrollment Guide and the wording in either the of cial
plan documents or Summary Plan Descriptions, the plan documents and/or Summary Plan Descriptions always govern. The Company expects to continue these plans inde nitely but reserves the right to terminate, suspend, withdraw, and amend or modify them at any time without prior notice to participants to the extent permitted by law. Any change, termination of bene ts or increase in costs to participants will be based solely on the decision of the Company and may apply to active employees, employees on leave of absence, and former employees with coverage through COBRA. In addition, the tax treatment of these bene ts is subject to change without notice, as determined by federal, state or local tax authorities.
This document is an outline of the coverage proposed by the carrier(s), based on information provided by your company. It does not include all of the terms, coverage, exclusions, limitations, and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference will be made available upon request. The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to, your current employee bene ts environment. It does not necessarily fully address all of your speci c issues. It should not be construed as, nor is it intended to provide, legal advice. Questions regarding speci c issues should be addressed by your general counsel or an attorney [who specializes] in this practice area.
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