Eligibility Enrollment and Termination. Note: If a Subscriber enrolls any eligible Dependent(s), the family level annual Deductible must be met before any benefits will be provided and the family level Out-of-pocket Maximum will apply.
Eligibility Enrollment and Termination. In Hospital on Your Effective Date If you are confined in a Hospital or Skilled Nursing Facility on the Effective Date of coverage, the SELECT Plan will cover the remainder of that confinement only if you inform Health Net’s Customer Contact Center upon your Effective Date about the confinement. Health Net and your selected Physician Group will consult with your attending Physician and may transfer you to a participating facility when medically appropriate. Totally Disabled on Your Effective Date Generally, under the federal Health Insurance Portability and Accountability Act, Health Net cannot deny You benefits due to the fact that You are totally disabled on your Effective Date. However, if upon your Effective Date you are totally disabled and pursuant to state law you are entitled to an extension of benefits from your prior group health plan, benefits of this Plan will be coordinated with benefits payable by your prior group health plan, so that not more than 100% of covered expenses are provided for services rendered to treat the disabling condition under both plans. For the purposes of coordinating benefits under this Evidence of Coverage, if you are entitled to an extension of benefits from your prior group health plan, and state law permits such arrangements, your prior group health plan shall be considered the primary plan (paying benefits first) and benefits payable under this Evidence of Coverage shall be considered the secondary plan (paying any excess covered expenses), up to 100% of total covered expenses. No extension will be granted unless Health Net receives written certification of such total disability from the Member’s Physician Group within 90 days of the date on which coverage was terminated, and thereafter at such reasonable intervals as determined by Health Net. Late Enrollment Rule Health Net’s late enrollment rule requires that if an individual does not enroll within 30 days of becoming eligible for coverage, he or she must wait until the next Open Enrollment Period to enroll. (Time limits for enrolling are explained in the "Employee" or "Newly Acquired Dependents" provisions above.) The term "form" within this section may include electronic enrollment forms or enrollment over the phone. Electronic enrollment forms or phone enrollments are deemed signed when you use your employer’s enrollment system to make or confirm changes to your benefit enrollment. You may have decided not to enroll upon first becoming eligible. At that time, ...
Eligibility Enrollment and Termination. When the Extension Ends The Extension of Benefits will end on the earliest of the following dates:
Eligibility Enrollment and Termination
