Changes for Covered Clause Samples

Changes for Covered. Retirees Who Are Medicare Eligible Applicable Beginning January 1, 2017 – Medicare Advantage Program. Effective January 1, 2017, Medicare-eligible Covered Retirees and dependents will participate in the Company-sponsored Medicare Advantage plan(s). The Medicare Advantage plan(s) will be a fully-insured or self- insured benefit. The Company shall from time to time designate the insurer(s) or TPA(s) of the Medicare Advantage plan(s), provided that prior to each such designation, the Company must: (i) prior to the issuance of a request for proposals or equivalent document soliciting bids for a TPA or an insurer for the Medicare Advantage plan(s) (a “MA RFP”), provide members of the ACHC the opportunity to sign a confidentiality agreement and for those who signed a confidentiality agreement, provide a copy of the proposed MA RFP; (ii) provide the members of the ACHC who signed a confidentiality agreement with seven (7) days to review the MA RFP and to submit comments to the Company; (iii) provide the members of the ACHC who signed a confidentiality agreement with the final MA RFP at the time it is issued by the Company; (iv) provide members of the ACHC who signed a confidentiality agreement with seven (7) days to review the bids submitted by companies in response to the MA RFP and to submit comments to the Company; however, as to bidders who object to the members of the ACHC reviewing their entire bid, members of the ACHC who signed a confidentiality agreement will be provided seven (7) days to review the participant-impacting terms of the bid; (v) consult with the ACHC regarding the designation of two finalist candidates, provided that the ACHC must make itself available to consult within seventy two (72) hours of the Company’s request; and (vi) arrange for the ACHC to meet with the two finalist candidates on dates and times designated by the candidates. Within seventy two (72) hours of the later of the dates designated by the candidates, the ACHC shall provide the Company with its recommendation regarding which candidate to select for the designation. If a majority of members of the ACHC cannot agree on a recommendation, the union members of the ACHC may within seventy two (72) hours of the later of the dates designated by the candidates submit their recommendation to the Company. The Company shall designate the insurer(s) or TPA(s) after having given due consideration to any such recommendation from the ACHC or the union members of the ACHC and must demonst...