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Agmt94 Managed Health Network
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Agmt94 Managed Health Network
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Last modified
7/5/2005 2:32:18 PM
Creation date
11/4/2004 2:05:29 PM
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Template:
Agreement
Contractor Name
Managed Health Network formerly Occupational Health Services
RMP File Number
304
Date
7/14/1994
Reso Ref
12379 12687 13007
Box
5858
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<br />responsibilities are the sole obligation of Employer. <br /> <br />Generally, COBRA requires all employers of 20 or more employees to <br />offer to continue group health coverage for up to l8 months to <br />employees and their Dependents who lose coverage due to termination <br />of employment (except for gross misconduct) or reduction in hours <br />worked, and for up to 36 months to Dependents who lose coverage due <br />to the death of the employee, divorce or legal separation from the <br />employee or to children who no longer qualify as covered Dependents. <br />"Extended" coverage of up to 29 months is available to certain COBRA <br />beneficiaries who are disabled at the time of their qualifying <br />event. Continuation of group coverage rights under COBRA continue <br />until either the exhaustion of the previously mentioned maximum <br />continuation periods or a "terminating event" occurs (e.g., <br />termination of all group plans provided by Employer, failure of the <br />Member to pay monthly prepayment fees when due, the Member is or <br />becomes covered under any other group plan without limitation as to <br />a preexisting condition, or the Member is or becomes entitled to <br />Medicare coverage). <br /> <br />Benefits of the continuation plan are identical to this group plan. <br />The cost to the Member who elects such coverage will be 102% of the <br />then current applicable group rate (including any portion previously <br />paid by Employer) during the period of basic COBRA coverage and 150% <br />of the then current applicable group rate during the period of <br />"extended" coverage (Le., 19th through 29th month). <br /> <br />Employer must notify OHS of the occurrence and related date of any <br />qualifying event within 60 days of the incidence thereof. <br /> <br />IV. CONSIDERATION PAYABLE BY EMPLOYER <br /> <br />In consideration of the services to be performed pursuant to this <br />Agreement by OHS, Employer shall pay to OHS the prepayment fees in <br />the amounts and manner specified in Addendum Two. <br /> <br />V. COVERED SERVICES <br /> <br />Subject to the limitations, exclusions, terms and conditions stated <br />in the Evidence of Coverage and this Group Agreement, Covered <br />Services are as set forth in the Evidence of Coverage. <br /> <br />VI. GENERAL PROVISIONS <br /> <br />A. Endorsement of Change <br /> <br />No agent of OHS is authorized to change the form or content of this <br />Agreement in any manner or degree other than by duly executed <br />endorsement issued to form a part hereof. <br /> <br /> <br /> <br />- 4 - <br /> <br /> <br /> <br /> <br /> <br />'r---- <br />
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