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2nd Amendment 12/15/2010Monroe County Board of County Commissioners Group Health Plan Document Amendment #2 WHEREAS, the Monroe County Board of County Commissioners ("Plan Sponsor") sponsors the Monroe County Group Health Plan ("Plan") effective January 1, 2010; and WHEREAS, the Plan Sponsor reserves the right to amend the Plan at any time; and WHEREAS, in light of the adoption of the Patient Protection and Affordable Care Act ("PPACA"), the Plan must be amended in certain particulars; and NOW, THEREFORE, pursuant to the Plan amendment provisions, the Plan shall be amended effective January 1, 2011 as follows: 1. Page 1-2: The "Accumulated Total Lifetime Maximum Benefit" line item of Section 1 C of the Plan is amended to read as follows: "Accumulated Total Lifetime Maximum Benefit Per Covered Participant (includes medical care services & pharmaceuticals) .................. Unlimited 2. Page 1-2: The "Autism Spectrum Disorder" line item of Section 1 C of the Plan is amended to read as follows: "Autism Spectrum Disorder Per Covered Plan Participant Per Calendar Year ...... ....... $36,000" 3. Page 4-1: The Introduction section of Section 4 of the Plan is amended to read as follows: "Introduction Covered Plan Participants when initially enrolled in the Plan will be subject to a Pre- existing Condition exclusionary period, except for the following properly -enrolled individuals: newborn or adopted dependents; and individuals under the age of 19. A Covered Plan Participant with Creditable Coverage in effect for a continuous period of 12 months or longer prior to initial enrollment will not be subject to a Pre-existing Condition exclusionary period." 4. Page 7-3: The Exclusion under the "Autism" section of Section 7 of the Plan is amended to read as follows: "Exclusion — The plan will not pay for Covered Services which exceed the annual maximum for Autism Spectrum Disorder listed in the Schedule of Benefits." 5. Page 9-2: Paragraph 3a of the "Eligibility Requirements for Dependent(s)" subsection of Section 9 of the Plan is amended to read as follows: "a. is under the age of 26 or is still within the Calendar Year in which he or she reaches age 26 and who is not eligible to enroll in an eligible employer -sponsored health plan other than a grandfathered health plan of a parent; or" 6. Page 11-1: Paragraph 2 of the "Termination of a Covered Dependent's Coverage" subsection of Section 11 is amended to read as follows: "2. on the date the Covered Dependent's coverage terminates for any reason; a. As further clarification for purposes of this subsection, a Covered Dependent child who has reached the end of the Calendar Year in which he or she becomes 26, but who has not reached the end of the Calendar Year in which the Covered Dependent child becomes 30 will lose coverage if the Covered Dependent child incurs any of the following: i. marriage; ii. no longer resides in Florida or is no longer a full-time or part-time student; iii. obtains a dependent (e.g., through birth or adoption); iv. obtains other coverage; or V. on the date of termination of the Covered Employee's coverage. " PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a regular meeting of said Board held on the 15th day of December , 2010. Mayor Heather Carruthers Mayor Pro Tern David Rice Commissioner George Neugent C Commissioner Kim Wigington fturnissioner Sylvia Murphy Cr O Lj -- O C C met Li Yes Yes Yes Yes Yes BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA MON E COUNTY ATTORNEY AP OV&HL. r XV NTIA HALL ASSIST T COUIJTY ATTORNEY