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. . <br /> � <br /> • Specify Open Enrollment Period: <br /> . Such person's Coverage Date, Family Coverage Date, and/or dependent's Coverage Date will be a <br /> date mutually agreed to by the Claim Administrator and the Employer. Such date shall be subsequent <br /> to the Open Enrollment Period. <br /> 12. Extension of Coverage due to Temporary Layoff, Leave of Absence or Disability shall be a period of <br /> 0 days. <br /> However,benefits shall be extended for the duration of an Eligible Person s leave in accordance wiih the Family and Medical Leave <br /> Act of 1993,as amended. <br /> IN WITNESS WHEREOF,the Employer hereby duly executes this Adoption Agreement and the Plan this <br /> day of , 2001. <br /> For: <br /> By: <br /> nt ame <br /> By: <br /> � <br /> Title: <br /> � ATTEST: �_ � <br /> ��-�_ , c��t�i <br /> •�%C� <br /> Title: � 2- <br /> . <br />