OTHER FEDERAL PROVISIONS FAMILY AND MEDICAL LEAVE ACT (FMLA) If an Employee is on a family or medical leave of absence that meets the eligibility requirements under the Family and Medical Leave Act of 1993 (FMLA), his or her employer will continue coverage under this Plan in accordance with state and federal FMLA regulations, provided the following conditions are met: • Contributions are paid; and • The Employee has a written, approved leave from the employer. Coverage will be continued for up to the greater of: • The leave period required by the federal FMLA and any amendment; or • The leave period required by applicable state law. An Employee may choose not to retain group health coverage during an FMLA leave. When the Employee returns to work following the FMLA leave, the Employee’s coverage will usually be restored to the level the Employee would have had if the FMLA leave had not been taken. For more information, please contact Your Human Resources or Personnel office. QUALIFIED MEDICAL CHILD SUPPORT ORDERS PROVISION A Dependent Child will become covered as of the date specified in a judgment, decree, or order issued by a court of competent jurisdiction or through a state administrative process. The order must clearly identify all of the following: • The name and last known mailing address of the participant; • The name and last known mailing address of each alternate recipient (or official state or political designee for the alternate recipient); • A reasonable description of the type of coverage to be provided to the Child or the manner in which such coverage is to be determined; and • The period to which the order applies. Please contact the Plan Administrator to request a copy, at no charge, of the written procedures that the Plan uses when administering Qualified Medical Child Support Orders. NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT Under federal law, group health plans and health insurance issuers offering group health insurance generally may not restrict benefits for any Hospital length of stay in connection with childbirth for the mother or the newborn Child to less than 48 hours following a vaginal delivery, or less than 96 hours following a Cesarean section. However, the plan or issuer may pay for a shorter stay if the attending Physician (i.e., Your Physician, nurse, or midwife, or a physician assistant) after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and insurers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. In addition, a plan or issuer may not, under federal law, require that a Physician or other health care provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). However, to use certain providers or facilities, or to reduce Your out-of-pocket costs, You may be required to obtain precertification. For information on precertification, contact Your Plan Administrator. -108- 7670-00-413597
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