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Home → Welfare→ SPD → ELIGIBILITY RULES FOR DEPENDENTS 
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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.
3.1 PRE-EXISTING CONDITIONS
LIMITATION
3.2 TERMINATION
OF ELIGIBILITY FOR DEPENDENTS
3.3 QUALIFIED
MEDICAL CHILD SUPPORT ORDERS
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