Eligible Dependents (Active Employee Plans)

Who is Eligible as a Dependent?
Dependents eligible for coverage (once you are eligible) include your lawful spouse and unmarried children defined as follows:

Children: Your unmarried sons and daughters (including stepchildren, legally adopted children or children for whom you and/or your spouse are the legally appointed guardian) who depend primarily on you for financial support, or a person for whom you are required to provide health coverage as the result of a Qualified Medical Child Support Order (QMCSO).
Note: Children who are eligible as employees in a TBT Plan or in full-time service in the armed forces are not eligible as your dependents.

Your eligible children qualify for dependent coverage at the following ages:

  1. Children to age 19.
  2. Children age 19 to age 26 provided that they are primarily dependent on you for financial support and enrolled as full-time students at an accredited school or college (for at least nine units).
  3. Children age 19 and over who are unable to earn a living due to a mental or physical disability which existed prior to reaching age 19 are eligible provided that proof of disability (in the form of a doctor's written statement of disability) is provided to the Plan upon request (no more frequently than once per year). Coverage will end on the date when the person no longer qualifies for this extension or on the 31st day after failing to provide requested proof of continued disability.

DOMESTIC PARTNERS

If your Employer is required by local ordinance or state law to provide coverage to "domestic partners," the Plan will cover domestic partners. Upon request, the Plan Administration Office will provide a written explanation of the Plan's domestic partner coverage requirements.

Change in Family Status

It is your responsibility to notify the Plan Administration Office in writing when a change occurs that affects the eligibility of your dependents or when you wish to add a new dependent.

You must notify the Plan Administration Office within 30 days if:

  1. You get married or divorced.
  2. You have a newborn child.
  3. You adopt or gain custody of a child.
  4. Your covered child loses coverage due to age (see above).
  5. A covered family member dies.

With your notice, send a copy of your:

  • Marriage certificate
  • Divorce decree
  • Birth certificate (if a child is added after one year following birth)
  • Adoption or legal guardianship documents

…to the Plan Administration Office.

If you have HMO coverage, the Plan Administration Office will send you a Change of Status Form (required by the HMO) upon request.



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