2020 LFG Life Certificate

SECTION 3 - ELIGIBILITY AND EFFECTIVE DATES (Continued)

What Happens to Your Coverage During a Family and Medical Leave? Your coverage may be continued under this plan for an approved family or medical leave of absence for up to 12 weeks following the date coverage would have terminated, subject to the following: 1. the authorized leave is in writing; 2. the required premium is paid; 3. your benefit level, or the amount of earnings upon which your benefit may be based, will be that in effect on the date before said leave begins; and 4. continuation of coverage will cease immediately if any one of the following events should occur:

a. you return to work; b. this plan terminates; c. you are no longer in an eligible class; d. nonpayment of premium when due by the Sponsor or you; e. your employment terminates.

What Happens During Lay-off? The Sponsor may continue your coverage(s) by paying the required premiums, if you are temporarily laid off. Your coverage(s) will not continue beyond a period of three months. In continuing such coverage(s) under this provision, the Sponsor agrees to treat all Covered Employees equally. What Happens During Leave of Absence? The Sponsor may continue your coverage(s) by paying the required premiums, if you are granted an approved leave of absence. Your coverage(s) will not continue beyond a period of six months. In continuing such coverage(s) under this provision, the Sponsor agrees to treat all Covered Employees equally. What Happens During Leave of Absence Due to Disability? The Sponsor may continue your coverage(s) by paying the required premiums, if you are granted an approved leave of absence due to a disability. Your coverage(s) will not continue beyond a period of six months. In continuing such coverage(s) under this provision, the Sponsor agrees to treat all Covered Employees equally.

GLC-ELG-4

Eligibility and Effective Dates

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