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HomeMy WebLinkAbout000181.tiff It January 30, 1985 THE HARTFORD Weld County The Hartford Insurance Group (203)547-5000 915 10th Street P.O. Box 758 Greeley, CO 80631 Dear Employer, Re: Stop Loss Replacement Material Attached is replacement material for Stop Loss protection of your self-funded plan. This replacement material includes a new Stop Loss Agreement form that must be used in place of the agreement previously issued to you. The Stop Loss protection provided by this replacement agreement is the same as that provided by the prior Stop Loss Agreement. The text of this replacement agreement has been changed to conform to state filing requirements for the State in which you are domiciled. Sincerely, The Hartford Accident and Indemnity Company RECEIVED FEB 41985 GROUP DEPT. 181 Hartford Fire Insurance Company and Its Affiliates Hartford Plaza,Hartford,Connecticut 06115 RIDER This Rider is attached to and made a part of the Individual Excess Risk Insurance Agreement Effective January 1, 1985 between WELD COUNTY, INC. and HARTFORD ACCIDENT AND INDEMNITY COMPANY. It is understood and agreed that said Agreement is amended as follows: 1. The term "Prior Agreement" is added to the Definitions Section. Prior Agreement means your Stop Loss Agreement through HARTFORD ACCIDENT AND INDEMNITY COMPANY that was in effect from January 1, 1983 until December 31, 1984 the day immediately before the effective date of The Agreement. 2. The Limitations on Eligible Participants concerning an employee who is absent from work on the Effective Date of the Agreement or a dependent who is confined on the Effective Date of the Agreement is hereby waived for those Eligible Participants who were covered under your Plan and the Prior Agreement. In all other respects, the Agreement remains the same. Rider Effective Date: January 1, 1985 Signed by the Insurance Company on 36 /98,8 Date ed/4490-A, Secretary Registrar AN INDIVIDUAL EXCESS RISK INSURANCE AGREEMENT HARTFORD ACCIDENT AND INDEMNITY COMPANY Hartford, Connecticut (a stock insurance company) will reimburse the Employer named in the Schedule for Plan Benefits Paid under the Employee Benefit Plan, subject to the Deductible Amount and all other conditions of this agreement. Signed for the Company r by /JP' 17245" 7` (/ Secre Registrar D o Issue TABLE OF CONTENTS SCHEDULE DEFINITIONS DEDUCTIBLE AMOUNT REIMBURSEMENT LIMITATIONS ON COVERED EXPENSES AND PLAN BENEFITS PAID LIMITATIONS ON ELIGIBLE PARTICIPANTS PAYMENT OF CLAIMS PREMIUMS TERMINATION OF AGREEMENT GENERAL PROVISIONS This agreement is a replacement of the Stop Loss Agreement effective on January 1, 1983 between WELD COUNTY and HARTFORD ACCIDENT AND INDEMNITY COMPANY. GR-11221 ISL - 1.0 T-IPOO 4 SCHEDULE Employer Name: WELD COUNTY Place of Delivery: Greeley, CO Effective Date: January 1, 1985 Monthly Premium Rate: $3.46 per Employee Participant $5.51 per Dependent Unit Premium Due Dates: First day of each calendar month Minimum Annual Premium: $2,500.00 Deductible Amount: $50,000.00 per Eligible Participant Deductible Accumulation Period: 12 Consecutive Months or less Reimbursement Period: up to 12 Consecutive Months Reimbursement Percent: 100% Maximum Lifetime Reimbursement per Eligible Participant for Mental Illness, Alcoholism, and Drug Abuse: $1,250.00 each agreement period from January 1 to December 31 beginning January 1, 1985. for all Covered Expenses: $1,000,000.00 Required Group Policies: GL-19628 Type of Benefits to which Insurance Applies: Medical Administrator: James/Galbraith & Green 3895 Upham Street #100 P.O. Box 987 Wheat Ridge, CO 80033 GR-11221 ISL - 2.0 T-IP01 DEFINITIONS As used in this agreement: . We, our, or us, means Hartford Accident and Indemnity Company or any of its subsidiaries or affiliates which it designates to perform the functions and the obligations to which it agrees in this agreement. . You or your means the employer named in the Schedule . . He means he or she. . His means his or her. . Employee Benefit Plan or The Plan means the benefit plan that you have established for Eligible Participants. The insurance provided under this agreement applies only to the Type of Benefits provided under the Employee Benefit Plan that are listed in the Schedule. . Plan Document means the written description of The Plan which is attached to and forms a part of this agreement. The insurance provided under this agreement is subject to all of the terms and provisions of the Plan Document, except as otherwise noted in this agreement. . Eligible Participant means employees and dependents who are eligible for benefits in accordance with the Plan Document. . Proof of Loss means written evidence of a claim on a form customarily required by the Administrator and satisfactory to us. . Consecutive Months means, with respect to the Deductible Accumulation Period, 365 consecutive days that begins when a Covered Expense is Incurred. With respect to a Reimbursement Period, Consective Months means 365 days that begins when the Deductible Amount is met. . Covered Expenses mean only those expenses that are payable under the terms of the Plan Document and which represent the Type of Benefits shown in the Schedule. Seventy-five (75%) percent of expenses rendered by you or any of your affiliates will be Covered Expenses. The expenses must arise from services and supplies which are medically necessary to diagnose or treat an Eligible Participant's sickness, injury or pregnancy. GR-11221 ISL - 3.0 T-IP28 DEFINITIONS (continued) . Incurred means the date on which the Eligible Participant receives the service or supply for which a charge is made. . Plan Benefits mean only Covered Expenses payable under the terms of the Plan Document. . Paid means that a check or draft to satisfy an Eligible Participant's claim for benefits under the Plan has been issued and sent by the Administrator. The check or draft can be sent to the Eligible Participant or his assignee. GR-11221 ISL - 4.0 IPO4 DEDUCTIBLE AMOUNT The Deductible Amount for each Eligible Participant is satisfied when he has Covered Expenses incurred equal to the Deductible Amount: a) while this agreement is in force; and b) within the Deductible Accumulation Period. In order to be applied against the Deductible, the Plan Benefits for Covered Expenses Incurred must have been Paid: a) while the Agreement is in force; and b) within 60 days of the Administrator's receipt of Proof of Loss. The Deductible Amount and the Deductible Accumulation Period are shown in the Schedule. GR-11221 ISL - 5.0 T-IP51 REIMBURSEMENT We will reimburse the Employer for Covered Expenses Incurred during the Agreement Year which exceed the Deductible Amount. To be eligible for reimbursement, the Plan Benefits Paid for Covered Expenses Incurred must be paid: a) while this agreement is in force; b) within the Reimbursement Period shown in the Schedule; c) within 60 days of the Administrator's receipt of Proof of Loss. Reimbursement for Plan Benefits Paid for Covered Expenses Incurred will not exceed the percentage shown in the Schedule for Reimbursement Percent and will continue for the Reimbursement Period shown in the Schedule. A new Reimbursment Period will be established when a new Deductible Amount has been satisfied. The total reimbursement under this agreement and all other Individual Excess Risk Agreements issued by us for all Covered Expenses Incurred by any Eligible Participant during his lifetime will not exceed the applicable Maximum Lifetime Reimbursement shown in the Schedule. GR-11221 ISL - 6.0 T-IP52 LIMITATIONS ON COVERED EXPENSES AND PLAN BENEFITS PAID The following Plan Benefits Paid do not qualify under this agreement for satisfaction of the Deductible Amount or for Reimbursement: Plan Benefits Paid for an Eligible Participant which have not been submitted to us when the payment equals 80% of the Deductible Amount. Plan Benefits Paid after the date this Agreement terminates. Plan Benefits Paid for expenses not considered a Covered Expense under the terms of the Plan Document. Plan Benefits Paid for a Type of Benefit which is not listed in the Schedule. Plan Benefits Paid because of a change in the Plan Document, unless we have agreed in writing to such change. Plan Benefits Paid regardless of the terms of your Plan Document for or in connection with any of the following expenses: a) court costs, or expenses for punitive or exemplary damages; b) administrative expenses, including expenses for investigation of claims; c) expenses which exceed the usual and customary charges for the service or supply in a geographical area where the service or supply is received; or d) expenses charged in connection with an accident or sickness arising out of any activity for wage or profit. GR-11221 ISL - 7.0 IP09 LIMITATIONS ON ELIGIBLE PARTICIPANTS For purposes of this agreement, Eligible Participants will be limited as follows: Those who do not enroll during the eligibility period described in the Plan Document will be required to furnish to us evidence of the Eligible Participant's good health. We will not cover any Plan Benefits Paid or Covered Expenses Incurred prior to the date that we approve his evidence of good health. Evidence of good health must be furnished at no expense to us. If an Employee is absent from work on the effective date of this agreement because of sickness, injury or pregnancy, Plan Benefits Paid for the employee or Covered Expenses Incurred by him will not be covered under this agreement. Plan Benefits Paid for Covered Expenses Incurred after the date an Employee returns to work will be covered under this agreement. "Work" means active full time work in your employ. If a Dependent is confined on the effective date of this agreement in a hospital or any other medical care institution because of sickness, injury or pregnancy, Plan Benefits Paid for the dependent or Covered Expenses Incurred by him will not be covered under this agreement. Plan Benefits Paid for Covered Expenses Incurred after: a) he has been discharged from the hospital or other medical care institution, and b) is able to do all the normal activities of a person of like age and sex in good health, and c) has not been confined for a period of 15 consecutive days, will be covered under this agreement. GR-11221 ISL - 8.0 T-IP53 PAYMENT OF CLAIMS We will reimburse you when we receive: a) Proof of Loss; and b) satisfactory proof that Plan Benefits have been Paid equal to the amount for which reimbursement is requested . We will not make reimbursement under this agreement more frequently than on a monthly basis. GR-11221 ISL - 9.0 IP12 PREMIUMS The monthly premium payable under this agreement will be equal to the sum of the Monthly Premium Rate* multiplied by the number of Employee Participants and by the number of dependent units eligible for The Plan as of each Premium Due Date*. If at the end of the Agreement Year the total of the twelve monthly premiums paid in accordance with the Monthly Premium Rate is less than the Minimum Annual Premium*, the remaining portion of the Minimum Annual Premium is due within 31 days of the date we notify you of the amount due. We may change the Monthly Premium Rate or Minimum Annual Premium after giving you 90 days advance written notice of such change. *These items are shown in the Schedule. GR-11221 ISL - 10.0 T-IP13 TERMINATION OF AGREEMENT This agreement will terminate on the earliest of the following dates: a) the anniversary date, if we or you terminates this Agreement by giving the other party at least 60 days advance written notice of termination; b) the date The Plan ceases to be administered by the Administrator shown in the Schedule, unless we agree in advance and in writing to the change in your Administrator; c) the date any of the Required Group Policies shown in the Schedule are terminated, unless we agree in advance and in writing of such termination; d) the date you discontinue or modify the Plan Document without our advance written approval and consent; e) the end of the period for which premium has been paid; f) the date you or your Administrator fail, without good and sufficient cause, to perform in good faith any of your duties or obligations under this agreement. GR-11221 ISL - 11.0 T-IP47 GENERAL PROVISIONS This agreement, together with any agreement riders, the attached Plan Document and any Plan amendments, copies of which are attached to this agreement, constitutes the entire contract between you and us. Our entire obiligation is set forth in this agreement. We assume no responsiblity or obligation for: a) administration of The Plan; or b) your acts or your Administrator's acts. We reserve the right to determine amounts payable under this agreement without regard to such acts. We have the right to inspect any of your records or other data pertaining to The Plan, including records or other data maintained by the Administrator. If material misrepresentation is found in your or your Administrators records or other data pertaining to the risk assumed by us, we have the right to rescind the Agreement as of the Effective Date shown in the Schedule. This agreement may be amended at any time by mutual agreement between you and us. However, no agent will have authority to make such a change. To be valid, any change or waiver must be in writing, approved by one of our officers and attached to this agreement. All periods begin and end at 12:01 A.M. , Standard Time at the place where this agreement is delivered. GR-11221 ISL - 12.0 T-IP15 a . AMENDMENT NO. I to • THE MASTER PLAN DOCUMENT of WELD COUNTY EMPLOYEE BENEFIT FUND Effective date of this amendment: May 1 , 1983 In addition to amending our Plan Document, request is hereby made to the Plan Administrator to administer our Plan according to the following amend(s) to our Master Plan Document. PAGE 21 (GENERAL LIMITATIONS) The existing paragraph is hereby replaced in its entirety as follows: 32. treatment of periodontal or periapical disease or any condition (other than a malignant tumor or surgical removal of bony impacted teeth) involving teeth surrounding tissue or structure. However, this exclusion does not apply to the benefits for dental treatment described under the "Supplemental Accident Expenses" Section; or IT IS AGREED BY WELD COUNTY that the provisions contained in this Plan Document are acceptable and will be the basis for the administration of said Employer' s Employee Benefit Program described herein. SIGNED AT Greeley . ro This 20th day of .7n.nB . . . . . ------- ----- -, 1983. WITNESS: a^^"^44-{Alita• By / ,Ca-(7 Title • AMENDMENT NO. II to the Health Plan Document of the WELD COUNTY EMPLOYEE BENEFIT FUND The Health Plan Document of the Weld County Employee Benefit Fund is hereby amended, effective August 1, 1983, as follows: Page 23 - The following paragraph( s) is hereby added to the following: COORDINATION OF -BENEFITS B. ORDER OF BENEFIT DETERMINATION 4. The benefits of this plan will .be the primary plan for those active employees ( and their dependents) until the covered person reaches age 70 and who have elected to participate in this plan. For those who are eligible for Medicare, any unpaid charges under this plan should be sub- mitted to Medicare for payment. - Enrolled, active employees age 70 or older are required to submit claims to Medicare as the primary plan. Page 4 - The following paragraph replaces the existing paragraph in its entirety: A. GENERAL DEFINITIONS 1. Age Discrimination - All active employees age 55 through 69 and their covered spouses age 65 through age 69 are entitled to the same and/or equal benefits they had prior to age 65. Medicare is the primary carrier on their 10th birthday, as required under Section 116, Tax Equity and Fiscal Responsibility Act. - Weld County hereby states that the intent of this amendment is to satisfy the requirements of Section 4(9) (1) of the Age Discrimination in Employment Act of 1967 (added by Section 116( a) of the Tax Equity and Fiscal Responsibility Act of 1982) . It is intended that this amendment is to be interpreted in a manner that will accomplish this purpose. IT IS AGREED BY WELD COUNTY that the provisions contained in the Plan Document and Amendment No. II thereto are acceptable and will be the basis for the administration of said Employer' s Employee Benefit Program described herein. i I SIGNED at (Nil( , Colorado, this r C day of • (,.; „�. , ff 1983. ( '%s. WELD COUNTY Witness: ByO.6?. "-rti .L. , taa.._ wti t; .c ��.,.' Title t l e i, • - `• V , Am1/10-1 /CSt' n--' ✓ V A,/f WELD COUNTY EMPLOYEE BENEFIT FUND Effective: January 1, 1983 TABLE OF CONTENTS Page PARTIES TO THE AGREEMENT STOP LOSS INSURANCE COMPANY EFFECTIVE DATE SUMMARY OF BENEFITS 1 DEFINITIONS 4 SUPPLEMENTAL ACCIDENT BENEFIT 12 MAJOR MEDICAL BENEFIT 13 HOSPITAL CARE BENEFIT 16 ANESTHESIOLOGY BENEFIT 17 SURGICAL BENEFIT 18 GENERAL LIMITATIONS 19 HOW TO FILE A CLAIM 22 COORDINATION OF BENEFITS 23 MISCELLANEOUS DEFINITIONS 25 COMMON LAW SPOUSE 27 FACILITY OF PAYMENT 27 PROCESS IN CASE OF DISPUTED CLAIM 28 CONVERSION PRIVILEGE 29 SIGNATURE PAGE 30 WtLD COUNTY EMPLOYEE BENEFIT FUND Weld County has adopted the Weld County Employee Benefit Fund (the "Plan"), as herein stated. Weld County agrees to provide for its eligible employees , during continuance of the Plan, the benefits hereinafter described in the event such employees incur a disability or they and/or their eligible dependents) incur medical expenses covered by the Plan. The Plan, designed for the exclusive benefit of eligible Weld County Employees , is subject to all terms, provisions and conditions recited in the following pages. In addition to the benefits hereinafter set forth, insurance policies have been purchased and are part of the Plan to insure against certain hazards and to provide for certain contingencies as follows: 1. An Aggregate Stop-Loss policy to insure maximum annual claim liabilities; 2. A Specific ( Individual ) Stop-Loss policy to insure individual claims in excess of the amount specified in the insurance contract. • 3. A Health Conversion provision to allow an individual to convert to an individual Medical Policy upon termination. Copies of the actual policy or policies are available for review at the offices of Weld County, or James Benefits , the Contract Administrator, and will be made available, upon request, at a reasonable charge. Weld County has caused this Plan to be EFFECTIVE as of 12:01 a.m. , January 1, 1983, at Greeley, Colorado. -i- SUMMARY OF BENEFITS FOR EMPLOYEES AND DEPENDENTS Supplemental Accident Benefit: 100% of the first $500.00 per accident, per person , not subject to the $100.00 deductible. Pre-Admission Testing: Covered at 100% of Usual , Reasonable and Customary medically necessary expenses. Birthing Centers : Covered at 100% of Usual , Reasonable and Customary medically necessary expenses. Major Medical Benefit: Maximum Lifetime Benefit: $1,000,000 each Covered Person. Deductible: $100.00 per person each Calendar Year, not to exceed $200.00 combined (aggregate) per family each Calendar Year. NOTE: The Family Deductible may be comprised of any combination of eligible medical expenses among covered family members. Co-Insurance: After the deductible has been met , 80% of the next $2,000 (80% of $4,000 per family) , and 100% thereafter of Covered Expenses will be paid per Covered Person each Calendar Year, but not to exceed the maximum lifetime benefit. Room and board charges shall not exceed the semiprivate, ICU and CCU room rates. All charges are subject to the "General Limitations" of this Plan. In-Hospital "Well Baby" Hospital Nursery charges and one Benefit : Physician visit covered as any other illness subject to the deductible and coinsurance. Outpatient Pediatric "Well Pediatric well baby care is available Baby" Benefit : until the child's second birthday; limited to a maximum of $90 per dependent child per Calendar Year. This "well baby" care includes lab and x-ray ser- vices. Routine immunizations are available until the child 's second birth- - -1- day, not limited to the Calendar Year maximum. Treatment of Alcoholism, Drug Abuse , Nervous and Mental Illness : In-Hospital : 45 days maximum per Calendar Year. NOTE: Partial hospitilization - the lesser of 1) the number of days of patient hospitilization or 2) 90 days in any Calendar Year. (Each two partial days will count as one full hospital day. ) Out-patient: 50% of each visit, not to exceed usual , reasonable and customary, up to a maximum payment of $1,250.00 per Calendar Year. The eligible charges for outpatient ser- vices are the reasonable charges for the care and treatment of mental , psycho- neurotic and personality disorders fur- nished (1) by a hospital (other than inpatient or partial hospitalization services) ; (2) by a Physician ; (3) under the direct supervision of a Physician by a comprehensive health care service cor- poration , a community mental health center, or other mental health clinic, which is licensed or approved to furnish mental health services by the state where rendered; or (4) by a social worker registered or licensed by the state where rendered, if furnished under the direct supervision of a Physician. Chiropractic: $30.00 maximum consideration per visit. $500.00 maximum payment per Calendar Year. $5,000.00 maximum payment per lifetime for each Covered Person. Covered Expenses (Up to Usual , Customary and Reasonable) Examples A. Doctor's services. B. Prescription drugs. C. Blood and blood plasma. D. Ambulance service. E. Artificial limbs. -2- • F. Rental of wheel chairs , braces, crutches, etc. G. Physical therapy and outpatient oxy- gen therapy. H. Intensive care unit room charges. I. Emergency room services. J. Hospital room and board. NOTE: This is a partial listing of covered major medical expenses. Items specifically excl uded are shown elsewhere in the Plan. • -3- DEFINITIONS Terms as used herein shall be deemed to define terms that may be used in the wording of the Plan Document. These definitions shall not be construed to pro- vide coverage under any benefit unless specifically provided. A. GENERAL DEFINITIONS 1. Age Discrimination - Subject to any changes in the Social Security Act, ITT active employees age 65 and over (up to 70 years of age) are entitled to the same and/or equal benefits that they had prior to age 65. 2. Amendment is a formal document changing the provisions of the Plan and signed by the representatives of Weld County. Amendments apply to all Covered Persons , including those persons who are covered before the Amendment becomes effective, unless otherwise specified. 3. Common-Law Marriages - In order for an employee of Weld County to be eligible for dependent medical coverage, the Common-Law Marriage must be recognized by the State of Colorado. (See page 27. ) 4. Calendar Year is the 12 month period beginning on each January 1st and ending one following December 31st. 5. Contract Administrator shall mean the person or firm employed by the Plan Administrator who is responsible for the processing of claims and payment of benefits, administration , accounts, reporting and other ser- vices contracted for by Weld County. 6. Plan Year is the 12 month period beginning on each January 1st and ending the following December 31st. 7. Employer shall refer to Weld County. 8. Medicare - Title XVIII (Health Insurance for the Aged) of the United States Social Security Act as amended. 9. Plan shall refer to the benefits and provisions as described herein for payment. 10. Plan Administrator - Weld County. 11. Subrogation - The transfer of one's liabilities for another's ; in this case the temporary assumption of the claimant 's liabilities by the Plan prior to repayment by the party of primary liability. This Plan con- tains a subrogation clause and the Claimant is obligated to obtain any monies available from third parties to reduce the Plan 's claim losses. -4- B. MEDICAL DEFINITIONS 1. Expense incurred means only the fees and prices regularly and custo- maril y charged for the medical services and supplies generally furnished for cases of comparable nature and severity in the particular geographi - cal area concerned. Any agreement as to fees or charges made between the individual and the Physician shall not bind the Plan Administrator in determining its liability with respect to expense incurred. Expense incurred is deemed to be incurred on the date on which the service or supply is rendered or obtained. 2. Illness shall mean bodily sickness or disease, psychiatric disorders , and , in the case of a newborn child, congenital abnormalities. Illness must be medically diagnosed and be treated by a Physician for purposes of determining benefits payable. 3. Morbid Obesity shall mean a condition in which the pressure of excess weight causes physical trauma; or where pulmonary and circulatory insuf- ficiencies are present; or where complications related to the treatment of conditions such as arteriosclerosis , diabetes or coronary disease exist ; and where the person is 100% or 100 pounds overweight , whichever is greater, according to the Metropolitan Life Table of Desirable Weights. (Excerpt from The Four Steps to Weight Control . ) 4. Injury is a condition which results independently of sickness and all ot�causes and is a result of an externally violent force , or acci - dent. 5. HIAA Prevailing Charge Study is The Health Insurance Association of America Schedule a�hall be the basis for dental claim reimbursement at "Usual , Reasonable and Customary" levels, applied to the particular Zip-code area where the procedure is performed. 6. Pregnancy includes (1) all pregnancies except extra-uterine, which are considered to be genito-urinary conditions , (2) childbirth , (3) mis- carriage , or (4) any complications arising wholly from these conditions , and (5) any pregnancy complications arising from any trauma, and (6) only those charges related to the pregnancy of a female employee or spouse of an enrolled employee. 7. Period of Disability for a Covered Employee as it applies to an indivi- dual , means all periods of disability arising from the same cause , including any and all complications therefrom except that if the indivi - dual completely recovers or returns to active full -time employment, any subsequent period of disability from the same cause shall be considered a new disability. For a Covered Dependent , the term "Period of Disability," means all periods of disability arising from the same cause including any and all complications therefrom, except that if the dependent re-covers for a period of three months and throughout such period is capable of resuming -5- the normal activities of a person in good health and of the same age and sex , any subsequent period of disability from the same cause shall be considered a new period of disability. 8. Total Disability shall mean that the Covered Employee is prevented, T1-3, because of a non-occupational injury or non-occupational disease, from engaging in the employee's regular or customary occupation and is performing no work of any kind for compensation or profit , or if a Covered Dependent is prevented, solely because of a non-occupational injury or non-occupational disease , from engaging in all of the normal activities of a person of like age and sex in good heZth. C. PROVIDER DEFINITIONS 1. Alcoholism Treatment Center - Any public or private place or other facility which is licensed by the State to provide alcoholism treatment services as a detoxification facility and/or inpatient rehabilitation facility. 2. Hospital means only an institution constituted and operated pursuant to awl ,engaged in providing on an inpatient basis at the patient 's expense, diagnostic and therapeutic facilities for the surgical and medical diagnosis, treatment and care of injured and sick individuals, by or under the supervision of a licensed Physician ; and providing • 24-hour-a-day services by registered nurses. The term "Hospital " shall not include an institutional part thereof which is other than inciden- tally a place for rest , a place for the aged , or a place for con- valescant care. However, an institution specializing in the care and treatment of mentally ill patients which would qualify under this defi - nition as a hospital , except solely for the fact that it lacks organized facilities on its premises for major surgery, shall nevertheless be deemed a hospital under the Plan. In-Hospital Convalescent Care Limitations: a. Convalescent Care benefits are limited to the normal Convalescent Care received by the Covered Person while the Covered Person is an in-patient in the hospital for treatment of a specific acute medi - cal , surgical , or psychiatric condition ; however, b. Convalescent Care is not a benefit when the Covered Person 's admission to the hospital is for Convalescent Care, or when such inpatient care ceases to be medically necessary. c. If a Covered Person remains in the hospital after the date that the Covered Person 's physician or other health care provider determines that in-patient hospital care is no longer necessary, then the Covered Person shall be liable for payment of any physician 's or other health care provider's charges after that date. 3. Intensive Care Unit is a section , ward , or wing within a hospital which is operated exclusively for critically ill pati ents and provides special -6- supplies , equipment and constant observation and care by registered grad- uate nurses or other highly trained personnel , excluding, however, any hospital facility maintained for the purpose of providing normal post- operative recovery treatment or service. 4. Nurse shall mean a Registered Graduate Nurse (R.N. ) , a Licensed Vocational Nurse (L.V.N. ) , or a Licensed Practical Nurse (L.P.N. ). 5. Outpatient is a Covered Person treated at a hospital and confined less than 15 consecutive hours or treated outside a hospital setting. 6. Physician is a person acting within the scope of his/her license and holding the degree of Doctor of Medicine (M.D. ) , Doctor of Ostheopathy (D.O. ) , Doctor of Dental Surgery (D.D.S. ) , Doctor of Medical Dentistry (D.M. D. ) Doctor of Podiatry (D.P.M. ) , a Board Certified Psychologist (PhD) , a Doctor of Chiropractic (D.C. ) , Physicians Assistant or Nurse Practitioner , who is legally entitled to practice medicine in all its branches under the laws of the State or jurisdiction where the services are rendered. 7. Semi -Private is a hospital room containing two (2) or more beds, but, benefits provided therefor do not include any charge made by the hospi - tal for Intensive Care. • 8. Usual , Reasonable and Customary: a. The usual charge is the most consistent charge by a physician or provialTrof service to patients for a given service. b. The charge is customary when it is within the range of usual charges for a given service billed by most physicians or providers of ser- vice with similar training and experience. c. A charge is reasonable when it meets the usual and customary cri - teria as determined by the Contract Administrator; or it may be reasonable if, upon review, it merits special consideration based on the nature and extent of treatment of the particular case. 9. Medically Necessary: Any service or supply for diagnosis or treatment that is : a. consistent with the illness, injury or condition of the Covered Person ; and b. ordered by an attending Physician ; and c. in accordance with approved and generally accepted medical or surgi - cal practice prevailing in the geographical locality where and at the time when the service or supply is ordered. Determination of "generally accepted practice" is the perogative of the Contract Administrator through consultation with appropriate authoritative medical or surgical persons. -7 10. Diagnostic Charges means the actual cost charged for X-Ray or Laboratory examinations of the Covered Person which are made or recom- ,— mended by a Physician for diagnostic purposes. 11. Covered Expense includes only those usual , reasonable, and customary charges made for medical services and supplies which most physicians would consider to be necessary for treatment of an injury or illness. D. PARTICIPATION DEFINITIONS 1. Active Service - An employee will be considered in Active Service with th-1731757r. on a day which is one of the employer's scheduled work days if the employee is performing in the customary manner all of the regular employment duties with the employer on a full -time basis on that day, either at one of the employer' s business establishments or at some loca- tion to which the employer' s business requires travel . An employee will be considered in Active Service on a day which is not one of the employer' s scheduled work days only if the employee was performing in the customary manner all of the regular employment duties on the pre- ceding scheduled work day. A Dependent will be considered in Active Service on any day if the dependent is then engaging in all the normal activities of a person in good health of the same age and sex, and is not confined in a medical facility. (This does not apply to a newborn). 2. Contribution shall mean the amount payable by the employer or the amount payable by the employer/employee jointly for participation in the bene- fits of the Plan. 3. Covered Dependents shall be those who are eligible as provided herein and enrolled by a Covered Employee. Covered Dependents shall be the spouse of the Covered Employee ; and children from birth to age 19, to age 23, if a registered student at an accredited college , vocational school , or university on a full -time basis, provided such children are unmarried , and dependent upon the Covered Employee for support and main- tenance. The term "children" shall include natural children , adopted children , foster children, and step children who depend upon the employee for support and maintenance. No employee will be considered both as a dependent and as an employee. If an employee and spouse are both eligible employees , only one may have dependent coverage for eligible children. Covered Dependent shall also include a dependent child after age 19, provided the child is (1) incapable of self-sustaining employment by reason of mental or physical handicap, (2) chiefly dependent upon the Covered Employee and/or the Covered Employee's Spouse for support and maintenance, and (3) has been continuously covered by the Plan prior to his/her 19th birthday. Proof of such incapacity and dependency must be furnished to the Administrator by the Covered Employee within the thirty one (31) days -8- prior to the child 's 19th birthday and at reasonable intervals thereafter. Dependents DO NOT include children of a dependent son or daughter. 4. Covered Employee is a permanent full -time employee of the Employer who is eligible hereunder and who has been enrolled in the Plan. To be con- sidered a full -time employee, one must work an average of 32 hours per week. In addition, such an employee will not be covered unless on the "date of eligibility" the employee is actually working a full day on that date; otherwise, his/her effective date will be deferred until return to actual service for a full day's work. 5. Covered Person is a Covered Employee or a Covered Dependent. 6. Eligibility and Effective Dates - Employees who are eligible for health coverage areiose full -time employees of Weld County. Full -time employees are those employed in a permanent position scheduled to work, 32 or more hours per week. Coverage shall become effective on the first day of the month following the first full month' s pay period. All employees shall become covered as they become eligible subject to the following: a. All enrollments are subject to making proper application for coverage under the Plan. b. Dependents shall be covered simultaneously with employees covering them as dependents, provided they are not confined in a hospital on the effective date. Coverage for newborn children will begin from birth. However, they need to be formally enrolled and appropriate coverage arranged within thirty-one (31) days from birth for coverage to be effective thereafter. c. For dependents (as stated in a and b above) who are not enrolled within this thirty-one (31) day period, and for whom coverage is subsequently desired, a health questionnaire showing evidence of insurability will be required. Coverage will begin on the date of approval of the Contract Administrator. d. An open-enrollment period will be scheduled in November of each year. 7. Pre-existing Conditions New Employees or Covered Persons becoming eligible after January 1, 1983 will not be entitled to covered medical expenses that are incurred as the result of an injury or sickness for which the Covered Person has consulted with a Physician or received any medical care or services within the three month period immediately preceding the effective date of coverage, unless incurred after the expiration of a period of: -9- a. Three (3) consecutive months ending after the date the benefits are effective for the Covered Person during which no medical care or treatment of such injury or illness has been received, or b. After a period of six (6) consecutive months during which the Covered Person was continuously at work and a member of the plan. (This does not pertain to Covered Dependents) ,or c. After a period of twelve (12) consecutive months during which the Covered Person has been continuously a member of the Plan. 8. Individual Termination of Coverage: Coveragefor Covered EmToyees and/or Covered Dependents will terminate on the earliest of the following dates : a. The date of termination of the Plan. b. The date the Covered Person becomes a full -time member of the Armed Forces of any country. c. The date the Covered Person ceases to meet eligibility requirements. d. The end of the month when contributions cease. 9. Late Entrants - Employees or dependents not enrolled within thirty-one 77TY days following their eligibility date , or, in the case of newly acquired dependents, within thirty-one (31) days of such acquisition , must provide evidence of good health satisfactory to the Contract Administrator. Coverage will begin on the date of approval by the Contract Administrator. An open enrollment will be conducted each year during the month of November. Enrollment during this month will not require evidence of good health. 10. Personal Leave of Absence - Properly enrolled employees of the Employer may continue , at t eeir expense, health coverage for themselves and/or their dependents while on an approved Personal Leave of Absence for the period indicated by the Employer's personnel policy. 11. Medical Leave of Absence - When a Physician requires that a Covered Person not retiiFn to work, benefits will be continued for a period not to exceed the length of time accrued under said employee's sick leave plan, or grants of sick days from the Weld County Sick Leave Bank, plus 31 days , provided the Covered Person makes the required contribution to the plan which he/she would otherwise be required to contribute. In order to be covered while on a Medical Leave of Absence, the employee must be : a. continuously and totally disabled, and b. under the care of a licensed Physician , and -10- • c. provide proof of disability satisfactory to the Employer at reaso- nable intervals upon request. 12. Dependents of Deceased Employees - Limited coverage for Covered Dependents 7 1-alEed employee can be continued provided application for conversion is made in writing to the Plan within thirty-one (31) days of the date of termination of benefits under this Plan. E. CONTRIBUTIONS The employer and employee share in the cost of the benefits under this plan. -11- SUPPLEMENTAL ACCIDENT BENEFIT A. BENEFIT PROVISION If a Covered Person shall , as a result of accidental bodily injuries sustained while covered under this Plan, incur expense which is usual , reasonable and customary for: (1) medical treatment or services performed by a legally qualified Phy- sician ; or (2) room and board and any other necessary medical services and care pro- vided by a legally constituted hospital ; or (3) nursing care provided by a registered graduate nurse; or (4) ambulance charges ; the Plan will pay for such related medical expense incurred during the ninety day period immediately following the date of the accident , but not to exceed, in the aggregate , for any one accident, the maximum payment spe- cified in the "Summary of Benefits. " B. LIMITATIONS 1. No payment shall be made under this benefit for expenses incurred for or on account of pregnancy; or 2. for expenses incurred for eye refractions, eye glasses, hearing aids, prosthetic devices or fitting of same; or 3. for expenses beyond the limitations described under "General Limitations" ; 4. nor shall payments under the Supplemental Accident Benefit serve to satisfy the major medical deductible. -12- MAJOR MEDICAL BENEFIT A. BENEFIT PROVISION Upon receipt of due proof, satisfactory to the Contract Administrator, that a Covered Person has incurred an expense for treatment of an illness or injury, the Plan will pay those amounts indicated in the "Summary of Benefits" of Medically Necessary Usual , Reasonable, and Customary charges. The benefits payable shall not exceed the "Maximum Lifetime Benefit" and are subject to the "Deductible" specified herein and are subject to all limita- tions and conditions of the Plan. B. DEDUCTIBLE 1. The "Deductible" equals the sum of the cash deductible specified in the "Summary of Benefits" and any other provision of this Plan. The deduc- tible amount applies during each Calendar Year. 2. Carry-over Provision : In order that a Deductible will not be applied late in one Calendar Year and soon again in the following year, any Covered Expenses incurred during the last three months of a Calendar Year which apply toward the Deductible (whether or not it is fully satisfied) for that year, may also be applied toward the Deductible for the subsequent Calendar Year. 3. Family Deductible: When the covered members of a family have satisfied the maximum Deductible per family in a Calendar Year, no further cash Deductible need be satisfied in that Calendar Year. This applies only to expenses incurred during the Calendar Year; expenses which are carried over from a prior year under the carry-over provision of this section will not be recognized. 4. Common Accident : If two or more Covered Persons in the same family are injured in a common accident , the Deductible amount applicable in the Calendar Year of the common accident shall be limited to a single cash. Deductible amount for that Calendar Year. C. MAXIMUM LIFETIME BENEFIT The Maximum Lifetime Benefit as shown in the "Summary of Benefits" , is the maximum lifetime amount of benefits available for any Covered Person , whether or not there has been an interruption in the continuity of coverage. D. COVERED MEDICAL EXPENSES Covered Medical Expenses shall include, subject to the "General Limitations ," only Medically Necessary Usual , Reasonable and Customary charges for services and supplies which are incurred by a Covered Person due to: 1. hospital charges by a "hospital " as defined herein for room and board and other hospital services required for purposes of treatment , but not -13- to exceed the average semi-private room rate or intensive care unit room rate ; 2. charges for anesthetics and their administration ; 3. charges made by a "Physician" or recommended by and directly supervised by a "Physician" for Medically Necessary services ; 4. charges made for the necessary professional services of a physiothera- pist ; 5. charges for speech therapy by a qualified speech therapist to restore speech loss, or correct an impairment , due to (a) a congenital defect for which corrective surgery has been performed, or (b) an injury or sickness except for a mental , psychoneurotic or personality disorders ; 6. charges for the following medical services or supplies that are recom- mended by the Physician: a. drugs and medicines requiring a Physician 's prescription ; b. oxygen and/or rental of equipment required for its administration , but not to exceed the purchase price of such equipment ; c. radiotherapy; d. diagnostic X-ray and laboratory services ; e. charges for braces, casts, splints, initial artificial limbs or other original prosthetic appliances to replace lost physical organs or parts or to aid in their functions when impaired if the loss or impaired function occurred while covered under this Plan. Covered charges are for original placement. f. blood and blood plasma; g. ambulance to a local hospital where adequate medical treatment can be administered ; h. insulin and insulin syringes ; i . head halter or other traction apparatus ; j. rental of a wheel chair, special hospital bed, iron lung, crutches , and other reasonable , Medically Necessary mechanical and therapeutic equipment but not to exceed their purchase price; k. emergency room services; 7. charges for pre and post natal visits ; 8. charges for vasectomies and tubal ligations ; -14- 9. Charges made by a legally qualified Physician for performing oral surgery consisting of cutting procedures for removal of tumors , cysts , and charges incurred to restore sound natural teeth within six months after the date of an accident, unless medically indicated that treatment be delayed, provided that the injury or condition and treatment thereof occurs while this coverage is in effect. Such charges includes dental X-rays and general anesthesia , Medically Necessary and prescribed by a legally qualified Physician ; 10. Chiropractic services rendered by a D.C. will only be covered for the detection and correction by manual or mechanical means, including X-rays incidental thereto, the structural imbalance, distortion or subluxation in the human body for the removal of nerve interference, where such 'interference is the result of or related to distortion , misalignment , or subluxation of or in the vertebral column. Chiropractic care which exceeds the following guidelines may not be considered as a covered expense if it is determined to be maintenance , palative, or excessive care: a. three visits per week for the first four weeks ; b. two visits per week for the next eight weeks ; c. one visit per week for the next four weeks ; • Consideration of treatment programs exceeding these guidelines must be accompanied by the attending Chiropractor' s statement outlining their Medical Necessity; The benefits payable under this provision will not exceed the following maximums: a. $30.00 maximum consideration per visit; b. $500.00 maximum payment per Calendar Year per Covered Person ; c. $5,000.00 maximum payment per lifetime per Covered Person. 11. charges for services of a registered graduate nurse or licensed prac- tical nurse or nurse practitioner, if authorized by a Physician ; 12. charges for allergy testing or injections. -15- HOSPITAL CARE BENEFIT Upon receipt of due proof of eligibility that a Covered Person has incurred -- necessary expenses which are recommended and approved by a "Physician" as herein defined , for hospital care for diagnosis or treatment of an illness or injury, the Plan will pay Usual , Reasonable and Customary charges not exceeding the maximum amount specified in the Summary of Benefits for such charges. A. DEDUCTIBLE The "Deductible" equals the sum of the Cash Deductible specified in the "Summary of Benefits" and any other provision of this Plan. The Deductible amount applies during each Calendar Year. B. ROOM, BOARD, AND GENERAL NURSING CARE The Plan will pay the amount charged by the hospital for a Covered Person who is confined for room, board, and general nursing care, not to exceed the Semi-Private, Intensive Care Unit , or Coronary Care Unit room rate. C. OTHER HOSPITAL CHARGES The Plan will pay the Usual , Reasonable and Customary amounts charged by the hospital for Medically Necessary services, medicines , and supplies for diagnosis or treatment of illness or injury during any one period of con- finement provided: 1. the Covered Person is hospital -confined as an inpatient ; or 2. the Covered Person has surgery performed in the hospital . D. SUCCESSIVE PERIODS OF HOSPITAL CONFINEMENT Successive periods of hospital confinement shall be considered as one con- finement unless: 1. The later confinement commences after complete recovery from the sickness or injury which caused an earlier confinement; 2. The later confinement results from causes entirely unrelated to the causes of an earlier confinement; 3. The confinements are separated by the employee's return to work for two weeks , or in the case of a dependent, a separation from the previous confinement of three (3) months duration. -16- ANESTHESIOLOGY BENEFIT A. BENEFIT PROVISION Benefits are payable when a Covered Person incurs charges for anesthetic services rendered by a licensed anesthesiologist in connection with a surgi- cal operation. Under this benefit, the 1974 American Society of Anesthesiologists Relative Value Guide will be used based on unit value plus time, but not to exceed the Usual , Customary and Reasonable charge. B. ANESTHESIOLOGY BENEFIT LIMITATIONS No amount will be payable under this Section for charges : 1. which are excluded under the General Limitations provisions ; 2. which result from any sickness or bodily injury arising out of or in the course of an individual 's employment ; 3. cosmetic surgery. • -17- SURGICAL BENEFIT A. BENEFIT PROVISION If a Covered Person incurs necessary expense as a result of an injury or illness which causes the person to undergo any non-cosmetic surgical proce- dure, the Plan shall pay the Medically Necessary Usual , Reasonable and Customary expense incurred for: 1. the services of the principal surgeon ; and/or 2. plastic and reconstructive surgery if the surgery is necessary to correct deformities causing functional physiological difficulties arising from illness or injury. B. MULTIPLE AND/OR BILATERAL PROCEDURES If two or more surgical procedures are performed at one time through the same incision or in the same operative field, the maximum amount payable for surgery will be the procedure for which the highest surgical benefit is pro- vided. In the event that two or more separate operations are performed during one period in the operating room, the amount payable shall be the Surgical Benefit payable for the operation performed for which the highest Surgical Benefit is provided ; plus not over 50% of the Surgical benefits specified for the other operation(s). C. LIMITATIONS 1. No payment shall be made under this benefit for expenses incurred for or on account of weight control or obesity, other than "Morbid Obesity" ; or 2. for treatment or services described under "General Limitations". -18- GENERAL LIMITATIONS No benefits shall be payable under any part of this Plan with respect to: 1. any charges not Medically Necessary for diagnosis or treatment of an illness, injury, or pregnancy; or 2. any charges for cosmetic surgery unless due to an accident or injury occuring while covered; or 3. any charges for rhinoplasty, blepharoplasty or brow lift except charges for rhinoplasties and blepharoplasties to correct a functional condition or charges for rhinoplasty to correct a condition as a result of an acci - dental injury; or 4. vaccinations, innoculations , or any charges for any examination for check- up purposes not incidental to or necessary to diagnose an injury or illness (except as otherwise provided for in this Plan) ; or 5. any injury or illness for which the Covered Person on whose behalf claim is presented is not under the regular care of a Physician ; or 6. any charges for any condition , disability or expense resulting from or sustained as a result of being engaged in an illegal occupation , commissioh of or attempted commission of an assault or a felonious act ; or 7. any charges for any condition , disability or expense resulting from or sustained as a result of war or act of war, declared or undeclared ; or 8. any charges for any condition or disability which would entitle the Covered Person to any benefit under a Worker's Compensation Act or similar legisla- tion or which is due to injury or sickness arising out of or in the course of any occupation or employment for wage or profit ; or 9. hearing aids, batteries or repairs ; or 10. any charges for professional services performed by a person who ordinarily resides in the Covered Person's household or who is related to the Covered Person as a spouse , parent, child, brother, sister, whether such rela- tionship is by blood or exists in law; or 11. charges for instruction or activities for weight reduction, weight control , or physical fitness even if the services are performed or prescribed by a Physician ; or 12. any charges for artificial insemination ; or reversal of vasectomies , or reversal of tubal ligation ; or 13. any charges for eye glasses , correction of vision , fitting of glasses or eye examinations ; or 14. any charges for air conditioners , purifiers , dehumidifiers , corrective shoes, heating pads , hot water bottles , and other clothing and equipment which is not solely for medical purposes ; or -19- 15. any charges for special education , counseling, or care for learning de- ficiencies or behavioral problems , whether or not associated with a mani - fest mental disorder or other disturbance ; or 16. any charges for routine health examinations , multiphasic screening tests , and physician checkups not associated with any disease, injury or condition requiring professional service or treatment (except as otherwise provided for in this Plan) ; or 17. travel expenses of a Physician attending a Covered Person , or travel ex- penses of a Covered Person , although recommended by a Physician ; or 18. any charges for preparing medical reports or itemized bills; or 19. non-medical expenses such as training, educational instructions or edu- cational materials , even if they are performed or prescribed by Physician ; or 20. services or supplies for which there is no legal obligation to pay, or charges which would not be made but for the availability of benefits under this Plan ; or 21. any expenses which exceed the usual , customary and reasonable expenses for the medical care rendered; or • 22. vitamins and/or nutritional supplements ; or 23. acupuncture administered by other than an M. D. or D.O. ; or 24. any charges related to custodial care , sanitarium care, or rest cares ; or 25. treatment not prescribed or recommended by a Physician ; or 26. hospitalization charges for dental treatment. However, the hospital charges will be covered if the patient has another medical condition which requires that dental treatment be provided on an inpatient basis and the Medical Necessity of hospitalization is certified by a Physician ; or 27. obstetrical care for a dependent other than the spouse of an enrolled employee or the female employee ; or 28. charges for mailing or sales tax ; or 29. medical expenses for equipment , supplies , procedures or treatments which are experimental in nature or which have not been approved by the Food and Drug Administration or the appropriate authorizing agency; or 30. treatment of (a) weak, strained, flat , unstable or unbalanced feet, metetar- salgia or bunions, except open cutting operations , (b) corns, calluses or toenails, except the removal of nail roots and necessary services in the treatment of metabolic or peripheral -vascular disease ; or -20- 31. expenses in connection with drug abuse , drug addiction, alcoholism, or ner- vous and mental conditions except where specifically noted herein ; or 32. treatment of periodontal or periapical disease or any condition (other than a malignant tumor) involving teeth, surrounding tissue or structure. However, this exclusion does not apply to the benefits for dental treatment described under the "Supplemental Accident Expenses" Section ; or 33. Chiropractic Maintenance , Palative or Excessive Care; or 34. any expenses resulting from intentional self-inflicted injury or attempted intentional self-destruction while sane or insane. 35. any-expenses related to treatment of temporomandibular joint disfunction. • -21- HOW TO FILE A CLAIM Claim forms can be obtained from the Personnel Office, or by calling or writing James Benefits , 3895 Upham Street, #100, Wheat Ridge, Colorado 80034-0987, (303) 423-2400. The Employee Statement on the top of the claim form must be completed in FULL and signed by the employee. Itemized bills (hospital , doctor anesthe- sio o ig st , laboratory, prescriptions , etc. ) should be attached to the claim form, and the Attending Physician Statement on the bottom of the claim form should be completed by the appropriate Physician unless ALL necessary infor- mation is included on the Physician 's own form. The completed claim form and the attached bills should be sent to: Weld County c/o James Benefits P.O. Box 987 Wheat Ridge, Colorado 80034-0987 Identification cards and claim forms are available for Plan participants from the Personnel Office of Weld County. • -22- COORDINATION OF BENEFITS A. APPLICATION If any individual covered under this Plan is also covered under other plans, the benefits payable under this Plan will be coordinated with benefits payable under all other plans. Coordination will apply in determining the benefits payable with respect to an individual for any Claim Determination Period if, for the Allowable Expenses incurred during that period, the sum of the following would exceed those Allowable Expenses: 1. the benefits that would be payable under this Plan in the absence of coordination , and 2. the benefits that would be payable under all other plans in the absence of provisions for coordination in those plans. Except as provided in the following paragraph, when Coordination of Benefits applies to the benefits payable with respect to an individual for Claim Determination Period, the benefits that would be payable for Allowable Expenses incurred during that period under this Plan in the absence of Coordination of Benefits will be reduced to the extent necessary so the sum of those reduced benefits and all the benefits payable for those Allowable . Expenses under all other plans will not exceed the total of those Allowable Expenses. Benefits payable under all other plans include the benefits that would have been payable had claim been properly made for them. If, in coordinating the benefits of this Plan with those of another plan, the rules set forth in the following paragraph would require this Plan to determine its benefits before the other plan and the other plan which con- tains a provision coordinating its benefits with those of this Plan would, according to its rules , determine its benefits after the benefits of this Plan have been determined, then the benefits of that other plan will be ignored for the purposes of determining the benefits of this Plan. B. ORDER OF BENEFIT DETERMINATION The rules establishing the order of benefit determination are: 1. The benefits of a plan which covers the individual for whom claim is made other than as a Dependent will be determined before the benefits of a plan which covers that individual as a Dependent. 2. The benefits of a plan which covers the individual for whom claim is made as a Dependent of a male will be determined before the benefits of a plan which covers that individual as a Dependent of a female. However, for a dependent child of a divorced couple , the coverage of the parent who has custody of the child will be determined before the bene- fits of the other parent are determined (unless stipulated otherwise by a court decree). -23- 3. When Rules 1 and 2 do not establish an order of benefit determination , the benefits of a plan which has covered the individual for whom claim is made for the longer period of time will be determined before the benefits of a plan which has covered the individual the shorter period of time. When Coordination of Benefits operates to reduce the total amount of benefits otherwise payable during any Claim Determination Period with respect to an individual covered under this Plan , each benefit that would be payable in the absence of Coordination of Benefits , will be reduced proportionately, and the reduced amount will be charged against any applicable benefit limit of this Plan. C. DEFINITIONS APPLICABLE TO THIS PROVISION 1. Plan The term "Plan" includes the following plans under which a person is entitled to receive or received benefits or services for or by reason of medical or dental treatment. a. Group Plans , insured or self-funded ; group, blanket , or franchise insurance coverage; group hospital or medical service plans , and other group pre-payment coverage ; any coverage under labor manage ment trusted plans , union welfare plans , employer organization plans , or employee benefit organization plans. b. The "Medicare" program, including Part A and Part B, established by Title XVIII of the Social Security Act. A person shall be con- sidered to be entitled to all of the coverage provided by Medicare on and after the earliest date the person would have become so entitled if the person had promptly submitted all applications and proofs required for such coverage. A person who is entitled to the coverage provided by Medicare will be considered entitled to receive benefits, whether or not application for such coverage or benefits has been made. It shall be deemed that any disabled person eli - gible for Medicare benefits or any individual age 65 or over shall be entitled to Medicare. NOTE: Medicare benefits will be considered as secondary payments for any eligible individual between the ages of 65 through age 69 wishing to be covered by this plan. c. Any coverage required or provided by any statute , including any no- fault automobile insurance provided or required by statute and/or any automobile medical insurance. 2. Allowable Expense Means any Usual , Reasonable and Customary item of expense at least a portion of which is covered under at least one of the plans covering the individual for whom claim is made. When a plan provides benefits in the -24- form of services rather than cash payments , the reasonable cash value of each service rendered will be considered to be both an Allowable Expense and a benefit paid. 3. Claim Determination Period The term "Claim Determination Period" means a period commencing with any January 1 and ending at twelve o'clock (12:00) midnight on the next suc- ceeding December 31, or that portion of such period during which the person on whose expenses claim is based has been covered under this plan. D. RELEASE OF INFORMATION For the purposes of determining the applicability of and implementing the terms of the above provisions of this Plan or any similar provision of another plan , the Contract Administrator may, without consent of or notice to any individual , release to or obtain from any other insurance company or other organization or individual any information , concerning any individual , which the Contract Administrator considers to be necessary for those pur- poses. Any individual claiming benefits under this Plan will furnish to the Contract Administrator the information that may be necessary to implement the above provisions. E. PAYMENTS Whenever payments which should have been made under this Plan in accordance with the above provisions have been made under any other plans , the Contract Administrator will have the right , exercisable alone and in its sole discre- tion to pay to any organization making those payments any amounts it deter- mines to be warranted in order to satisfy the intent of the Coordination of Benefits Provisions. Amounts paid in this manner will be considered to be benefits paid under this Plan ; and to the extent of these payments , the Employer will be fully discharged from liability under this Plan. F. CLAIMS PAYMENTS MADE IN ERROR If payments in excess of the correct amount due are made, the Plan may recover all excess amounts paid. Recovery will be made by reducing or suspending future plan payments, or by requiring the Covered Person to pay back the overpayment in full , or in installments, until the overpayment is recovered. G. RECOVERY AND SUBROGATION Whenever payments have been made by the Contract Administrator in excess of the maximum amount of payment necessary to satisfy the intent of the Coordination of Benefit provisions , the Contract Administrator will have the right to recover excess payment from any individuals, insurance companies or other organizations. -25- In the event of payment in part or in full by this Plan of any expense incurred for hospital , surgical , medical , or dental services , and medical supplies for the benefit of an Eligible Participant or an Eligible Participant 's dependent , this Plan shall be subrogated to the extent of the amount of such payment to all the rights , powers, privileges and remedies, of the Eligible Participant or the Eligible Participant 's dependent against any person , firm, corporation , organization , plan or other entity regarding the payment of such expense. H. LEGAL ACTIONS No action at law or in equity shall be brought to recover on the policy prior to the expiration of 60 days after written proof of loss has been fur- nished in accordance with the requirements of the Plan. No such action shall be brought after the expiration of three years after the time written proof of loss is required to be furnished. I. PROOFS OF LOSS/TIMELY SUBMISSION OF CLAIMS Written proof of loss must be furnished to James Benefits, in case of claim for loss for which the policy provides any payment , within 90 days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible ; and in no event, except in the absence of legal capa- city of the claimant , later than one year from the time proof is otherwise required. Under no circumstances will a claim be honored for payment beyond 90 days following the date coverage terminates. -26- COMMON LAW SPOUSE Coverage is provided for a common-law spouse, as defined by the courts , in accordance with the laws of the State of Colorado. The requirements which must be met for a relationship to gain recognition as a Common-Law Marriage are coha- bitation and general reputation as married. Both factors must be present. Mere cohabitation is not sufficient. General reputation as to marital relation has been defined by the courts to mean "the understanding among neighbors and acquaintances with whom the parties associate in their daily lives that they are living together as husband and wife , and not in meretricious intercourse". (Citations omitted) To establish the presumption of marriage by cohabitation and repute there must be presented clear, consistent , convincing and positive evidence. The sorts of things the courts in Colorado have relied upon are: 1. What the parties call themselves in introductions , "my wife, Betty rather than "my girlfriend, Betty Maiden name": 2. How each fill out forms such as credit or employment applications, i .e. checking the block marked married or the one marked single, and the name used by the woman. ; 3. Whether they rent their apartment or home as Mr. and Mrs. Smith; 4. Presence of joint bank accounts in a married name (joint bank account where woman uses her family name was held to go against the presumption of marriage relationship). If such evidence is present and the couple are holding themselves out as husband and wife , they are entitled to the benefits and privileges of any other married couple. FACILITY OF PAYMENT If, in the opinion of the Contract Administrator, a valid release cannot be ren- dered for the payment of any benefit payable under this Plan, the Contract Administrator may, at its option , make such payment to the individual or indivi- duals as have , in their opinion , assumed the care and principal support of the Covered Person and are , therefore, equitably entitled thereto. In the event of the death of the Covered Person prior to such time as all benefit payments due him/her have been made , the Plan Administrator may, at its sole discretion and option , honor benefit assignments , if any, made prior to the death of such Covered Person. Any payment made by the Plan in accordance with the above provision shall fully discharge the Plan to the extent of such payment. -27- PROCESS IN CASE OF DISPUTED CLAIM If a Covered Employee has reason to believe a claim has not been settled pro- perly, or a claim has been improperly denied, the following process applies : 1. Contact the Contract Administrator in writing to ask for a second review. The claim will be reviewed by the Contract Administrator and the Plan Administrator's consultant servicing the account. If the result of this review is not satisfactory, then : 2. Request a review in writing from the Director of Personnel of Weld County stating in clear and concise terms the reason for disagreement with the handling of the claim. This request must be made within sixty (60) days after receipt of a declination letter from the Contract Administrator (James Benefits). Upon receipt of the request, the file will be reviewed and the results of the review will be furnished to the Covered Employee, along with copies of pertinent Plan Documents upon which this declination is based. If the Covered Employee still finds the claim is improperly denied per the Plan Documents , he/she has a legal right to take what appropriate action he/she believes is necessary. -28- CONVERSION PRIVILEGE Any Covered Person , within thirty-one days after the date health benefits ter- minate because of termination of employment or because of membership in a class or classes eligible for such coverage, shall be entitled to have issued to him/her , without evidence of insurability, an individual policy of health insurance provided written application therefor and payment of the first premium thereon is made to the insurance company within said thirty-one days. Any such individual policy issued shall cover: a. the Person, if the health benefits under this Plan covered the Person only; or b. the Person and his/her Dependents, if the health benefits under this Plan covered both the Person and the Person 's dependents ; and shall become effective on the day immediately following the date of ter- mination of coverage under this Plan. The form of this individual policy, the coverage thereunder and all other terms and conditions thereof shall be such as is then provided by the insuring company with respect to insurance issued pursuant to an application made in accordance with these provisions. * If a Covered Person 's health coverage under this Plan with respect to a Dependent spouse is terminated because of the death of the Person , such spouse shall be entitled to have issued to him/her an individual policy of health insurance in the same manner and subject to the same conditions as provided for the Covered Person. If a Covered Person 's health coverage under this Plan with respect to a Dependent child is terminated because of the child's marriage or attainment of the maximum age specified in this Plan for Dependent children , such child shall be entitled to an individual policy of health insurance in the same manner and subject to the same conditions as provided for the Covered Person. THE PROVISIONS OF THIS SECTION SHALL NOT BE APPLICABLE TO ANY INDIVIDUAL ON AND AFTER THE DATE THE COVERED PERSON BECOMES AN ELIGIBLE INDIVIDUAL UNDER TITLE XVIII OF THE SOCIAL SECURITY ACT AS AMENDED (MEDICARE) , OR WOULD HAVE BECOME AN ELIGIBLE INDIVIDUAL UNDER SUCH LAW HAD TIMELY APPLICATION BEEN MADE. * The Conversion Privilege described herein shall also be applicable to a spouse who ceases to be a Dependent due to legal separation or legal dissolu- tion of marriage. -29- The effective date of this Plan Document is January 1, 1983. IT IS AGREED BY WELD COUNTY that the provisions contained in this Plan Document are acceptable and will be the basis for the administration of said Employer's Employee Benefit Program described herein. SIGNED AT Greeley, Colorado This 15th day of December , 1982. WITNESS: �Jl n — v..l %{�71iri/ BY ,y z--/"1-w -i / V 1,c t a ChPirmAn, ROard_Of County Carrrnissioners Title By Title -30- AN AGGREGATE EXCESS RISK INSURANCE AGREEMENT HARTFORD ACCIDENT AND INDEMNITY COMPANY Hartford, Connecticut (a stock insurance company) will reimburse the Employer named in the Schedule for Plan Benefits Paid under his Employee Benefit Plan, subject to the Annualized Deductible Amount in an Agreement Year and all other conditions of this agreement. Signed for the Company by b(d 7 es AS Secr Registrar JO, r98S ate o Iss TABLE OF CONTENTS SCHEDULE DEFINITIONS MONTHLY REPORTS REQUIRED DEDUCTIBLE AMOUNT REIMBURSEMENT LIMITATIONS ON COVERED EXPENSES AND PLAN BENEFITS PAID LIMITATIONS ON ELIGIBLE PARTICIPANTS PAYMENT OF CLAIMS PREMIUMS TERMINATION OF AGREEMENT GENERAL PROVISIONS This agreement is a replacement of the Aggregate Excess Risk Insurance Agreement effective on September 15, 1983 between WELD COUNTY and HARTFORD ACCIDENT AND INDEMNITY COMPANY. GR-11259 ER - 1.0 T-K10 SCHEDULE Employer Name: WELD COUNTY Place of Delivery: Greeley, CO Effective Date: January 1, 1985 Annual Premium : $6,000.00 Excess Risk Determinant Factor: $140.89 Individual Claim Limit: $50,000.00 Reimbursement Percent: 100% Maximum Reimbursement : $1,000,000.00 Required Group Policies: GL-19628 Type of Benefits to which Insurance Applies: Type Reported Number of Eligible Employee Participants Medical 634 Companion Individual Excess Risk Agreement X Yes No Administrator: James/Galbraith & Green Wheat Ridge, CO 80033 GR-11259 ER - 2.0 T-K20 DEFINITIONS As used in this agreement: . We, our, or us, means Hartford Accident and Indemnity Company or any of its subsidiaries or affiliates which it designates to perform the functions and the obligations to which it agrees in this agreement. . You or your means the employer named in the Schedule . . He means he or she. . His means his or her. . Employee Benefit Plan or The Plan means the benefit plan that you have established for Eligible Participants. The insurance provided under this agreement applies only to the Type of Benefits provided under the Employee Benefit Plan that are listed in the Schedule. . Plan Document means the written description of The Plan which is attached to and forms a part of this agreement. The insurance provided under this agreement is subject to all of the terms and provisions of the Plan Document, except as otherwise noted in this agreement. . Eligible Participant means employees and dependents who are eligible for benefits in accordance with the Plan Document, but not including retired employees or their dependents. . Proof of Loss means written evidence of a claim on a form customarily required by the Administrator and satisfactory to us. . Agreement Year means a one year period that begins on the Agreement Effective Date and ends 12 consecutive months later. Subsequent Agreement Years begin on each anniversary of the Agreement Effective Date and end 12 consecutive months later. . Covered Expenses mean only those expenses that are payable under the terms of the Plan Document and which represent the Type of Benefits shown in the Schedule. The expenses must arise from services and supplies which are medically necessary to diagnose or treat an Eligible Participant's sickness, injury or pregnancy. GR-11259 ER - 3.0 K30 DEFINITIONS (continued) . Incurred means the date on which the Eligible Participant receives the service or supply for which a charge is made. . Plan Benefits mean only Covered Expenses payable under the terms of the Plan Document. . Paid means that a check or draft to satisfy an Eligible Participant's claim for benefits under the Plan has been issued and sent by the Administrator. The check or draft can be sent to the Eligible Participant or his assignee. GR-11259 ER - 4.0 K40 MONTHLY REPORTS REQUIRED You will provide us with monthly reports of Plan Benefits Paid and the number of Eligible Employee Participants covered under The Plan. These reports must be sent to us in a format satisfactory to us and within 31 days of the last day in each calendar month during the Agreement Year. Plan Benefits Paid must include: a. each Eligible Employee Participant's name or identification number; b. the date a check or draft in payment of Plan Benefits was issued; c. the amount of each check or draft; and d. the Type of Plan Benefits Paid as shown in the Schedule. You must submit the number of Eligible Employee Participants covered on the first day of each calendar month for each month in the Agreement Year. This report of Eligible Employee Participants for any calendar month must show: a. the name of each Eligible Employee Participant; b. whether or not these employees have dependent's covered, and c. the effective date of employee coverage and the effective date of dependent coverage. We may, at our option, terminate this agreement by providing 31 days notice of such termination if you fail to provide reports required. GR-11259 ER - 5.0 K50 ANNUALIZED DEDUCTIBLE AMOUNT The Annualized Deductible Amount for an Agreement Year is calculated in the following manner: a) multiply the number of Eligible Employee Participants covered under The Plan on the first day of each month within the Agreement Year by the Excess Risk Insurance Determinant Factor shown in the Schedule. b) add the products of each month for the entire twelve months in the Agreement Year. The number of Eligible Employee Participants used in each monthly calculation can never be less than 85% of the Reported Number of Eligible Employee Participants shown in the Schedule. This Annualized Deductible Amount is satisfied when Plan Benefits have been Paid in an amount in excess of the Annualized Deductible Amount during the Agreement Year. In order to be applied against the Annualized Deductible, Plan Benefits must have been Paid in excess of the Individual Claim Limit shown in the Schedule and within 60 days of the Administrator's receipt of Proof of Loss. GR-11259 ER - 6.0 T-K60 REIMBURSEMENT We will reimburse the Employer for Plan Benefits Paid which exceed the Annualized Deductible Amount. To be eligible for Reimbursement, Plan Benefits for Covered Expenses must be Paid in excess of the Individual Claim Limit as shown in the Schedule and: a) while this agreement is in force; b) within the Agreement Year; c) within 60 days of the Administrator's receipt of Proof of Loss. Reimbursement for Plan Benefits will not exceed the Reimbursement Percent shown in the Schedule. The total reimbursement under this agreement will not exceed the Maximum Reimbursement shown in the Schedule. GR-11259 ER - 7.0 T-K70 LIMITATIONS ON COVERED EXPENSES AND PLAN BENEFITS PAID The following Plan Benefits Paid do not qualify under this agreement for reimbursement or for satisfaction of the Annualized Deductible Amount: Plan Benefits Paid for an Eligible Participant in excess of the Individual Claim Limit as shown in the Schedule. Plan Benefits Paid for which you are entitled to reimbursement under any other insurance or any other agreement, including any other insurance or agreement provided by us. Plan Benefits Paid after the date this Agreement terminates. Plan Benefits Paid for expenses not considered a Covered Expense under the terms of the Plan Document. Plan Benefits Paid for a Type of Benefit which is not listed in the Schedule. Plan Benefits Paid because of a change in the Plan Document, unless we have agreed in writing to such change. Plan Benefits Paid regardless of the terms of your Plan Document for or in connection with any of the following expenses: a) court costs, or expenses for punitive or exemplary damages; b) administrative expenses, including expenses for investigation of claims; c) expenses which exceed the usual and customary charges for the service or supply in a geographical area where the service or supply is received; or d) expenses charged in connection with an accident or sickness arising out of any activity for wage or profit. GR-11259 ER - 8.0 K80 LIMITATIONS ON ELIGIBLE PARTICIPANTS For purposes of this agreement, Eligible Participants will be limited as follows: Those who do not enroll during the eligibility period described in the Plan Document will be required to furnish to us evidence of the Eligible Participant's good health. We will not cover any Plan Benefits Paid or Covered Expenses Incurred prior to the date that we approve his evidence of good health. Evidence of good health must be furnished at no expense to us. GR-11259 ER - 9.0 K90 PAYMENT OF CLAIMS We will reimburse you when we receive: a) Proof of Loss; and b) satisfactory proof that Plan Benefits have been Paid in accordance with the provisions of the Plan Document and this agreement and are in excess of the Annualized Deductible Amount for which reimbursement is requested. We will make reimbursement of benefits due under this agreement within 60 work days of receipt of such proof. GR-11259 ER - 10.0 K100 PREMIUMS The Annual Premium payable under this agreement will be based on the Reported Number of Eligible Employee Participants shown in the Schedule. The Annual Premium* is due on the Effective Date*. We may change the Annual Premium after giving you 31 days advance written notice of such change. *These items are shown in the Schedule. GR-11259 ER - 11.0 T-K110 TERMINATION OF AGREEMENT This agreement will terminate on the earliest of the following dates: a) the date shown in The Hartford's written notice of termination; b) the date The Plan ceases to be administered by the Administrator shown in the Schedule, unless we agree in advance and in writing to the change in your Administrator; c) the date any of the Required Group Policies shown in the Schedule are terminated, unless we agree in advance and in writing to such termination; d) the date you discontinue or modify the Plan Document without our advance written approval and consent; e) the 31st day after the Annual Premium is due if that premium -- has not been paid. f) the date you or your Administrator fail, without good and sufficient cause, to perform in good faith any of your duties or obligations under this agreement. g) the Effective Date shown in the Schedule, if the information you provide us on the Reported Number of Eligible Employee Participants is materially misrepresentative of the actual number of Eligible Employee Participants insured under The Plan. h) the date we receive written notice of termination from you or the date stated in the notice. i) the date shown in our written notice to you, if you fail to provide required reports. GR-11259 ER - 12.0 K120 GENERAL PROVISIONS This agreement, together with any agreement riders, the attached Plan Document and any Plan amendments, copies of which are attached to this agreement, constitute the entire contract between you and us. Our entire obiligation is set forth in this agreement. We assume no responsiblity or obligation for: a) administration of The Plan; or b) your acts or your Administrator's acts. We reserve the right to determine amounts payable under this agreement without regard to such acts. We have the right to inspect any of your records or other data pertaining to The Plan, including records or other data maintained by the Administrator. If material misrepresentation is found in your or your Administrators records or other data pertaining to the risk assumed by us, we have the right to rescind the Agreement as of the Effective Date shown in the Schedule. This agreement may be amended at any time by mutual agreement between you and us. However, no agent will have authority to make such a change. To be valid, any change or waiver must be in writing, approved by one of our officers and attached to this agreement. All periods begin and end at 12:01 A.M. , Standard Time at the place where this agreement is delivered. GR-11259 ER - 13.0 T-K130 •. L .-1 AMENDMENT NO. I -,N to THE MASTER PLAN DOCUMENT of WELD COUNTY EMPLOYEE BENEFIT FUND Effective date of this amendment: May 1 , 1983 In addition to amending our Plan Document, request is hereby made to the Plan Administrator to administer our Plan according to the following amend(s) to our Master Plan Document. PAGE 21 (GENERAL LIMITATIONS) The existing paragraph is hereby replaced in its entirety as follows: 32. treatment of periodontal or periapical disease or any condition (other than a malignant tumor or surgical removal of bony impacted teeth) involving teeth surrounding tissue or structure. However, this exclusion does not apply to the benefits for dental treatment described under the "Supplemental Accident Expenses" Section; or IT IS AGREED BY WELD COUNTY that the provisions contained in this Plan Document are acceptable and will be the basis for the administration of said Employer's Employee Benefit Program described herein. SIGNED AT Areeley, rn This 20th day of :rune -- — — -— -, 1983. WITNESS: ES `� {{ i fC 42> 7¢tict4m / By CW1 ✓ Title ., AMENDMENT NO. II to the Health Plan Document of the WELD COUNTY EMPLOYEE BENEFIT FUND The Health Plan Document of the Weld County Employee Benefit Fund is hereby amended, effective August 1, 1983, as follows : Page 23 - The following paragraph(s) is hereby added to the following: COORDINATION OF -BENEFITS B. ORDER OF BENEFIT DETERMINATION 4. The benefits of this plan will .be the primary plan for those active employees ( and their dependents) until the covered person reaches age 70 and who have elected to participate in this plan. For those who are eligible for Medicare, any unpaid charges under this plan should be sub- mitted to Medicare for payment. Enrolled, active employees age 70 or older are required to submit claims to Medicare as the primary plan. Page 4 - The following paragraph replaces the existing paragraph in its • entirety: A. GENERAL DEFINITIONS 1. Age Discrimination - All active employees age 55 through 69 and their covered spouses age 65 through age 69 are entitled to the same and/or equal benefits they had prior to age 65. Medicare is the primary carrier on their 70th birthday, as required under Section 116, Tax Equity and Fiscal Responsibility Act. - Weld County hereby states that the intent of this amendment is to satisfy the requirements of Section 4(g) (1) of the Age Discrimination in Employment Act of 1967 ( added by Section 116(a) of the Tax Equity and Fiscal Responsibility Act of 1982) . It is intended that this amendment is to be interpreted in a manner that will accomplish this purpose. IT IS AGREED BY WELD COUNTY that the provisions contained in the Plan Document and Amendment No. II thereto are acceptable and will be the basis for the administration of said Employer' s Employee Benefit Program described herein. , SIGNED at Q.J. , , Colorado, this 2 r) day of 1983. - WELD COUNTY Witness: By - �> :? L . {e r ( wile .% ?Lit/ Title L / L�vi-v. . Amt/10-1 i 77 J r WELD COUNTY EMPLOYEE BENEFIT FUND Effective: January 1, 1983 TABLE OF CONTENTS Page PARTIES TO THE AGREEMENT STOP LOSS INSURANCE COMPANY EFFECTIVE DATE SUMMARY OF BENEFITS 1 DEFINITIONS 4 SUPPLEMENTAL ACCIDENT BENEFIT 12 MAJOR MEDICAL BENEFIT 13 HOSPITAL CARE BENEFIT 16 ANESTHESIOLOGY BENEFIT 17 SURGICAL BENEFIT 18 GENERAL LIMITATIONS 19 HOW TO FILE A CLAIM 22 COORDINATION OF BENEFITS 23 MISCELLANEOUS DEFINITIONS 25 COMMON LAW SPOUSE 27 FACILITY OF PAYMENT 27 PROCESS IN CASE OF DISPUTED CLAIM 28 CONVERSION PRIVILEGE 29 SIGNATURE PAGE 30 WILD COUNTY EMPLOYEE BENEFIT FUND Weld County has adopted the Weld County Employee Benefit Fund (the "Plan") , as herein stated. Weld County agrees to provide for its eligible employees , during continuance of the Plan , the benefits hereinafter described in the event such employees incur a disability or they and/or their eligible dependent(s) incur medical expenses covered by the Plan. The Plan, designed for the exclusive benefit of eligible Weld County Employees , is subject to all terms, provisions and conditions recited in the following pages. In addition to the benefits hereinafter set forth, insurance policies have been purchased and are part of the Plan to insure against certain hazards and to provide for certain contingencies as follows: 1. An Aggregate Stop-Loss policy to insure maximum annual claim liabilities; 2. A Specific ( Individual ) Stop-Loss policy to insure individual claims in excess of the amount specified in the insurance contract. 3. A Health Conversion provision to allow an individual to convert to an individual Medical Policy upon termination. Copies of the actual policy or policies are available for review at the offices of Weld County, or James Benefits, the Contract Administrator, and will be made available, upon request , at a reasonable charge. Weld County has caused this Plan to be EFFECTIVE as of 12:01 a.m. , January 1, 1983, at Greeley, Colorado. -i - r-. SUMMARY OF BENEFITS FOR Elf PLOYEES AND DEPENDENTS Supplemental Accident Benefit: 100% of the first $500.00 per accident , per person , not subject to the $100.00 deductible. Pre-Admission Testing : Covered at 100% of Usual , Reasonable and Customary medically necessary expenses. Birthing Centers: Covered at 100% of Usual , Reasonable and Customary medically necessary expenses. Major Medical Benefit: Maximum Lifetime Benefit: $1,000,000 each Covered Person. Deductible : $100.00 per person each Calendar Year, not to exceed $200.00 combined (aggregate) per family each Calendar Year. NOTE: The Family Deductible may be comprised of any combination of eligible medical expenses among covered family members. Co-Insurance: After the deductible has been met , 80% of the next $2,000 (80% of $4,000 per family) , and 100% thereafter of Covered Expenses will be paid per Covered Person each Calendar Year, but not to exceed the maximum lifetime benefit. Room and board charges shall not exceed the semiprivate, ICU and CCU room rates. All charges are subject to the "General — Limitations" of this Plan. In-Hospital "Well Baby" Hospital Nursery charges and one Benefit : Physician visit covered as any other illness subject to the deductible and coinsurance. Outpatient Pediatric "Well Pediatric well baby care is available Baby" Benefit : until the child's second birthday; limited to a maximum of $90 per dependent child per Calendar Year. This "well baby" care includes lab and x-ray ser- vices. Routine immunizations are available until the child's second birth- .-- -1- day, not limited to the Calendar Year maximum. Treatment of Alcoholism, Drug Abuse , Nervous and Mental Illness : In-Hospital : 45 days maximum per Calendar Year. NOTE: Partial hospitilization - the lesser of 1) the number of days of patient hospitilization or 2) 90 days in any Calendar Year. (Each two partial days will count as one full hospital day. ) Out-patient: 50% of each visit , not to exceed usual , reasonable and customary, up to a maximum payment of $1,250.00 per Calendar Year. The eligible charges for outpatient ser- vices are the reasonable charges for the care and treatment of mental , psycho- neurotic and personality disorders fur- nished (1) by a hospital (other than inpatient or partial hospitalization services) ; (2) by a Physician ; (3) under the direct supervision of a Physician by a comprehensive health care service cor- poration , a community mental health center, or other mental health clinic, which is licensed or approved to furnish mental health services by the state where rendered ; or (4) by a social worker registered or licensed by the state where rendered, if furnished under the direct supervision of a Physician. Chiropractic: $30.00 maximum consideration per visit. $500.00 maximum payment per Calendar Year. $5,000.00 maximum payment per lifetime for each Covered Person. Covered Expenses (Up to Usual , Customary and Reasonable) Examples A. Doctor's services. B. Prescription drugs. C. Blood and blood plasma. D. Ambulance service. E. Artificial limbs. -2- F. Rental of wheel chairs , braces , crutches , etc. G. Physical therapy and outpatient oxy- gen therapy. H. Intensive care unit room charges. I. Emergency room services. J. Hospital room and board. NOTE: This is a partial listing of covered major medicaTpenses. Items specifically excl uded are shown elsewhere in the Plan. -3- DEFINITIONS Terms as used herein shall be deemed to define terms that may be used in the wording of the Plan Document. These definitions shall not be construed to pro- vide coverage under any benefit unless specifically provided. A. GENERAL DEFINITIONS 1. Age Discrimination - Subject to any changes in the Social Security Act , 1T active employees age 65 and over (up to 70 years of age) are entitled to the same and/or equal benefits that they had prior to age 65. 2. Amendment is a formal document changing the provisions of the Plan and signed by the representatives of Weld County. Amendments apply to all Covered Persons , including those persons who are covered before the Amendment becomes effective, unless otherwise specified. 3. Common-Law Marriages - In order for an employee of Weld County to be eligible for dependent medical coverage, the Common-Law Marriage must be recognized by the State of Colorado. (See page 27. ) 4. Calendar Year is the 12 month period beginning on each January 1st and ending on the following December 31st. 5. Contract Administrator shall mean the person or firm employed by the Plan Administrator who is responsible for the processing of claims and payment of benefits, administration , accounts , reporting and other ser- vices contracted for by Weld County. 6. Plan Year is the 12 month period beginning on each January 1st and ending the following December 31st. 7. Employer shall refer to Weld County. 8. Medicare - Title XVIII (Health Insurance for the Aged) of the United States Social Security Act as amended. 9. Plan shall refer to the benefits and provisions as described herein for payment. 10. Plan Administrator - Weld County. 11. Subrogation - The transfer of one ' s liabilities for another's ; in this case the temporary assumption of the claimant 's liabilities by the Plan prior to repayment by the party of primary liability. This Plan con- tains a subrogation clause and the Claimant is obligated to obtain any monies available from third parties to reduce the Plan 's claim losses. -4- B. MEDICAL DEFINITIONS 1. Expense incurred means only the fees and prices regularly and custo- mare y charged for the medical services and supplies generally furnished for cases of comparable nature and severity in the particular geographi - cal area concerned. Any agreement as to fees or charges made between the individual and the Physician shall not bind the Plan Administrator in determining its liability with respect to expense incurred. Expense incurred is deemed to be incurred on the date on which the service or supply is rendered or obtained. 2. Illness shall mean bodily sickness or disease , psychiatric disorders , and, in the case of a newborn child , congenital abnormalities. Illness must be medically diagnosed and be treated by a Physician for purposes of determining benefits payable. 3. Morbid Obesity shall mean a condition in which the pressure of excess weigh causes physical trauma ; or where pulmonary and circulatory insuf- ficiencies are present ; or where complications related to the treatment of conditions such as arteriosclerosis, diabetes or coronary disease exist ; and where the person is 100% or 100 pounds overweight , whichever is greater, according to the Metropolitan Life Table of Desirable Weights. (Excerpt from The Four Steps to Weight Control . ) 4. Injury is a condition which results independently of sickness and all other causes and is a result of an externally violent force, or acci - dent. 5. HIAA Prevailing Charge Study is The Health Insurance Association of Mienica S— chime a�hall be the basis for dental claim reimbursement at "Usual , Reasonable and Customary" levels, applied to the particular Zip-code area where the procedure is performed. 6. Pregnancy includes (1) all pregnancies except extra-uterine, which are considered to be genito-urinary conditions , (2) childbirth, (3) mis- carriage , or (4) any complications arising wholly from these conditions , and (5) any pregnancy complications arising from any trauma, and (6) only those charges related to the pregnancy of a female employee or spouse of an enrolled employee. 7. Period of Disability for a Covered Employee as it applies to an indivi- ueal,means all periods of disability arising from the same cause, including any and all complications therefrom except that if the indivi - dual completely recovers or returns to active full -time employment , any subsequent period of disability from the same cause shall be considered a new disability. For a Covered Dependent , the term "Period of Disability," means all periods of disability arising from the same cause including any and all complications therefrom, except that if the dependent re-covers for a period of three months and throughout such period is capable of resuming -5- the normal activities of a person in good health and of the same age and sex , any subsequent period of disability from the same cause shall be considered a new period of disability. 8. Total Disability shall mean that the Covered Employee is prevented, solely because of a non-occupati onal injury or non-occupational disease, from engaging in the employee's regular or customary occupation and is performing no work of any kind for compensation or profit, or if a Covered Dependent is prevented, solely because of a non-occupational injury or non-occupational disease , from engaging in all of the normal activities of a person of like age and sex in good heTTh. C. PROVIDER DEFINITIONS 1. Alcoholism Treatment Center - Any public or private place or other facility which is licensed by the State to provide alcoholism treatment services as a detoxification facility and/or inpatient rehabilitation facility. 2. Hospital means only an institution constituted and operated pursuant to awl ,engaged in providing on an inpatient basis at the patient's expense, diagnostic and therapeutic facilities for the surgical and medical diagnosis, treatment and care of injured and sick individuals, by or under the supervision of a licensed Physician ; and providing • 24-hour-a-day services by registered nurses. The term "Hospital " shall not include an institutional part thereof which is other than inciden- tally a place for rest, a place for the aged, or a place for con- valescant care. However, an institution specializing in the care and treatment of mentally ill patients which would qualify under this defi - nition as a hospital , except solely for the fact that it lacks organized facilities on its premises for major surgery, shall nevertheless be deemed a hospital under the Plan. In-Hospital Convalescent Care Limitations: a. Conval escent Care benefits are limited to the normal Conval escent Care received by the Covered Person while the Covered Person is an in-patient in the hospi tal for treatment of a specific acute medi - cal , surgical , or psychiatric condition ; however, b. Convalescent Care is not a benefit when the Covered Person ' s admission to the hospital is for Convalescent Care, or when such inpatient care ceases to be medically necessary. c. If a Covered Person remains in the hospital after the date that the Covered Person 's physician or other health care provider determines that in-patient hospital care is no longer necessary, then the Covered Person shall be liable for payment of any physician 's or other health care provider's charges after that date. 3. Intensive Care Unit is a section , ward, or wing within a hospital which is operated exclusively for critically ill patients and provides special -6- supplies , equipment and constant observation and care by registered grad- uate nurses or other highly trained personnel , excluding, however, any hospital facility maintained for the purpose of providing normal post- operative recovery treatment or service. 4. Nurse shall mean a Registered Graduate Nurse (R.N. ) , a Licensed Vocational Nurse (L.V. N. ) , or a Licensed Practical Nurse (L.P. N. ). 5. Outpatient is a Covered Person treated at a hospital and confined less than 15 consecutive hours or treated outside a hospital setting. 6. Physician is a person acting within the scope of his/her license and holding the degree of Doctor of Medicine (M.D. ) , Doctor of Ostheopathy (0.0. ) , Doctor of Dental Surgery (D.D.S. ) , Doctor of Medical Dentistry (D.M. D. ) Doctor of Podiatry (D.P.M. ) , a Board Certified Psychologist (PhD) , a Doctor of Chiropractic (D.C. ) , Physicians Assistant or Nurse Practitioner, who is legally entitled to practice medicine in all its branches under the laws of the State or jurisdiction where the services are rendered. 7. Semi -Private is a hospital room containing two (2) or more beds, but, benefits provided therefor do not include any charge made by the hospi - tal for Intensive Care. 8. Usual , Reasonable and Customary: a. The usual charge is the most consistent charge by a physician or provider of service to patients for a given service. b. The charge is customary when it is within the range of usual charges for a given service billed by most physicians or providers of ser- vice with similar training and experience. c. A charge is reasonable when it meets the usual and customary cri - teria as determined by the Contract Administrator ; or it may be reasonable if, upon review, it merits special consideration based on the nature and extent of treatment of the particular case. 9. Medically Necessary: Any service or supply for diagnosis or treatment that is: a. consistent with the illness, injury or condition of the Covered Person ; and b. ordered by an attending Physician ; and c. in accordance with approved and generally accepted medical or surgi - cal practice prevailing in the geographical locality where and at the time when the service or supply is ordered. Determination of "generally accepted practice" is the perogative of the Contract Administrator through consultation with appropriate authoritative medical or surgical persons. -7- 10. Diagnostic Charges means the actual cost charged for X-Ray or Laboratory examinations of the Covered Person which are made or recom- mended by a Physician for diagnostic purposes. 11. Covered Expense includes only those usual , reasonable, and customary charges made for medical services and supplies which most physicians would consider to be necessary for treatment of an injury or illness. D. PARTICIPATION DEFINITIONS 1. Active Service - An employee will be considered in Active Service with tit e emp oyT er on a day which is one of the employer's scheduled work days if the employee is performing in the customary manner all of the regular employment duties with the employer on a full -time basis on that day, either at one of the employer's business establishments or at some loca- tion to which the employer's business requires travel . An employee will be considered in Active Service on a day which is not one of the employer' s scheduled work days only if the employee was performing in the customary manner all of the regular employment duties on the pre- ceding scheduled work day. A Dependent will be considered in Active Service on any day if the dependent is then engaging in all the normal activities of a person in good health of the same age and sex, and is not confined in a medical facility. (This does not apply to a newborn). 2. Contribution shall mean the amount payable by the empl oyer or the amount payable by the employer/employee jointly for participation in the bene- fits of the Plan. 3. Covered Dependents shall be those who are eligible as provided herein and enrolled by a Covered Employee. Covered Dependents shall be the spouse of the Covered Employee ; and children from birth to age 19, to age 23, if a registered student at an accredited college, vocational school , or university on a full -time basis , provided such children are unmarried, and dependent upon the Covered Employee for support and main- tenance. The term "children" shall include natural children , adopted children , foster children, and step children who depend upon the employee for support and maintenance. No employee will be considered both as a dependent and as an employee. If an employee and spouse are both eligible employees , only one may have dependent coverage for eligible children. Covered Dependent shall also include a dependent child after age 19, provided the child is (1) incapable of self-sustaining employment by reason of mental or physical handicap, (2) chiefly dependent upon the Covered Employee and/or the Covered Employee 's Spouse for support and maintenance, and (3) has been continuously covered by the Plan prior to his/her 19th birthday. Proof of such incapacity and dependency must be furnished to the Administrator by the Covered Employee within the thirty one (31) days -8- prior to the child's 19th birthday and at reasonable intervals thereafter. Dependents DO NOT include children of a dependent son or daughter. 4. Covered Employee is a permanent full -time employee of the Employer who isis eligible hereunder and who has been enrolled in the Plan. To be con- sidered a full -time employee, one must work an average of 32 hours per week. In addition, such an employee will not be covered unless on the "date of eligibility" the employee is actually working a full day on that date; otherwise, his/her effective date will be deferred until return to actual service for a full day's work. 5. Covered Person is a Covered Employee or a Covered Dependent. 6. Eligibility and Effective Dates - Employees who are eligible for health coverage areiose full -time employees of Weld County. Full-time employees are those employed in a permanent position scheduled to work, 32 or more hours per week. Coverage shall become effective on the first day of the month following the first full month's pay period. All employees shall become covered as they become eligible subject to the following : a. All enrollments are subject to making proper application for coverage under the Plan. b. Dependents shall be covered simultaneously with employees covering them as dependents , provided they are not confined in a hospital on the effective date. Coverage for newborn children will begin from birth. However, they need to be formally enrolled and appropriate coverage arranged within thirty-one (31) days from birth for coverage to be effective thereafter. c. For dependents (as stated in a and b above) who are not enrolled within this thirty-one (31) day period, and for whom coverage is subsequently desired, a health questionnaire showing evidence of insurability will be required. Coverage will begin on the date of approval of the Contract Administrator. d. An open-enrollment period will be scheduled in November of each year. 7. Pre-existing Conditions New Employees or Covered Persons becoming eligible after January 1, 1983 will not be entitled to covered medical expenses that are incurred as the result of an injury or sickness for which the Covered Person has consulted with a Physician or received any medical care or services within the three month period immediately preceding the effective date of coverage, unless incurred after the expiration of a period of: -9- • a. Three (3) consecutive months ending after the date the benefits are effective for the Covered Person during which no medical care or treatment of such injury or illness has been received, or b. After a period of six (6) consecutive months during which the Covered Person was continuously at work and a member of the plan. (This does not pertain to Covered Dependents) ,or c. After a period of twelve (12) consecutive months during which the Covered Person has been continuously a member of the Plan. 8. Individual Termination of Coverage: Coverage for Covered Em7oyees and/or Covered Dependents will terminate on the earliest of the following dates : a. The date of termination of the Plan. b. The date the Covered Person becomes a full -time member of the Armed Forces of any country. c. The date the Covered Person ceases to meet eligibility requirements. d. The end of the month when contributions cease. 9. Late Entrants - Employees or dependents not enrolled within thirty-one (31) days following their eligibility date , or, in the case of newly acquired dependents, within thirty-one (31) days of such acquisition , must provide evidence of good health satisfactory to the Contract Administrator. Coverage will begin on the date of approval by the Contract Administrator. An open enrollment will be conducted each year during the month of November. Enrollment during this month will not require evidence of good health. 10. Personal Leave of Absence - Properly enrolled employees of the Employer may continue , at t eeir expense, health coverage for themselves and/or their dependents while on an approved Personal Leave of Absence for the period indicated by the Employer's personnel policy. 11. Medical Leave of Absence - When a Physician requires that a Covered Person not return to work, benefits will be continued for a period not to exceed the length of time accrued under said employee's sick leave plan , or grants of sick days from the Weld County Sick Leave Bank, plus 31 days , provided the Covered Person makes the required contribution to the plan which he/she would otherwise be required to contribute. In order to be covered while on a Medical Leave of Absence, the employee must be : a. continuously and totally disabled, and b. under the care of a licensed Physician , and -10- • c. provide proof of disability satisfactory to the Employer at reaso- nable intervals upon request. 12. Dependents of Deceased Employees - Limited coverage for Covered Dependents T a deceased employee can be continued provided application for conversion is made in writing to the Plan within thirty-one (31) days of the date of termination of benefits under this Plan. E. CONTRIBUTIONS The employer and employee share in the cost of the benefits under this plan. • -11- SUPPLEMENTAL ACCIDENT BENEFIT A. BENEFIT PROVISION If a Covered Person shall , as a result of accidental bodily injuries sustained while covered under this Plan , incur expense which is usual , reasonable and customary for: (1) medical treatment or services performed by a legally qualified Phy- sician ; or (2) room and board and any other necessary medical services and care pro- vided by a legally constituted hospital ; or (3) nursing care provided by a registered graduate nurse; or (4) ambulance charges ; the Plan will pay for such related medical expense incurred during the ninety day period immediately following the date of the accident , but not to exceed , in the aggregate , for any one accident, the maximum payment spe- cified in the "Summary of Benefits." B. LIMITATIONS • 1. No payment shall be made under this benefit for expenses incurred for or on account of pregnancy; or 2. for expenses incurred for eye refractions , eye glasses, hearing aids , prosthetic devices or fitting of same; or 3. for expenses beyond the limitations described under "General Limitations" ; 4. nor shall payments under the Supplemental Accident Benefit serve to satisfy the major medical deductible. -12- MAJOR MEDICAL BENEFIT • A. BENEFIT PROVISION Upon receipt of due proof, satisfactory to the Contract Administrator, that a Covered Person has incurred an expense for treatment of an illness or injury, the Plan will pay those amounts indicated in the "Summary of Benefits" of Medically Necessary Usual , Reasonable, and Customary charges. The benefits payable shall not exceed the "Maximum Lifetime Benefit" and are subject to the "Deductible" specified herein and are subject to all limita- tions and conditions of the Plan. B. DEDUCTIBLE 1. The "Deductible" equals the sum of the cash deductible specified in the "Summary of Benefits" and any other provision of this Plan. The deduc- tible amount applies during each Calendar Year. 2. Carry-over Provision: In order that a Deductible will not be applied late in one Calendar Year and soon again in the following year, any Covered Expenses incurred during the last three months of a Calendar Year which apply toward the Deductible (whether or not it is fully satisfied) for that year, may also be applied toward the Deductible for the subsequent Calendar Year. 3. Family Deductible: When the covered members of a family have satisfied the maximum Deductible per family in a Calendar Year, no further cash Deductible need be satisfied in that Calendar Year. This applies only to expenses incurred during the Calendar Year; expenses which are carried over from a prior year under the carry-over provision of this section will not be recognized. 4. Common Accident: If two or more Covered Persons in the same family are injured in a common accident , the Deductible amount applicable in the Calendar Year of the common accident shall be limited to a single cash Deductible amount for that Calendar Year. C. MAXIMUM LIFETIME BENEFIT The Maximum Lifetime Benefit as shown in the "Summary of Benefits" , is the maximum lifetime amount of benefits available for any Covered Person , whether or not there has been an interruption in the continuity of coverage. D. COVERED MEDICAL EXPENSES Covered Medical Expenses shall include, subject to the "General Limitations ," only Medically Necessary Usual , Reasonable and Customary charges for services and supplies which are incurred by a Covered Person due to: 1. hospital charges by a "hospital " as defined herein for room and board and other hospital services required for purposes of treatment , but not -13- to exceed the average semi-private room rate or intensive care unit room rate ; 2. charges for anesthetics and their administration ; 3. charges made by a "Physician" or recommended by and directly supervised by a "Physician" for Medically Necessary services ; 4. charges made for the necessary professional services of a physiothera- pist ; 5. charges for speech therapy by a qualified speech therapist to restore speech loss, or correct an impairment, due to (a) a congenital defect for which corrective surgery has been performed, or (b) an injury or sickness except for a mental , psychoneurotic or personality disorders ; 6. charges for the following medical services or supplies that are recom- mended by the Physician: a. drugs and medicines requiring a Physician 's prescription ; b. oxygen and/or rental of equipment required for its administration , but not to exceed the purchase price of such equipment ; c. radiotherapy; d. diagnostic X-ray and laboratory services ; e. charges for braces, casts, splints, initial artificial limbs or other original prosthetic appliances to replace lost physical organs or parts or to aid in their functions when impaired if the loss or impaired function occurred while covered under this Plan. Covered charges are for original placement. f. blood and blood plasma ; g. ambulance to a local hospital where adequate medical treatment can be administered ; h. insulin and insulin syringes ; i . head halter or other traction apparatus; j. rental of a wheel chair, special hospital bed , iron lung, crutches , and other reasonable , Medically Necessary mechanical and therapeutic equipment but not to exceed their purchase price; k. emergency room services; 7. charges for pre and post natal visits ; 8. charges for vasectomies and tubal ligations ; -14- 9. Charges made by a legally qualified Physician for performing oral surgery consisting of cutting procedures for removal of tumors , cysts , and charges incurred to restore sound natural teeth within six months after the date of an accident, unless medically indicated that treatment be delayed, provided that the injury or condition and treatment thereof occurs while this coverage is in effect. Such charges includes dental X-rays and general anesthesia , Medically Necessary and prescribed by a legally qualified Physician ; 10. Chiropractic services rendered by a D.C. will only be covered for the detection and correction by manual or mechanical means, including X-rays incidental thereto, the structural imbalance , distortion or subluxation in the human body for the removal of nerve interference , where such interference is the result of or related to distortion , misalignment , or subluxation of or in the vertebral column. Chiropractic care which exceeds the following guidelines may not be considered as a covered expense if it is determined to be maintenance, palative, or excessive care: a. three visits per week for the first four weeks ; b. two visits per week for the next eight weeks ; c. one visit per week for the next four weeks ; • Consideration of treatment programs exceeding these guidelines must be accompanied by the attending Chiropractor's statement outlining their Medical Necessity; The benefits payable under this provision will not exceed the following maximums: a. $30.00 maximum consideration per visit; b. $500.00 maximum payment per Calendar Year per Covered Person ; c. $5,000.00 maximum payment per lifetime per Covered Person. 11. charges for services of a registered graduate nurse or licensed prac- tical nurse or nurse practitioner, if authorized by a Physician ; 12. charges for allergy testing or injections. -15- HOSPITAL CARE BENEFIT Upon receipt of due proof of eligibility that a Covered Person has incurred necessary expenses which are recommended and approved by a "Physician" as herein defined , for hospital care for diagnosis or treatment of an illness or injury, the Plan will pay Usual , Reasonable and Customary charges not exceeding the maximum amount specified in the Summary of Benefits for such charges. A. DEDUCTIBLE The "Deductible" equals the sum of the Cash Deductible specified in the "Summary of Benefits" and any other provision of this Plan. The Deductible amount applies during each Calendar Year. B. ROOM, BOARD, AND GENERAL NURSING CARE The Plan will pay the amount charged by the hospital for a Covered Person who is confined for room, board , and general nursing care , not to exceed the Semi-Private , Intensive Care Unit , or Coronary Care Unit room rate. C. OTHER HOSPITAL CHARGES The Plan will pay the Usual , Reasonable and Customary amounts charged by the hospital for Medically Necessary services, medicines , and supplies for diagnosis or treatment of illness or injury during any one period of con- finement provided: 1. the Covered Person is hospital -confined as an inpatient; or 2. the Covered Person has surgery performed in the hospital . D. SUCCESSIVE PERIODS OF HOSPITAL CONFINEMENT Successive periods of hospital confinement shall be considered as one con- finement unless : 1. The later confinement commences after complete recovery from the sickness or injury which caused an earlier confinement ; 2. The later confinement results from causes entirely unrelated to the causes of an earlier confinement; 3. The confinements are separated by the employee's return to work for two weeks , or in the case of a dependent , a separation from the previous confinement of three (3) months duration. -16- • ANESTHESIOLOGY BENEFIT A. BENEFIT PROVISION Benefits are payable when a Covered Person incurs charges for anesthetic services rendered by a licensed anesthesiologist in connection with a surgi- cal operation. Under this benefit, the 1974 American Society of Anesthesiologists Relative Value Guide will be used based on unit value plus time, but not to exceed the Usual , Customary and Reasonable charge. B. ANESTHESIOLOGY BENEFIT LIMITATIONS No amount will be payable under this Section for charges : 1. which are excluded under the General Limitations provisions ; 2. which result from any sickness or bodily injury arising out of or in the course of an individual ' s employment ; 3. cosmetic surgery. • -17- SURGICAL BENEFIT A. BENEFIT PROVISION If a Covered Person incurs necessary expense as a result of an injury or illness which causes the person to undergo any non-cosmetic surgical proce- dure, the Plan shall pay the Medically Necessary Usual , Reasonable and Customary expense incurred for: 1. the services of the principal surgeon ; and/or 2. plastic and reconstructive surgery if the surgery is necessary to correct deformities causing functional physiological difficulties arising from illness or injury. B. MULTIPLE AND/OR BILATERAL PROCEDURES If two or more surgical procedures are performed at one time through the same incision or in the same operative field, the maximum amount payable for surgery will be the procedure for which the highest surgical benefit is pro- vided. In the event that two or more separate operations are performed during one period in the operating room, the amount payable shall be the Surgical Benefit payable for the operation performed for which the highest Surgical Benefit is provided ; plus not over 50% of the Surgical benefits specified for the other operation(s). C. LIMITATIONS 1. No payment shall be made under this benefit for expenses incurred for or on account of weight control or obesity, other than "Morbid Obesity" ; or 2. for treatment or services described under "General Limitations". -18- GENERAL LIMITATIONS No benefits shall be payable under any part of this Plan with respect to: 1. any charges not Medically Necessary for diagnosis or treatment of an illness, injury, or pregnancy; or 2. any charges for cosmetic surgery unless due to an accident or injury occuring while covered; or 3. any charges for rhinoplasty, blepharoplasty or brow lift except charges for rhinoplasties and blepharoplasties to correct a functional condition or charges for rhinoplasty to correct a condition as a result of an acci - dental injury; or 4. vaccinations, innoculations , or any charges for any examination for check- up purposes not incidental to or necessary to diagnose an injury or illness (except as otherwise provided for in this Plan) ; or 5. any injury or illness for which the Covered Person on whose behalf claim is presented is not under the regular care of a Physician; or 6. any charges for any condition , disability or expense resulting from or sustained as a result of being engaged in an illegal occupation , commission of or attempted commission of an assault or a felonious act ; or 7. any charges for any condition , disability or expense resulting from or sustained as a result of war or act of war, declared or undeclared ; or 8. any charges for any condition or disability which would entitle the Covered Person to any benefit under a Worker's Compensation Act or similar legisla- tion or which is due to injury or sickness arising out of or in the course of any occupation or employment for wage or profit ; or 9. hearing aids, batteries or repairs ; or 10. any charges for professional services performed by a person who ordinarily resides in the Covered Person's household or who is related to the Covered Person as a spouse , parent, child, brother, sister, whether such rela- tionship is by blood or exists in law; or 11. charges for instruction or activities for weight reduction, weight control , or physical fitness even if the services are performed or prescribed by a Physician ; or 12. any charges for artificial insemination; or reversal of vasectomies , or reversal of tubal ligation ; or 13. any charges for eye glasses, correction of vision, fitting of glasses or eye examinations ; or 14. any charges for air conditioners , purifiers , dehumidifiers, corrective shoes, heating pads , hot water bottles , and other clothing and equipment which is not solely for medical purposes ; or -19- 15. any charges for special education , counseling, or care for learning de- ficiencies or behavioral problems, whether or not associated with a mani - - fest mental disorder or other disturbance; or 16. any charges for routine health examinations , multiphasic screening tests, and physician checkups not associated with any disease, injury or condition requiring professional service or treatment (except as otherwise provided for in this Plan) ; or 17. travel expenses of a Physician attending a Covered Person, or travel ex- penses of a Covered Person , although recommended by a Physician ; or 18. any charges for preparing medical reports or itemized bills ; or 19. non-medical expenses such as training, educational instructions or edu- cational materials, even if they are performed or prescribed by Physician ; or 20. services or supplies for which there is no legal obligation to pay, or charges which would not be made but for the availability of benefits under this Plan ; or 21. any expenses which exceed the usual , customary and reasonable expenses for the medical care rendered; or • 22. vitamins and/or nutritional supplements ; or 23. acupuncture administered by other than an M. D. or D.O. ; or 24. any charges related to custodial care , sanitarium care, or rest cares ; or 25. treatment not prescribed or recommended by a Physician ; or 26. hospitalization charges for dental treatment. However, the hospital charges will be covered if the patient has another medical condition which requires that dental treatment be provided on an inpatient basis and the Medical Necessity of hospitalization is certified by a Physician ; or 27. obstetrical care for a dependent other than the spouse of an enrolled employee or the female employee; or 28. charges for mailing or sales tax; or 29. medical expenses for equipment , supplies , procedures or treatments which are experimental in nature or which have not been approved by the food and Drug Administration or the appropriate authorizing agency; or 30. treatment of (a) weak, strained , flat, unstable or unbalanced feet, metetar- salgia or bunions , except open cutting operations , (b) corns , calluses or toenails, except the removal of nail roots and necessary services in the treatment of metabolic or peripheral -vascular disease; or -20- 31. expenses in connection with drug abuse, drug addiction , alcoholism, or ner- vous and mental conditions except where specifically noted herein ; or 32. treatment of periodontal or periapical disease or any condition (other than a malignant tumor) involving teeth, surrounding tissue or structure. However, this exclusion does not apply to the benefits for dental treatment described under the "Supplemental Accident Expenses" Section ; or 33. Chiropractic Maintenance , Palative or Excessive Care; or 34. any expenses resulting from intentional self-inflicted injury or attempted intentional self-destruction while sane or insane. 35. any expenses related to treatment of temporomandibular joint disfunction. -21- HOW TO FILE A CLAIM Claim forms can be obtained from the Personnel Office, or by calling or writing James Benefits , 3895 Upham Street , #100, Wheat Ridge, Colorado 80034-0987, (303) 423-2400. The Employee Statement on the top of the claim form must be completed in FULL and signed by the employee. Itemized bills (hospital , doctor anesthe- siologist, laboratory, prescriptions , etc. ) should be attached to the claim form, and the Attending Physician Statement on the bottom of the claim form should be completed by the appropriate Physician unless ALL necessary infor- mation is included on the Physician 's own form. The completed claim form and the attached bills should be sent to: Weld County c/o James Benefits P.O. Box 987 Wheat Ridge, Colorado 80034-0987 Identification cards and claim forms are available for Plan participants from the Personnel Office of Weld County. • -22- COORDINATION OF BENEFITS A. APPLICATION If any individual covered under this Plan is also covered under other plans, the benefits payable under this Plan will be coordinated with benefits payable under all other plans. Coordination will apply in determining the benefits payable with respect to an individual for any Claim Determination Period if, for the Allowable Expenses incurred during that period , the sum of the following would exceed those Allowable Expenses: 1. the benefits that would be payable under this Plan in the absence of coordination , and 2. the benefits that would be payable under all other plans in the absence of provisions for coordination in those plans. Except as provided in the following paragraph, when Coordination of Benefits applies to the benefits payable with respect to an individual for Claim Determination Period, the benefits that would be payable for Allowable Expenses incurred during that period under this Plan in the absence of Coordination of Benefits will be reduced to the extent necessary so the sum of those reduced benefits and all the benefits payable for those Allowable Expenses under all other plans will not exceed the total of those Allowable Expenses. Benefits payable under all other plans include the benefits that would have been payable had claim been properly made for them. If, in coordinating the benefits of this Plan with those of another plan, the rules set forth in the following paragraph would require this Plan to determine its benefits before the other plan and the other plan which con- tains a provision coordinating its benefits with those of this Plan would, according to its rules , determine its benefits after the benefits of this Plan have been determined, then the benefits of that other plan will be ignored for the purposes of determining the benefits of this Plan. B. ORDER OF BENEFIT DETERMINATION The rules establishing the order of benefit determination are: 1. The benefits of a plan which covers the individual for whom claim is made other than as a Dependent will be determined before the benefits of a plan which covers that individual as a Dependent. 2. The benefits of a plan which covers the individual for whom claim is made as a Dependent of a male will be determined before the benefits of a plan which covers that individual as a Dependent of a female. However, for a dependent child of a divorced couple, the coverage of the parent who has custody of the child will be determined before the bene- fits of the other parent are determined (unless stipulated otherwise by a court decree). -23- 3. When Rules 1 and 2 do not establish an order of benefit determination , the benefits of a plan which has covered the individual for whom claim is made for the longer period of time will be determined before the benefits of a plan which has covered the individual the shorter period of time. When Coordination of Benefits operates to reduce the total amount of benefits otherwise payable during any Claim Determination Period with respect to an individual covered under this Plan , each benefit that would be payable in the absence of Coordination of Benefits , will be reduced proportionately, and the reduced amount will be charged against any applicable benefit limit of this Plan. C. DEFINITIONS APPLICABLE TO THIS PROVISION 1. Plan The term "Plan" includes the following plans under which a person is entitled to receive or received benefits or services for or by reason of medical or dental treatment. a. Group Plans , insured or self-funded; group, blanket , or franchise insurance coverage; group hospital or medical service plans , and other group pre-payment coverage; any coverage under labor manage- . ment trusted plans , union welfare plans , employer organization plans , or employee benefit organization plans. b. The "Medicare" program, including Part A and Part B, established by Title XVIII of the Social Security Act. A person shall be con- sidered to be entitled to all of the coverage provided by Medicare on and after the earliest date the person would have become so entitled if the person had promptly submitted all applications and proofs required for such coverage. A person who is entitled to the coverage provided by Medicare will be considered entitled to receive benefits , whether or not application for such coverage or benefits has been made. It shall be deemed that any disabled person eli - gible for Medicare benefits or any individual age 65 or over shall be entitled to Medicare. NOTE: Medicare benefits will be considered as secondary payments for any eligible individual between the ages of 65 through age 69 wishing to be covered by this plan. c. Any coverage required or provided by any statute, including any no- fault automobile insurance provided or required by statute and/or any automobile medical insurance. 2. Allowable Expense Means any Usual , Reasonable and Customary item of expense at least a portion of which is covered under at least one of the plans covering the individual for whom claim is made. When a plan provides benefits in the -24- form of services rather than cash payments , the reasonable cash value of each service rendered will be considered to be both an Allowable Expense • and a benefit paid. 3. Claim Determination Period The term "Claim Determination Period" means a period commencing with any January 1 and ending at twelve o'clock (12:00) midnight on the next suc- ceeding December 31, or that portion of such period during which the person on whose expenses claim is based has been covered under this plan. D. RELEASE OF INFORMATION For the purposes of determining the applicability of and implementing the terms of the above provisions of this Plan or any similar provision of another plan, the Contract Administrator may, without consent of or notice to any individual , release to or obtain from any other insurance company or other organization or individual any information , concerning any individual , which the Contract Administrator considers to be necessary for those pur- poses. Any individual claiming benefits under this Plan will furnish to the Contract Administrator the information that may be necessary to implement the above provisions. E. PAYMENTS Whenever payments which should have been made under this Plan in accordance with the above provisions have been made under any other plans , the Contract Administrator will have the right , exercisable alone and in its sole discre- tion to pay to any organization making those payments any amounts it deter- mines to be warranted in order to satisfy the intent of the Coordination of Benefits Provisions. Amounts paid in this manner will be considered to be benefits paid under this Plan ; and to the extent of these payments, the Employer will be fully discharged from liability under this Plan. F. CLAIMS PAYMENTS MADE IN ERROR If payments in excess of the correct amount due are made, the Plan may recover all excess amounts paid. Recovery will be made by reducing or suspending future plan payments, or by requiring the Covered Person to pay back the overpayment in full , or in installments , until the overpayment is recovered. G. RECOVERY AND SUBROGATION Whenever payments have been made by the Contract Administrator in excess of the maximum amount of payment necessary to satisfy the intent of the Coordination of Benefit provisions , the Contract Administrator will have the right to recover excess payment from any individuals , insurance companies or other organizations. -25- In the event of payment in part or in full by this Pian of any expense incurred for hospital , surgical , medical , or dental services , and medical supplies for the benefit of an Eligible Participant or an Eligible Participant 's dependent , this Plan shall be subrogated to the extent of the amount of such payment to all the rights , powers, privileges and remedies , of the Eligible Participant or the Eligible Participant 's dependent against any person , firm, corporation , organization, plan or other entity regarding the payment of such expense. H. LEGAL ACTIONS No action at law or in equity shall be brought to recover on the policy prior to the expiration of 60 days after written proof of loss has been fur- nished in accordance with the requirements of the Plan. No such action shall be brought after the expiration of three years after the time written proof of loss is required to be furnished. I. PROOFS OF LOSS/TIMELY SUBMISSION OF CLAIMS Written proof of loss must be furnished to James Benefits , in case of claim for loss for which the policy provides any payment , within 90 days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible ; and in no event, except in the absence of legal capa- city of the claimant , later than one year from the time proof is otherwise required. Under no circumstances will a claim be honored for payment beyond 90 days following the date coverage terminates. -26- COMMON LAW SPOUSE Coverage is provided for a common-law spouse, as defined by the courts, in accordance with the laws of the State of Colorado. The requirements which must be met for a relationship to gain recognition as a Common-Law Marriage are coha- bitation and general reputation as married. Both factors must be present. Mere cohabitation is not sufficient. General reputation as to marital relation has been defined by the courts to mean "the understanding among neighbors and acquaintances with whom the parties associate in their daily lives that they are living together as husband and wife, and not in meretricious intercourse". (Citations omitted) To establish the presumption of marriage by cohabitation and repute there must be presented clear, consistent , convincing and positive evidence. The sorts of things the courts in Colorado have relied upon are: 1. What the parties call themselves in introductions , "my wife, Betty rather than "my girlfriend, Betty Maiden name": 2. How each fill out forms such as credit or employment applications , i .e. checking the block marked married or the one marked single , and the name used by the woman. ; 3. Whether they rent their apartment or home as Mr. and Mrs. Smith; • 4. Presence of joint bank accounts in a married name (joint bank account where woman uses her family name was held to go against the presumption of marriage relationship). If such evidence is present and the couple are holding themselves out as husband and wife , they are entitled to the benefits and privileges of any other married couple. FACILITY OF PAYMENT If, in the opinion of the Contract Administrator, a valid release cannot be ren- dered for the payment of any benefit payable under this Plan, the Contract Administrator may, at its option , make such payment to the individual or indivi- duals as have , in their opinion , assumed the care and principal support of the Covered Person and are , therefore , equitably entitled thereto. In the event of the death of the Covered Person prior to such time as all benefit payments due him/her have been made , the Plan Administrator may, at its sole discretion and option, honor benefit assignments, if any, made prior to the death of such Covered Person. Any payment made by the Plan in accordance with the above provision shall fully discharge the Plan to the extent of such payment. -27- PROCESS IN CASE OF DISPUTED CLAIM If a Covered Employee has reason to believe a claim has not been settled pro- perly, or a claim has been improperly denied, the following process applies : 1. Contact the Contract Administrator in writing to ask for a second review. The claim will be reviewed by the Contract Administrator and the Plan Administrator's consultant servicing the account. If the result of this review is not satisfactory, then : 2. Request a review in writing from the Director of Personnel of Weld County stating in clear and concise terms the reason for disagreement with the handling of the claim. This request must be made within sixty (60) days after receipt of a declination letter from the Contract Administrator (James Benefits). Upon receipt of the request, the file will be reviewed and the results of the review will be furnished to the Covered Employee, along with copies of pertinent Plan Documents upon which this declination is based. If the Covered Employee still finds the claim is improperly denied per the Plan Documents , he/she has a legal right to take what appropriate action he/she believes is necessary. 23 CONVERSION PRIVILEGE Any Covered Person , within thirty-one days after the date health benefits ter- minate because of termination of employment or because of membership in a class or classes eligible for such coverage, shall be entitled to have issued to him/her, without evidence of insurability, an individual policy of health insurance provided written application therefor and payment of the first premium thereon is made to the insurance company within said thirty-one days. Any such individual policy issued shall cover: a. the Person, if the health benefits under this Plan covered the Person only; or b. the Person and hi s/her Dependents, if the health benefits under this Plan covered both the Person and the Person 's dependents ; and shall become effective on the day immediately following the date of ter- mination of coverage under this Plan. The form of this individual policy, the coverage thereunder and all other terms and conditions thereof shall be such as is then provided by the insuring company with respect to insurance issued pursuant to an application made in accordance with these provisions. * If a Covered Person ' s health coverage under this Plan with respect to a • Dependent spouse is terminated because of the death of the Person , such spouse shall be entitled to have issued to him/her an individual policy of health insurance in the same manner and subject to the same conditions as provided for the Covered Person. If a Covered Person 's health coverage under this Plan with respect to a Dependent child is terminated because of the child's marriage or attainment of the maximum age specified in this Plan for Dependent children , such child shall be entitled to an individual policy of health insurance in the same manner and subject to the same conditions as provided for the Covered Person. THE PROVISIONS OF THIS SECTION SHALL NOT BE APPLICABLE TO ANY INDIVIDUAL ON AND AFTER THE DATE THE COVERED PERSON BECOMES AN ELIGIBLE INDIVIDUAL UNDER TITLE XVIII OF THE SOCIAL SECURITY ACT AS AMENDED (MEDICARE) , OR WOULD HAVE BECOME AN ELIGIBLE INDIVIDUAL UNDER SUCH LAW HAD TIMELY APPLICATION BEEN MADE. * The Conversion Privilege described herein shall also be applicable to a spouse who ceases to be a Dependent due to legal separation or legal dissolu- tion of marriage. -29- The effective date of this Plan Document is January 1, 1983. IT IS AGREED BY WELD COUNTY that the provisions contained in this Plan Document are acceptable and will be the basis for the administration of said Employer' s Employee Benefit Program described herein. SIGNED AT Greeley, Colorado This l5-h day of December , 1982. WITNESS: ‘717 -• r ' titr✓ BY , �.av //l'csv Chairman. Pnard .£et CamlissiOrieYS Ti tl e �-^ By Title r -30- AMENDATORY RIDER This Rider forms a part of the Individual Excess Risk Insurance Agreement issued by HARTFORD ACCIDENT AND INDEMNITY COMPANY to: WELD COUNTY Rider Effective Date: January 1 , 1987 The Agreement is hereby amended as follows: The Deductible Amount shown on the Schedule page is changed to $75,000.00. This Deductible Amount will apply with respect to any Eligible Participant who has not satisfied the prior Deductible Amount as of the effective date of this rider. This Deductible Amount will also apply to the establishment of any new Reimbursement Period. In all other respects, the Agreement remains the same. Signed by the Insurance Company on February 12, 1987. tota4duct-% Secretar Regis rar �7 Accepted by ,31ioj27 oy r / (v e) GR-11221 IP17 Hello