Laserfiche WebLink
NOTICE TO PLAN PARTICIPANTS REGARDING THE CITY OF PARIS'S <br /> <br /> ELECTION UNDER 42 U.S.C 300 gg-21 <br /> <br />THIS IS TO NOTIFY YOU THAT FEDERAL LAW IMPOSES UPON GROUP HEALTH PLANS CERTAIN <br /> <br />LIMITATIONS OF PREEXISTING CONDITION EXCLUSION PERIODS. SPECIAL ENROLLMENT PERIODS <br /> <br />FOR INDIVIDUALS (AND DEPENDENTS) LOSING OTHER COVERAGE, PROHIBITIONS AGAINST <br /> <br />DISCRIMINATING AGAINST INDIVIDUAL PARTICIPANTS AND BENEFICIARIES BASED ON HEALTH <br />STATUS. STANDARDS RELATING TO BENEFITS FOR MOTHERS AND NEWBORNS. PARITY IN THE <br />APPLICATION OF CERTAIN LIMITS TO MENTAL HEALTH BENEFITS, AND A WOMAN'S RIGHT TO <br />TREATMENT OF THE UNAFFECTED BREAST FOLLOWING A MASTECTOMY. FEDERAL LAW ALLOWS <br />A NON-FEDERAL GOVERNMENTAL PLAN (SUCH AS THE CITY OF PARIS'S PLAN) TO EXEMPT ITS PLAN <br />IN WHOLE OR IN PART FROM THESE REQUIREMENTS. THE CITY OF PARIS HAS ELECTED TO BE <br /> <br />EXEMPT FROM THE FOLLOWING REQUIREMENTS: LIMITATIONS ON PREEXISTING CONDITION <br />EXCLUSION PERIODS: SPECIAL ENROLLMENT PERIODS FOR INDIVIDUALS (AND DEPENDENTS) <br /> <br />LOSING COVERAGE: PROHIBITIONS AGAINST DISCRIMINATING AGAINST iNDIVIDUAL PARTICIPANTS <br />AND BENEFICIARIES BASED ON HEALTH STATUS: STANDARDS RELATING TO BENEFITS FOR <br />MOTHERS AND NEWBORNS: PARITY IN THE APPLICATION OF CERTAIN LIMITS TO MENTAL HEALTH <br />BENEFITS: AND A WOMAN'S RIGHT TO TREATMENT OF THE UNAFFECTED BREAST AND <br />RECONSTRUCTIVE SURGERY FOLLOWING A MASTECTOMY. BECAUSE OF THIS ELECTION, <br />EMPLOYEES AND DEPENDENTS WILL BE SUBJECT TO BENEFIT LIMITS EVEN IF THEY HAD 12 OR 18 <br />MONTHS OF COVERAGE UNDER ANOTHER PLAN WITHIN THE LAST 63 DAYS, THE DURATION OF A <br />HOSPITAL CONFINEMENT FOR A MOTHER AND NEWBORN FOLLOWING THE BIRTH OF A CHILD WILL <br />BE DETERMINED ON MEDICAL NECESSITY. AND MENTAL HEALTH BENEFITS HAVE AN ANNUAL <br />MAXIMUM WHICH IS LES S THAN THE MAXIMUMS FOR OTHER MEDICAL CONDITIONS. EVEN THOUGH <br />THE PLAN IS EXEMPT, EMPLOYEES AND DEPENDENTS WILL BE ABLE TO ENROLL IF THEY HAVE A <br />QUALIFYING EVENT DURING THE PLAN YEAR AS SET FORTH IN THIS BOOKLET AND NO INDIVIDUAL <br />WILL BE DECLINED COVERAGE OR CHARGED A HIGHER RATE BASED ON A MEDICAL CONDITION. <br /> <br />EXHIBIT B <br /> <br /> <br />