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Posted

The plan uses an "hour bank" to determine

eligibility for coverage. (160 hours of service

buys one month of coverage.)

A plan participant is returning to work after a 15

month deployment. When he left, his dollar

bank was frozen. Upon his return, coverage will

commence immediately with no waiting periods.

Here is the catch...since the member has transitional

TRICARE for the next 6 months, he does not want

the plan to recommence his coverage right away.

By using the government plan, he could build up

several months of surplus coverage hours in his

hour bank.

The regs don't seem to address this. My inclination

is to resume coverage immediately and coordinate

with TRICARE.

Any thoughts?

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