Page 18 - PWH 2018 Plan Documents

TABLE OF CONTENTS

Page

ARTICLE I GENERAL TERMS AND CONDITIONS .................................................... 1
Section 1 Purpose ..................................................................................................... 1
Section 2 Definitions .................................................................................................. 1
Section 3 General ...................................................................................................... 3

ARTICLE II SECTION 125 CAFETERIA PLAN ............................................................ 9
Section 1 General ...................................................................................................... 9
Section 2 Eligibility..................................................................................................... 9
Section 3 Irrevocable Elections.................................................................................. 9
Section 4 Additional Required Terms ........................................................................ 9

ARTICLE III HEALTH BENEFIT PROGRAMS............................................................... 9
Section 1 Health Benefit Programs............................................................................ 9
Section 2 HIPAA Privacy and Security Standards ..................................................... 9
Section 3 Family and Medical Leave Act ................................................................. 11
Section 4 COBRA .................................................................................................... 11
Section 5 USERRA.................................................................................................. 12
Section 6 Qualified Medical Child Support Order Procedures ................................. 12
Section 7 Medicaid .................................................................................................. 12
Section 8 Coverage of Dependent Children in Case of Adoption ............................ 12
Section 9 HIPAA Portability and Nondiscrimination Requirements.......................... 13
Section 10 Newborn and Mothers Health Protection Act ........................................... 13
Section 11 Mental Health Parity Act .......................................................................... 14
Section 12 Women’s Health and Cancer Rights Act.................................................. 14
Section 13 Subrogation and Recovery ...................................................................... 14
Section 14 Coordination of Benefits........................................................................... 14
Section 15 Claims Procedures .................................................................................. 17

ARTICLE IV FULLY INSURED BENEFIT PROGRAMS............................................... 20
Section 1 General .................................................................................................... 20
Section 2 Claims Procedures .................................................................................. 21