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COORDINATION
WITH SUBSIDIZED COVERAGE:
If there
is a qualifying event but the employee’s employer or the Fund
provides coverage without charge, or on account of your taking
a leave of absence
pursuant to the Family and Medical Leave Act of 1993, then COBRA
continuation
coverage does not begin until the date you lose coverage because
the subsidized
coverage ceases. This rule applies to self-pay coverage as well.
(The rules for self-
payment are set forth in the eligibility Section, above.). So,
if you elect to receive self-
pay coverage, you will be entitled to continuation coverage after
your self-pay coverage
ends. You will have at least 60 days to make an election to accept
or reject COBRA
coverage beginning with the later of the date you would otherwise
lose coverage or the
date we provide you with notice of your COBRA rights and an election
form. You will
not receive coverage unless within forty-five (45) days of the
date you elect COBRA,
you submit the applicable premium for the period from the date
you lost coverage to the
date of the payment.
HEALTH
INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
If you
cease coverage under this Fund and become covered under
another group health plan, you will be eligible to receive a "Certificate
of Creditable
Coverage" to present to your new group health plan. The Fund
will provide this
certificate under the Health Insurance Portability and Accountability
Act ("HIPAA"). This
is a federal law under which your new health plan may be required
to reduce any period
during which your claims would not be covered because of the new
plan’s pre-existing
condition exclusion by the time you were covered under this Plan.
To see if the new
plan’s pre-existing condition exclusion period can be reduced
for you, present this
Certificate to your new plan. You do not need to provide the Fund
with a Certificate of
Creditable Coverage because the Fund does not exclude pre-existing
conditions from
coverage.
MASTECTOMIES
AND RECONSTRUCTIVE SURGERY
Under recently
enacted federal law, group health plans such as the Fund
that provide medical and surgical benefits in connection with
a mastectomy must
provide benefits for certain reconstructive surgery effective
January 1, 1999. These
benefits cover reconstruction of the breast on which the mastectomy
was performed,
surgery and reconstruction of the other breast to produce a symmetrical
appearance,
as well as prostheses and treatment of physical complications
at all stages of
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