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Late Enrollment Penalty ("LEP") means an amount added to the Part D Premium of an <br /> individual who did not have Part D coverage or other creditable prescription drug plan when the <br /> individual first became eligible for Part D or who had a break in Part D or other creditable <br /> prescription drug coverage for at least 63 days. <br /> Low Income Subsidy ("LIS") means the premium subsidy amount paid to us by CMS for <br /> qualifying Covered Persons with Medicare Part D coverage. <br /> Medicare Plan means the group Medicare Advantage Plan, Medicare Advantage Prescription <br /> Drug Plan, and/or standalone Medicare Prescription Drug Plan that you select. <br /> Premium means the amount required to be paid by the Group to us for coverage under this <br /> Agreement. <br /> Service Area means a geographic area where a Medicare Plan accepts members. <br /> SECTION 3:_ELIGIBILITY, ENROLLMENT,AND DISENROLLMENT <br /> A. Eligibility Determination <br /> Determination of whether an individual is an Eligible Retiree or Eligible Dependent will be a <br /> two-step process: <br /> 1. You will determine whether the individual is eligible to participate in the retiree group <br /> health benefit plan that you sponsor. For individuals meeting your eligibility criteria, you <br /> will promptly forward completed applications to us. You are responsible for complying <br /> with all applicable laws and regulations, including but not limited to the Employee <br /> Retirement Income Security Act (ERISA) and the Internal Revenue Code, in making this <br /> eligibility determination. You must also comply with all eligibility guidelines included <br /> in the benefit administrative guide and Evidence of Coverage. <br /> 2. After receiving a complete application, we will process the application in accordance <br /> with CMS Requirements. An application must be approved by us and accepted by CMS <br /> for an individual to be enrolled in a Medicare Plan. <br /> B. Distribution of Enrollment Materials <br /> You.may only distribute materials describing the Medicare Plan that we have provided to you or <br /> that we have approved in writing. You will distribute any pre-enrollment materials that we <br /> provide to you to each potential enrollee before collecting enrollment applications. Nothing in <br /> this Section will preclude you from making additional disclosures about your group health <br /> benefit plan as applicable to comply with ERISA, such as a wrap-around summary plan <br /> description or other plan document. If applicable, you are solely responsible for compliance with <br /> ERISA disclosure requirements in connection with the Medicare Plan(s). <br /> 3 <br />