HomeMy WebLinkAbout20120678.tiff AGREEMENT FOR CONTINUATION OF HEALTH INSURANCE FOR FORMER
WELD COUNTY EMPLOYEE OR ELECTED OFFICIAL WHO IS NOW DRAWING
BENEFITS FROM THE WELD COUNTY RETIREMENT PLAN
THIS AGREEMENT is entered/' into this /% day of /29 ciir ,(9%2, by and
between kathryh L, _John c/6n whose address isZ�S/ht-t/berry Qr,'bet
W , hereinafter referred to as "Retiree," and the Board of County
Commissioner of Weld County, Colorado, whose address is P.O. Box 758, 915 10th Street,
Greeley, CO 80632, hereinafter referred to as "Board."
WITNESSETH:
WHEREAS, Retiree:
a. retired from employment with Weld County on or after December 16,
1998, after at least 10 years of service, or was an elected official of Weld
County, Colorado, for at least one full four-year term, and
b. has attained the age of 55 years, and
c. is now drawing benefits from the Weld County Retirement Plan, and
WHEREAS, on the date of his or her retirement or end of office, Retiree and his/her
dependent(s) (if any) was (were) enrolled and in good standing with Weld County's health
insurance program, and
WHEREAS, Retiree wishes to continue his/her health insurance and his/her
dependent(s)' (if any) health insurance through Weld County's health insurance program
pursuant to the terms and conditions set forth in this Agreement.
NOW, THEREFORE, in consideration of the mutual promises and covenants set forth
herein, and in consideration of Retiree's service to Weld County for the past ten years, or as an
elected official for at least one full four-year term, the parties hereto agree as follows:
1. CONTINUED HEALTH INSURANCE FOR RETIREE: Conditioned upon Retiree's
prompt payment of the monthly health insurance premium as detailed in Paragraph 4.,
below, and non-cancellation of the Retiree's health insurance, Retiree shall be eligible for
continued health insurance through Weld County's health insurance provider until
Retiree attains the Normal Retirement Age for Social Security ("NRA"), becomes
eligible for health insurance coverage with another employer, becomes eligible for
Medicaid or Medicare coverage before attaining the NRA, or until June 30, 2012, when
continued health insurance coverage for the Retiree is available under the Consolidated
Omnibus Budget Reconciliation Act of 1985 (COBRA) until December 31, 2013, when
coverage can be obtained under the state insurance exchange authorized under the Patient
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ccmo vit Q , 2012-0678
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Protection and Affordable Care Act. Such continued health insurance shall be the same
as that offered to regular, full-time, current employees of Weld County, through the same
health insurance provider. Retiree acknowledges and agrees that the health insurance
provider who is providing such continued health insurance may change without Retiree's
consent.
2. CONTINUED HEALTH INSURANCE FOR RETIREE'S DEPENDENT(S) (IF
APPLICABLE): On the date of Retiree's retirement, he or she had O dependant(s)
(hereinafter "Dependent(s)") enrolled in and in good standing with Weld County's health
insurance program. Conditioned upon Retiree's prompt payment of the monthly health
insurance premium on behalf of Dependent(s), as detailed in Paragraph 4., below, and
non-cancellation of the Dependant(s)' health insurance, Dependent(s) shall be eligible for
continued health insurance through Weld County's health insurance provider, until either
of the following: I) Retiree attains the NRA, becomes eligible for health insurance
coverage with another employer, becomes eligible for Medicaid or Medicare coverage
before attaining the NRA, or until June 30, 2012, when continued health insurance
coverage for the Retiree is available under COBRA until December 31, 2013, when
coverage can be obtained under the state insurance exchange authorized under the Patient
Protection and Affordable Care Act, or becomes otherwise ineligible; or 2) Dependent(s)
lose(s) his or her (their) eligibility for continued health insurance by attaining the NRA,
er becomes eligible for health insurance coverage with another employer, becomes
eligible for Medicaid or Medicare coverage before attaining the NRA, or until June 30,
2012, when continued health insurance coverage for the Dependent(s) is available under
COBRA until December 31, 2013, when coverage can be obtained under the state
insurance exchange authorized under the Patient Protection and Affordable Care Act.
Such continued health insurance shall be the same as that offered to regular, full-time,
current employees of Weld County, through the same health insurance provider. Retiree,
on behalf of his/her Dependent(s), acknowledges and agrees that the health insurance
provider who is providing such continued health insurance may change without Retiree's
and his/her Dependent(s)' consent. Dependants of the Retiree who are not enrolled in
and in good standing with Weld County's health insurance program as of the date of the
signing of this Agreement are not eligible for continued health insurance as detailed
herein.
3. DETERMINATION OF ELIGIBILITY: The determination of eligibility for the Retiree's
and his/her Dependent(s) (if any) in the continued health insurance shall be by the Weld
County Director of Personnel, with any appeal to the insurance carrier, who shall have
final authority to make such determination.
4. COBRA RIGHTS: Retiree and his/her dependents(s) (if any) shall have the same rights
under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) as do
regular, full-time, current employees of Weld County eligible for and participating in the
County's regular health insurance program. An eligible Retiree, upon retirement has the
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choice between electing this Retiree coverage, if eligible, COBRA continuation coverage,
or no additional coverage.
5. CONTINUED HEALTH INSURANCE PREMIUM: The premium Retiree shall pay, for
his own continued health insurance coverage and for continued health insurance coverage
for his or her Dependant(s) (if any), shall be the same as that paid on behalf of regular,
full-time, current employees of Weld County. The County contribution paid for the
Retiree's and his/her Dependent(s) (if any) shall also be the same as that paid on behalf of
regular, full-time, current employees of Weld County. Retiree, on his own behalf and on
behalf of his Dependent(s) (if any), acknowledges and agrees that premium rates may
change without Retiree's and such Dependent(s)' consent.
6. RETIREE WORKING FOR WELD COUNTY IN LESS THAN FULL-TIME
POSITION: The fact that Retiree may continue to work for Weld County in less than a
full-time position does not make Retiree and his/her Dependent(s) (if any) ineligible for
continued health insurance, if the requisites of eligibility set forth above are otherwise
met.
7. TERM: The term of this Agreement is from the Retiree's date of retirement, to and until
such time as Retiree and his/her Dependent(s) (if any) are no longer eligible for continued
health insurance as determined by the terms of this Agreement.
8. NATURE OF AND AUTHORITY FOR CONTINUED HEALTH INSURANCE: The
continued health insurance contemplated by this Agreement is being offered to Retiree
and his/her Dependent(s) (if any) as a fully funded benefit in consideration of Retiree's
service to Weld County over the course of the previous 10 years, or as an elected official
for at least one full four-year term. The continued health insurance is not a part of or paid
from the Weld County Retirement Plan, nor is it a defined benefit retirement plan
pursuant to the provisions of Section 401(a) of the I.R.S. Code.
9. CERTIFICATION OF CONTINUED ELIGIBILITY: This program requires a
recertification of eligibility by covered Retirees and their dependent(s) every six months
(annual enrollment and July first of each year). Failure to complete and return the
recertification by the deadline date on the recertification form or falsification of the
recertification will result in the permanent loss of coverage under this Agreement for the
Retiree and/or dependent(s).
10. SEVERABILITY: If any term or provision of this Agreement, or the application thereof
to any person or circumstances shall, to any extent, be held invalid or unenforceable, the
remainder of this Agreement, or the application of such terms or provisions, to a person
or circumstances other than those as to which it is held invalid or unenforceable, shall not
be affected, and every other term and provision of this Agreement shall be deemed valid
and enforceable to the extent permitted by law.
Page 3 of 5 Pages
11. NO WAIVER OF IMMUNITY: No portion of this Agreement shall be deemed to
constitute a waiver of any immunities the parties or their officers or employees may
possess, nor shall any portion of this Agreement be deemed to have created a duty of care
which did not previously exist with respect to any person not a party to this Agreement.
12. NO THIRD PARTY BENEFICIARY ENFORCEMENT: It is expressly understood and
agreed that the enforcement of the terms and conditions of this Agreement, and all rights
of action relating to such enforcement, shall be strictly reserved to the undersigned parties
(including the Retiree's Dependent(s), if any) and nothing in this Agreement shall give or
allow any claim or right of action whatsoever by any other person not included in this
Agreement. It is the express intention of the undersigned parties that any entity other
than the undersigned parties receiving services or benefits under this Agreement shall be
an incidental beneficiary only.
13. MODIFICATION AND BREACH; APPLICABLE LAW; VENUE: This Agreement
contains the entire agreement and understanding between the parties hereto and
supersedes any other agreements concerning the subject matter of this transaction,
whether oral or written. Modifications, amendments, notations, renewals, or other
alterations of or to this Agreement shall only be deemed valid or of any force or effect
whatsoever if mutually agreed upon in writing by the undersigned parties. No breach of
any term, provision, or clause of this Agreement shall be deemed waived or excused,
unless such waiver or consent shall be in writing and signed by the party claimed to have
waived or consented. Any consent by any party hereto or waiver of, a breach by any
other party, either expressed or implied, shall not constitute a consent to, waiver of or
excess of any other different or subsequent breach. Applicable law in any dispute
between the parties hereto with respect to the subject matter herein shall be the law of the
State of Colorado. Venue for any litigation between the parties shall be in Weld County
District Court.
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THE PARTIES HERETO HAVE SET THEIR SIGNATURES HERETO THE DATE
ENTERED ABOVE.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CLERK TO THE BOARD OF t%. t j; �./4 OF WELD COUNTY, COLORADO
COUNTY COMMISSIONE , Cr
1861
BY: , 7BY:
Deputy erk to the Bo Sean P. Conway , Ch it
t .'‘
NAME OF DEPENDENT(S): RETIREE: MAR 1 2 2012
176n ‘e .
(Print Name of Dependent(s)) Si ature46fRetireeG�
*Lkr n L. JJ7ns7Lon
(Print Narrib of Retiree)
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