Page | 68 DENTAL INSURANCE PLAN 703 Employees who work thirty (30) hours or more per week on an on-going basis are eligible to participate in the city’s dental plan. New employees have thirty (30) days to elect or decline coverage. Coverage becomes effective on the first day of the calendar month after plan eligibility requirements have been met and all required enrollment forms have been submitted to Human Resources. For those employees hired on the first day of a month, coverage can become immediate provided all of the required enrollment paperwork has been submitted to Human Resources on his/her start date. Employees that elect to decline participation will be asked to document coverage under another plan or program. The premium cost of each coverage option is published by Human Resources and is subject to change each plan year. The City prohibits spouses that are co-employed to split coverage under its dental plan. Employees must remain in active pay status or on FMLA leave to receive City premium contributions. Employees on a non-FMLA designated unpaid leave of absence will be required to pay the full premium cost in order to maintain coverage under the plan. Coverage under the Dental plan ends upon expiration of paid coverage (usually month-end), unless the employee elects to continue coverage under COBRA (if applicable). The premium cost of each coverage option is published by Human Resources and is subject to change each plan year. The City requires co-employed spouses to be covered under one policy. Employees must remain in active pay status or on FMLA leave to receive City premium contributions. Employees on a non-FMLA designated unpaid leave of absence will be offered continuation of coverage through COBRA. Dental plan coverage terminates upon expiration of paid coverage (usually month-end) unless the employee elects to continue coverage under COBRA (if applicable). During the annual Open Enrollment period, employees have the opportunity to change plan and coverage elections, and eligible family members may be enrolled or dropped. It is the responsibility of each employee to notify the Human Resources Department when there is any change in family status because a change may have an effect on benefits. (e.g., in the event of a divorce, the former spouse should be dropped from coverage). In most cases, notice is required within 30 days of an event or family status change. The City is not responsible for plan change denials when an employee fails to notify the Human Resources Department in a timely manner. For purposes of the Dental Plan enrollment, a “Spouse” is defined as a person of the same or opposite sex to whom the employee is legally married under the laws of the jurisdiction in which the marriage was entered into (as such laws existed at the time of marriage). A qualified “Dependent” is defined as the employee’s natural child, lawfully adopted child (including a child placed with the participant for adoption but for whom the adoption is not yet final), stepchild, or other child for whom the participant has obtained legal guardianship pursuant to a court order, until such child attains age 26 (or until such child attains age 18 in the case of a legal guardianship). Children placed with a participant for adoption and children who are the subject of a National Medical Support Notice will also be considered dependents. FLEXIBLE SPENDING ACCOUNT 704 Those employees that work 30 hours or more on an on-going basis are eligible to participate in the city’s flexible spending account (FSA) program. These flexible spending accounts make it possible for the employee to set aside money pre-tax to assist with qualifying medical or dependent care expenses throughout the calendar year. During the City’s annual open enrollment period, employees may allocate up to the maximum amount allowed in the plan documents. Employees are encouraged to be conservative when determining howmuch to set aside in a flexible spending account since unreimbursed funds are forfeited on March 15th of the following calendar year. COBRA CONTINUATION COVERAGE 705 The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives employees and their qualified beneficiaries the opportunity to continue certain insurance coverage under the City’s group plan when a qualifying event would normally result in the loss of eligibility. Some common qualifying events include separation from employment, death of an
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