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Rules Coverning Eligibility
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Evidence of Coverage  PDF (552K)
Table of Contents   Evidence of Coverage
CERTIFICATE OF GROUP HEALTH CARE COVERAGE
  1. RULES GOVERNING ELIGIBILITY.
  2. GROUP HEALTH CARE COVERAGE.
  3. RIGHT OF SUBROGATION AND REIMBURSEMENT UNDER THE GROUP HEALTH CARE COVERAGE.
  4. RULES FOR COORDINATION OF BENEFITS OF THE GROUP CONTRACT WITH OTHER BENEFITS.
  5. EFFECT OF MEDICARE ON THE GROUP HEALTH CARE COVERAGE.
  6. CLAIM RULES.
  7. INCONTESTABILITY OF COVERAGE.
  8. GENERAL INFORMATION.
  9. DEFINITIONS

All determinations and interpretations of membership eligibility and effective dates of coverage for You and Your Dependents shall be made solely by ERS in accordance with the Rules and Regulations of the Board of Trustees of ERS (ERS Rules).  Please refer to the definitions of "Eligible Employee,"  "Dependent" and "Eligible Retiree" in the Definitions section of this Certificate.  In general:

  • Eligible Employees that reside or work in the Service Area, and Eligible Retirees that reside in the Service Area, may enroll themselves and their Dependents in Community First, in accordance with ERS Rules.

  • It is the responsibility of ERS to inform Community First of all changes that affect Member Eligibility, including, but not limited to, marriage of a Dependent, death, address change, birth or adoption of a Dependent, etc.

Please contact Your Benefits Coordinator concerning all enrollment questions.

 
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