Notice of Enrollment Rights
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, as per IRS regulations (under Section 125), you cannot change your benefit choices until the next annual enrollment unless you have a qualifying “Life Event.” You may in the future be able to enroll yourself or your dependents in the CSHL benefit plans, provided that you request enrollment and submit the required paperwork and supporting documentation within 31 days after your other coverage ends. In addition, if you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment and submit the required paperwork and supporting documentation within 31 days after the marriage, birth, adoption or placement for adoption. CSHL will request appropriate documentation to substantiate dependent eligibility. CSHL reserves the right to amend or terminate your benefit elections, seek recovery for overpayments of benefits, as well as applying disciplinary action to the extent information is found to be falsified or incorrect.
Women’s Health and Cancer Rights Act of 1998 (WHCRA)
As required by the Women’s Health and Cancer Rights Act of 1998 (WHCRA), benefits are provided for mastectomy, including reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy (including lymphedema).
If you receiving benefits in connection with a mastectomy, benefits are also provided for the following covered health services, as you determine appropriate with your attending physician:
• All stages of reconstruction of the breast on which the mastectomy was performed; • Surgery and reconstruction of the other breast to produce a symmetrical appearance; • Prostheses; and • Treatment of physical complications of the mastectomy, including lymphedema. The amount you must pay for such covered health services (including copayments, coinsurance and any annual deductible) and the benefit coverage limitations are the same as are required for any other covered health service as described in your Summary Plan Description (SPD).
Please call the Benefits Office at 516-367-5011, 516-367-5226, 516-367-5026, or 516-367-5033 if you would like more information.
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