Plan Description

The Putnam/Northern Westchester Health Benefits Consortium Health Plan, a Municipal Cooperative Health Benefit Plan, referred to as the Plan, assures covered individuals during the continuance of the Plan that all benefits hereinafter described shall be paid to them, or on their behalf, in the event they incur covered expenses as defined herein. The Plan is subject to all the terms, provisions and limitations stated on the following pages.

This Municipal Cooperative Health Benefit Plan is not a licensed insurer. It operates under a more limited Certificate of Authority granted by the Superintendent of Insurance. Municipal Corporations participating in the Municipal Cooperative Health Benefit Plan are subject to Contingent Assessment Liability.

It is intended that the terms of the Plan be legally enforceable and that the Plan be maintained for the exclusive benefit of eligible employees, retirees and dependents.

The terms of the Plan of benefits are described herein. The eligibility, coverage and benefit provisions, terms and conditions are subject to change from time to time by the Plan's Joint Governance Board if such changes are determined, in their sole discretion, to be required for the prudent administration of the Plan.

The Joint Governance Board has the full power and authority in their absolute discretion to determine all questions of eligibility for benefits of all claimants. Such determinations, upon proper and adequate review, shall be conclusive and binding upon all interested parties.

Whenever the masculine pronoun is used in this document it shall include the feminine gender unless the context clearly indicates otherwise.

New York State Insurance Department Document Form No. PNW-November 2006-01
Aetna Plan No.: ASC-100166
Document Form No.: PNW-November 2006-01