A. Basic Group Insurance Plan: If an applicant is determined to be eligible for PSEBA benefits, the applicant will be eligible to receive continued health coverage consistent with the PSEBA under the Village's basic group health insurance plan. The basic group health insurance plan shall be the least expensive health plan offered to Village employees at the time PSEBA benefits are awarded as determined solely by the Village from time to time. PSEBA benefits do not include benefits not provided in the Village's basic group health insurance plan, such as, but not limited to, dental, vision, life insurance, etc.
B. Reduction Or Elimination Of PSEBA Benefits By Other Health Coverage: If an applicant becomes eligible to receive health insurance benefits from any other source, including, but not limited to, Medicare, the applicant's PSEBA coverage may be reduced or eliminated as determined by the Village consistent with PSEBA.
C. Affidavit Of Continued PSEBA Eligibility: All recipients of PSEBA benefits from the Village shall complete and return to the Village Manager on an annual basis an affidavit verifying the recipient's continued eligibility for PSEBA benefits. The affidavit must be completed and returned to the Village Manager within sixty (60) calendar days of written notice from the Village. If the recipient does not complete and return the affidavit within the time required, the Village Manager shall give the recipient an additional written notice providing an additional thirty (30) calendar days for the recipient to complete and return the affidavit. Failure to return the affidavit within the time required shall result in the recipient incurring responsibility for reimbursing the Village for premiums paid during the period the affidavit is due and not filed. (Ord. 18-2922, 5-21-2018)