Page 4 - 2013 Wexford CCU PLAN DOC SPD

Limitations and Exclusions .....................................................................................................16
Claims and Appeals ...............................................................................................................16
For More Information .............................................................................................................16
Administrative Information .....................................................................................................17
Plan Sponsor and Administrator .............................................................................................17
Plan Year ...............................................................................................................................18
Type of Plan ...........................................................................................................................18
Identification Numbers ...........................................................................................................18
Plan Funding and Type of Administration ...............................................................................18
Insurers/Claims Administrators ..............................................................................................19
Agent for Service of Legal Process ........................................................................................20
No Obligation to Continue Employment .................................................................................20
Non-Alienation of Benefits......................................................................................................20
Severability ............................................................................................................................21
Payment of Benefits to Others ...............................................................................................21
Expenses ...............................................................................................................................21
Fraud .....................................................................................................................................21
Indemnity ...............................................................................................................................21
Compliance with State and Federal Mandates .......................................................................21
Refund of Premium Contributions ..........................................................................................21
Non-discrimination .................................................................................................................22
Future of the Plan ..................................................................................................................22
Claims Procedures/Coordination of Benefits .......................................................................23
Claims and Appeals ...............................................................................................................23
Exhaustion Required..............................................................................................................23
Non-Duplication of Benefits / Coordination of Benefits ...........................................................24
Health Care Coverage Coordination with Medicare ...............................................................24
Subrogation and Reimbursement...........................................................................................24
Your Rights under ERISA .......................................................................................................25

Receive Information about Your Plan and Benefits ................................................................25
Continue Group Health Plan Coverage ..................................................................................25
Prudent Actions by Plan Fiduciaries .......................................................................................25
Enforce Your Rights ...............................................................................................................25
Assistance with Your Questions .............................................................................................26
Your HIPAA Rights ..................................................................................................................27

Health Insurance Portability and Accountability Act (HIPAA) ..................................................27
Certificate of Creditable Coverage .........................................................................................28
Your COBRA Continuation Coverage Rights ........................................................................29

Continuing Health Care Coverage through COBRA ...............................................................29
COBRA Qualifying Events and Length of Coverage ...............................................................29
18-Month Continuation .......................................................................................................29
36-Month Continuation .......................................................................................................30

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