A Dependent Child of two or more Employees may only be insured once under the Policy. If a Dependent Child of two or more Employees who have enrolled Dependent Children incurs a claim, then any payable benefit will be divided equally among the Employees who have insured the Dependent Child unless the Employees otherwise agree.
If an Employee who has elected to insure Dependent Children ceases to do so, then the Employee’s Spouse may, within 31 days, elect to insure Dependent Children, provided he or she is insured as an Employee.
In all cases, a Dependent Child shall be defined with respect to the Employee who has enrolled Dependent Children.
ENROLLMENT
An eligible Employee may apply for coverage, subject to the Deferred Effective Date Provisions section of this Policy, for Himself or any eligible Spouse or Dependent Child or to increase coverage for any Covered Person under this Policy during the Initial Open Enrollment Period as agreed to by Us and the Subscriber.
Group Enrollment Events New Enrollees
Subject to the Deferred Effective Date Provisions , an Employee who is newly eligible to apply, or has been eligible but did not previously enroll, may apply for coverage for Himself or any eligible Spouse or Dependent Child for an amount shown as Guaranteed Issue without satisfying any Evidence of Insurability, during the Enrollment Events shown in the Policy. Current Insureds Subject to the Deferred Effective Date Provisions , an eligible Employee insured under this Policy, may apply for an increase in coverage for Himself or for coverage on any insured Spouse or Dependent Child for an amount shown as Guaranteed Issue without satisfying any Evidence of Insurability, during the Enrollment Events shown in the Policy.
An eligible Employee must apply for Himself and be insured for coverage for which He is required to contribute to the cost of insurance in order to apply for coverage for an eligible Spouse or Dependent Child.
During the Initial Open Enrollment Period, an Employee and His eligible Spouse or Dependent Child may become insured under the coverage provided by this Policy without satisfying any Evidence of Insurability.
Any Employee who is not in Active Service on the date His coverage would otherwise become effective under this Policy may not become covered under this Policy until He returns to Active Service.
If an Employee's eligible dependent is not in Active Service on the date the coverage would otherwise be effective, it will be effective on the date the dependent returns to Active Status.
Continuity of Coverage Subject to the Deferred Effective Date Provisions an Employee and His eligible Spouse or Dependent Child insured under the Prior Plan will be covered without further enrollment under this Policy for the amount(s) inforce under the Prior Plan on the day before the Policy Effective Date, not to exceed the Maximum Benefit Amount under this Policy. For purposes of determining premium rates, a Covered Person's age will be his or her Age as defined under this Policy.
EFFECTIVE DATE PROVISIONS
Subscriber Effective Date Subscriber Effective Date Coverage becomes effective for each Subscriber in consideration of the Subscriber's application, Subscription Agreement and payment of the initial premium when due. Coverage for the Subscriber becomes effective on the Effective date of Subscriber Participation as long as the Minimum Participation Requirements shown in the Schedule of Benefits have been satisfied.
Effective Date for Individuals (Newly Eligible and Life Status)
13
Made with FlippingBook - PDF hosting