2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 2
Table of Contents
GROUP HEALTH CARE PLAN ESTABLISHMENT OF THE GROUP HEALTH CARE PLAN .........................1
Grandfathered Plan Status .....................................................................................................................1
Purpose of the Plan ................................................................................................................................1
ELIGIBILITY AND ENROLLMENT ......................................................................................................................1
Employee Eligibility ................................................................................................................................1
Priests, Religious and Seminarians: .......................................................................................................1
Lay Employees .......................................................................................................................................1
Timely Enrollment...................................................................................................................................1
Re-hire Provision ....................................................................................................................................1
Dependent Eligibility ...............................................................................................................................2
When you and your Spouse are both Covered Employees ...................................................................3
Court Ordered Coverage for a Child ......................................................................................................3
Annual Enrollment Period.......................................................................................................................3
Late Enrollment ......................................................................................................................................3
Special Enrollment Event .......................................................................................................................3
TERMINATION OF COVERAGE ........................................................................................................................5
Termination of Employee Coverage .......................................................................................................5
Termination of Dependent Coverage .....................................................................................................5
Retroactive Termination of Coverage .....................................................................................................5
Continuation of Coverage under the Family and Medical Leave Act (FMLA) ........................................6
Continuation of Coverage under State Family and Medical Leave Laws ...............................................6
Continuation of Coverage under USERRA ............................................................................................6
BENEFITS EXTENSION PROGRAM .................................................................................................................8
COORDINATION OF BENEFITS......................................................................................................................10
REIMBURSEMENT RIGHTS ............................................................................................................................14
RIGHTS OF RECOVERY .................................................................................................................................16
Excess Insurance .................................................................................................................................16
Separation of Funds .............................................................................................................................16
Wrongful Death ....................................................................................................................................16
Obligations ...........................................................................................................................................16
Offset ....................................................................................................................................................17
Minor Status .........................................................................................................................................17
Language Interpretation .......................................................................................................................17
Severability ...........................................................................................................................................17
Right to Receive and Release Necessary Information .........................................................................17
HEALTH CARE PLAN ADMINISTRATION .......................................................................................................18
Delegation of Responsibility .................................................................................................................18
Authority to Make Decisions .................................................................................................................18
i
