Policy Manual sample

MDT Home Health Care Agency, Inc. MEDICAL INSURANCE References: Health Insurance Portability and Accountability Act of 1996 (HIPAA) Summary Plan Description Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) POLICY: MDT Home Health Care Agency, Inc. may provides eligible direct/full time Employees and their dependents with health insurance effective the first day of the month following 30 days of employment. All staff will be informed during initial application process about the availability of the Health InsuranceMarketplace under the Affordable Care Act (Final decision by the Board of directors, depend of Agency’s economical situation) PROCEDURE: A. Regular full-time and regular part-time Employees are eligible to participate in the health plan and may enroll during the first two weeks of employment. B. The cost for individual and dependent coverage will be provided to the new Employee upon hire and upon request from the Human Resource Department. C. Employees who fail to enroll during the first two weeks of employment must wait until open enrollment each year. D. Contact the Human Resource Department for enrollment applications. E. An Employee who terminates employment or who changes status to PRN, or is regularly scheduled less than twenty (24) hours per week as a part-time Employee, is ineligible to participate in the health insurance plan. The Human Resource Department will issue a COBRA letter to notify the Employees of their right to continued coverage F. Coverage will terminate the last day of the month following the change in status or termination of employment. H. Employees opting for continuation of coverage must notify the Human Resource Department within 60 days of termination of benefits. I. A summary plan description is provided in description of benefits manual. J. Plan Descriptions are updated annually. Each year the plan updates supercede the prior year plan. K. MDT Home Health Care Agency, Inc. reserves the right to change or modify benefit programs without prior notification to the Employee except where required by law. PRE-EXISTING CONDITIONS: An Employee may be subjected to pre-existing conditions (prior medical conditions excluded from health insurance coverage) in the following circumstances: · The new enrollee has had a lapse in health insurance coverage of more than sixty- three (63) days during the previous twelve (12) months. · The enrollee fails to provide a “Certificate of Creditable Coverage” to MDT Home Health Care Agency, Inc. Human Resources Department validating prior insurance coverage. (A “Certificate of Creditable Coverage” may be obtained by contacting the previous health insurance provider.) Home Health Agency. - - Personnel/Operations Policies B-131