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2009_0921_Packet
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2009_0921_Packet
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1/9/2012 3:13:41 PM
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10/13/2009 9:30:05 AM
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Status chan�es a�licable to the Dental Plan: <br />a. A change in your legal marital status due to marriage, divorce, death of a <br />spouse, legal separation or annulment; <br />b. A change in the number of your dependents because of birth, adoption, <br />placement for adoption or death; <br />c. A change in the employment status of you or your dependent such as <br />termination or commencement of employment, strike or lockout, <br />commencement of, or return from, an unpaid leave of absence, or a change in <br />work site; <br />d. Events that cause a dependent to satisfy or cease to satisfy eligibility <br />requirements of an employer plan such as gain or loss of student status, <br />reaching the limiting age for benefits or any similar circumstance; <br />e. A change in residence of you or your dependent that affects eligibility under <br />the plan or benefits; <br />f. A significant change in the health coverage or the cost of health coverage, of <br />you or your spouse that is beyond your control or your spouse's control and is <br />related to the employment of your spouse, or a prospective election change <br />that is on account of and corresponds with a change made under another <br />employer plan provided that the other plan permits participants to make an <br />election change; <br />g. A judgment, decree, or order ("order") resulting from a divorce, legal <br />separation, annulment or change in legal custody (including a qualified <br />medical child support order) which requires accident or health coverage for <br />your child; <br />h. A prospective election change that is on account of and corresponds with a <br />change made under another employer plan provided that the other plan permits <br />participants to make an election for a period of coverage that is different from <br />the period of coverage under the other cafeteria plan or qualified benefits plan; <br />or <br />i. Commencement or return from FMLA leave. <br />Status chan�es a�licable to the Medical Expense Reimbursement Plan: <br />a. A change in your legal marital status due to marriage, divorce, death of a <br />spouse, legal separation or annulment; <br />b. A change in the number of your dependents because of birth, adoption, <br />placement for adoption or death; <br />c. A change in the employment status of you or your dependent such as <br />termination or commencement of employment, strike or lockout, <br />commencement of, or return from, an unpaid leave of absence, or a change in <br />work site. In addition, if your spouse or your dependent has a change in <br />employment status that affects eligibility under an employer plan, that is a <br />status change; <br />4 <br />
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