Special Enrollee definition

Special Enrollee. An Eligible Person who is entitled to and who requests special enrollment (as described in this Benefit Plan) within thirty (30) days of losing other certain vision coverage or acquiring a new Dependent as a result of marriage, birth, adoption or placement for adoption. Specialty Type Contact Lenses – Contact Lenses that are newer in the market than Standard Type Contact Lenses and require a specialty fitting. These lens types include, but not limited to, toric, multifocal and gas permeable lenses. Spectacle Lenses – Devices that correct refractive errors in vision which are intended to be mounted on Eyeglass Frames to be worn externally, involving a transparent medium bounded by two geometrically describable surfaces one of which shall be curved, that is, spherical, cylindrical, toroidal or aspheric. Spouse – The Subscriber’s legal Spouse. Standard Anti-Reflective Coating – A non-glare, clear lens coating that limits light reflection, which allows the maximum amount of light to pass through the lens and provides anti-reflection protection, such as Aegis™ Anti- Reflective Treatment or equivalent. Standard High-Index Lenses – Material with a higher index of refraction than plastic, which is used to create lenses that are thinner (by almost one-third) and flatter than what is possible with normal plastic. Standard Progressive Lenses – Lenses with variable power zones from far distance to near distance correction with an older, proven branded progressive lens design.
Special Enrollee means an individual who applies for coverage outside the Open Enrollment Period and who satisfies the conditions in (a), (b), (c), (d), or (e) below:

Examples of Special Enrollee in a sentence

  • If an individual enrolls as a Special Enrollee, any period before such Special Enrollment is not an Eligibility Waiting Period.

  • In all Special Enrollee circumstances, an Employee, retiree, elected official, officer or director must be enrolled in this Plan in order for his Dependent(s) to be enrolled.

  • A Special Enrollment Period allows a Special Enrollee to enroll for coverage under this Plan upon a Special Enrollment Event as defined herein during a period of at least thirty-one (31) days following the Special Enrollment Event.

  • Special Enrollment Period: A period of time during which a Special Enrollee is allowed to enroll because of a loss of coverage, an adoption, placement for adoption, birth ormarriage, without being considered a Late Enrollee, subject to certain criteria as further described in the Contract.

  • A Special Enrollee under this section must request enrollment for coverage under this Benefit Plan within thirty (30) days after other coverage ends (or after the Employer stops contributing toward the other non- COBRA coverage).


More Definitions of Special Enrollee

Special Enrollee means any Participant or Beneficiary who is eligible to enroll as described in the Evidence of Coverage underExceptions to Late Enrollment Rule” in the “Eligibility, Enrollment and Termination” section.
Special Enrollee means an employee or Dependent who is entitled to Special Enrollment and requests Special Enrollment (i) within thirty (30) days of losing other health coverage, or (ii) for a newly added Dependent, within thirty (30) days of the marriage, birth, adoption, or placement of adoption.
Special Enrollee means a Participant whose past claims have exceeded the plan’s lifetime limits.
Special Enrollee. An Eligible Person who is entitled to and who requests special enrollment (as described in this Benefit Plan) within thirty (30) days of losing other certain vision coverage or acquiring a new Dependent as a result of marriage, birth, adoption or placement for adoption. Specialty Type Contact Lenses – Contact Lenses that are newer in the market than Standard Type Contact Lenses and require a specialty fitting. These lens types include, but not limited to, toric, multifocal and gas permeable lenses. Spectacle Lenses – Devices that correct refractive errors in vision which are intended to be mounted on Eyeglass Frames to be worn externally, involving a transparent medium bounded by two geometrically describable surfaces one of which shall be curved, that is, spherical, cylindrical, toroidal or aspheric. Standard Anti-Reflective Coating – A non-glare, clear lens coating that limits light reflection, which allows the maximum amount of light to pass through the lens and provides anti-reflection protection, such as Aegis™ Anti- Reflective Treatment or equivalent. Standard High-Index Lenses – Material with a higher index of refraction than plastic, which is used to create lenses that are thinner (by almost one-third) and flatter than what is possible with normal plastic. Standard Progressive Lenses – Lenses with variable power zones from far distance to near distance correction with an older, proven branded progressive lens design.
Special Enrollee means any Participant or Beneficiary who is eligible to enroll as described in the Evidence of Coverage underExceptions to Late Enrollment Rule” in the “Eligibility, Enrollment and Termination” section. PREPARATION OF SBCs: Health Net shall prepare and deliver to Group an SBC for each Health Net health benefit plan which Group offers to Covered and Eligible Persons. Health Net shall use reasonable commercial efforts to provide required SBCs to Group before Group’s open enrollment process for the next year beginning on or after September 23, 2012 is scheduled to commence. Health Net shall prepare and deliver a modified SBC to Group whenever Health Net determines that material modifications must be made to a previously delivered SBC.
Special Enrollee. An eligible person who enrolls for coverage during a Special Enrollment Period, as further described in this Contract. Special Enrollment Period: A period of time during which a Special Enrollee is allowed to enroll because of a loss of coverage, an adoption, placement for adoption, birth or marriage, without being considered a Late Enrollee, subject to certain criteria as further described in this Contract.
Special Enrollee means an Employee or Dependent who previously declined health coverage under the Plan and had coverage under another plan, but has experienced one of the following events: