Participation Terms and Conditions

Your Social Security number will be requested only when needed by benefit plan administration for financial reporting or to verify your identity, in compliance with state and federal law.

As a participant in LLNS-sponsored plans, you agree to the following terms and conditions:

1. Most of the medical plans that LLNS offers including the medical portion of Anthem Blue Cross PLUS, Anthem Blue Cross PPO and Anthem Blue Cross EPO (offered by Anthem Blue Cross of California®), Anthem Blue Cross CORE Value-CA, Anthem Blue Cross HDHP, Kaiser Permanente, Kaiser Permanente HDHP, and the DeltaCare USA dental plan require resolution of medical malpractice and other disputes through binding arbitration. When you enroll in these plans, you agree that any dispute between you (and/or your enrolled family members) and the medical or dental plan must be submitted to binding arbitration. You agree to waive your right to a jury or court trial to resolve these disputes. For more information about each plan’s arbitration provision, please see the appropriate plan booklet or call the plan.
2. You acknowledge and accept all terms and conditions of the LLNS-sponsored plans in which you are enrolled as stated in the plan booklets.
3. If you enroll family members, LLNS and/or the carrier may require proof of eligibility. Marriage or birth certificates, adoption papers, tax records, and the like may be requested. You agree to provide such documentation upon request.
4. If you enroll your eligible domestic partner and/or your partner’s eligible child(ren), or if you enroll or have enrolled your natural or adopted child who is not claimed as your tax dependent, you acknowledge that the LLNS/employer contribution for their medical and/or dental coverage may be considered your taxable income, subject, to FICA (Social Security and Medicare) and federal and California state income tax withholding.
5. If you specifically ask LLNS representatives to intercede on your behalf with your insurance plan, LLNS representatives will request minimum necessary health information required to assist you with your problem. If more protected health information is involved in solving your problem, in compliance with state privacy laws and federal laws, including HIPAA (Health Insurance Portability and Accountability Act of 1996), you may be required to sign an authorization allowing LLNS to provide the insurance plan with relevant personal health information or authorizing the insurance plan to release such information to the LLNS representative.
6. By making an election with your written or your electronic signature you are authorizing LLNS to take deductions from your earnings (employees) to cover your monthly costs, if any, for the plans you have chosen for yourself and your eligible family members.
7. Actions you take during Open Enrollment will be effective at the beginning of the following Plan Year unless otherwise stated.
8. Making false statements about satisfying eligibility criteria, failing to notify LLNS of loss of eligibility within 31 days of such loss, or failing to provide documentation when requested will lead to de-enrollment of the family members and possible legal action. In addition, employees/retirees may be subject to disciplinary action (e.g., loss of health benefits for up to 12 months) and will be responsible for any employer contributions to and benefits paid by the plan for the ineligible coverage.