Health and Welfare Summary Plan Description
2.8 Special Exclusion for Fraud.
No payments will be made by the Plan for benefits obtained through fraud including, but not limited to, the coverage of any individual who was fraudulently represented to the Plan to be the Participant's Dependent. Any Covered Individual, or any other person, who assisted with, or benefited from, the fraudulent conduct is liable to the Plan for repayment of any benefits improperly paid as a result of the fraud. If the Covered Individual has any outstanding liability for fraudulently paid benefits, no assignment may be made of any rights to benefits to a service provider or other person until all fraudulently paid benefits have been repaid in full. If fraudulently paid benefits are not repaid in full, any purported assignment of benefits may be disregarded by the Plan, and payment of benefits by the Plan under a purported assignment is not a waiver of the right of the Plan to refuse to acknowledge other purported assignments. If any fraudulently paid benefits have not been repaid when a Covered Individual incurs Covered Charges, such Covered Individual shall pay all charges directly and file a claim for credit against amounts owed the Plan in lieu of benefits, until the entire amount owed the Plan has been credited or paid. Any individual who purposefully defrauds the Plan may face criminal prosecution in addition to any civil action taken by the Plan for repayment of improperly paid benefits.