Declining Coverage Clause Samples
The Declining Coverage clause defines the insurer's right to reduce or deny coverage under certain circumstances. Typically, this clause applies when the policyholder fails to meet specific conditions, such as timely notification of a claim or providing necessary documentation. Its core practical function is to protect the insurer from liability in cases where the insured's actions or omissions compromise the insurer's ability to assess or defend a claim, thereby ensuring that coverage is only provided when policy requirements are met.
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Declining Coverage. With proof of insurance, an employee may decline coverage through the SEBB and therefore not have any payments or premiums deducted from their paychecks for this purpose.
Declining Coverage. An employee may decline medical coverage through the SEBB within the required SEBB timelines and therefore not have any payments or premiums deducted from their paychecks for this purpose.
Declining Coverage. If the employee declines the Employer’s medical insurance plan, and can provide proof of outside medical coverage, the Employer will contribute $150 per month to the employee as an alternate health coverage allowance. Part-time employees will receive a reduced benefit. For regular part-time employees working at least 30 hours per week, the Employer will contribute 75% of the benefit for regular full-time employees. For regular part-time employees working at least 20 hours per week, the Employer will contribute 50% of the benefit for regular full- time employees. Proof of coverage will be required annually during the Employer’s open enrollment period. This alternate health coverage allowance will be considered taxable income and subject to appropriate income taxes, as required by law.
Declining Coverage. 1. Any employee declining coverage under the family or individual health insurance contract shall be paid eight hundred dollars ($800) per year. If those declining coverage do not notify the District by the first day of required teacher attendance in September and thereafter by the last day of each month, the eight hundred dollars ($800) will be pro-rated. (See: Appendix A).
2. Pro-ration formula shall be based upon a September through June period with each month equaling a ten percent (10%) pro-rated reduction.
3. Employees can re-enroll within thirty (30) calendar days.
4. Payment for declining coverage shall be made in the first pay period in June.
5. Those members choosing to decline coverage will only need to file an initial form to secure the benefit of Article B.