SECTION 3.
ELIGIBILITY RULES FOR DEPENDENTS
A Dependent of an Eligible Employee or Retired Participant becomes eligible at the same time that Employee or Retired Participant becomes eligible, or the date the Dependent is acquired, if later. Retired Participants must enroll their existing Dependents at the same time they enroll, or such Dependents are forever ineligible for Plan Benefits. Retired Participants must enroll new Dependents within 31 days of marriage or the date the Dependent is acquired, or such Dependents are forever ineligible for Plan benefits. A Spouse, however, may be enrolled within 31 days of birth or adoption of a Dependent child.
A Participant with dual coverage (both husband and wife eligible to enroll in this Plan) may enroll both as a Participant and as a Dependent. A Participant may enroll in this Plan as a Dependent of more than one Participant (children of Participants with dual coverage under this Plan). In coordinating coverage under the Plan, the benefits provided to the Participant as an Eligible Employee or a Retired Participant will be primary and the benefits, provided to the Participant as a Dependent will be secondary. In this situation, the Plan will pay no more than the actual Covered Expenses incurred.
Dependents are defined as:
- The Spouse of an Eligible Employee or Retired Participant.
- Unmarried children of an Eligible Employee or Retired Participant who are not in military service anywhere, if they are:
- Genetic children under age 19, legally adopted children under age 19, and children under age 19 who have been placed in the Eligible Employee’s or Retired Participant’s home for adoption by that Employee or Participant;
- Stepchildren under age 19 who are the genetic or legally adopted children of the Eligible Employee’s or Retired Participant’s Spouse, and who spend more than 50% of their nights with the Employee or Participant;
- Grandchildren under age 19 who spend more than 50% of their nights with the Eligible Employee or Retired Participant, provided the Eligible Employee or Retired Participant has legal custody of the grandchild;
- Children less than 23 years of age who are Full-Time Students and receive more than half their support from the Eligible Employee or Retired Participant;
- Children who, when they turned age 19, were and continue to be incapable of earning a living because of a mental or physical handicap (provided the child was so handicapped and eligible as Dependent at the time they reached such limiting age), and is dependent upon the Eligible Employee or Retired Participant for support. Evidence of the child’s dependence and incapacity must be filed with the Plan within 31 days after attaining age 19, and periodically thereafter;
- Children under the age of 19 who are otherwise eligible for coverage as described above, and who are required to be enrolled by a Qualified Medical Child Support Order (QMCSO).
Eligible Employees and Retired Participants must enroll Dependents before the Trust will process the Dependent’s claims. Enrollment forms are available from the Trust Customer Service Office. Coverage for Dependents begins on the same day coverage for the Eligible Employee or Retired Participant begins, or on the date that Employee or Participant acquires the Dependent, if later.
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