Page 23 - 2015 Four Seasons Sante Fe/Vail Enrollment Guide
P. 23
2015 Open Enrollment
Losing Other Coverage
If you waived coverage for yourself or for an eligible
dependent because other health coverage (including
COBRA coverage, Medicare, or Medicaid) was in
effect, you may add coverage under the Four Seasons
Medical Plan in certain circumstances, including, but
not limited to the following:
z Employer contributions for that coverage are
terminated
z You lose eligibility for that coverage for reasons
including termination of employment, reduction
in work hours, legal separation or divorce, death,
or change in dependent eligibility
z You incur a claim that would meet or exceed the
lifetime limit on all beneits under the other plan
z The plan no longer offers any beneits to the
class of individuals of which you or your spouse
or domestic partner is a part If you do not enroll within 30
days, you generally will not be
Loss of eligibility for other coverage does not include a loss due to the permitted to enroll until the next
failure to pay premiums on a timely basis or termination of coverage for annual enrollment period, or a
cause, such as fraud. Voluntary loss of coverage is not considered a qualiied different change in status event,
life event. if earlier.
If you waived coverage under the Four Seasons Medical Plan, and you
involuntarily lose your other coverage, you may enroll yourself and your
eligible dependents in any beneit option. If you are already enrolled in
the Four Seasons Medical Plan, you may enroll your dependent in your
current option or you may change your election and enroll yourself and your
dependent in a different option.
You must request enrollment within 30 days after the date the other
coverage ends (or employer contributions terminate). The new election
will be effective going forward from the date you enroll.
23
Losing Other Coverage
If you waived coverage for yourself or for an eligible
dependent because other health coverage (including
COBRA coverage, Medicare, or Medicaid) was in
effect, you may add coverage under the Four Seasons
Medical Plan in certain circumstances, including, but
not limited to the following:
z Employer contributions for that coverage are
terminated
z You lose eligibility for that coverage for reasons
including termination of employment, reduction
in work hours, legal separation or divorce, death,
or change in dependent eligibility
z You incur a claim that would meet or exceed the
lifetime limit on all beneits under the other plan
z The plan no longer offers any beneits to the
class of individuals of which you or your spouse
or domestic partner is a part If you do not enroll within 30
days, you generally will not be
Loss of eligibility for other coverage does not include a loss due to the permitted to enroll until the next
failure to pay premiums on a timely basis or termination of coverage for annual enrollment period, or a
cause, such as fraud. Voluntary loss of coverage is not considered a qualiied different change in status event,
life event. if earlier.
If you waived coverage under the Four Seasons Medical Plan, and you
involuntarily lose your other coverage, you may enroll yourself and your
eligible dependents in any beneit option. If you are already enrolled in
the Four Seasons Medical Plan, you may enroll your dependent in your
current option or you may change your election and enroll yourself and your
dependent in a different option.
You must request enrollment within 30 days after the date the other
coverage ends (or employer contributions terminate). The new election
will be effective going forward from the date you enroll.
23
