Employee and Dependent Eligibility For Coverage*
All actively-at-work employees age 18 or older are eligible.
Dependent coverage is available to:
- A legally married spouse who lives with the eligible employee
- Any unmarried natural, adopted or stepchild of the eligible employee. Such child must be under age 25, and be dependent on the eligible employee for principal support and maintenance
Please note that this coverage may not be appropriate for anyone eligible for Medicaid.
*State insurance laws may affect the definition of an eligible dependent.
Effective Date Procedures
Two different effective date procedures are available:
“First of Month” – The employee’s coverage will take effect on the first day of the month following the enrollment process. This procedure requires that monthly or semi-monthly premium be submitted for employees. The administrator will update eligibility and provide benefits on a calendar month basis.
“Normal Pay Date” – The employee’s coverage will take effect on the first day after the Normal Pay Date for which the first payroll deduction is taken for coverage. Under this procedure, groups must remit premium on a pay cycle basis (weekly or bi-weekly) as deductions are made. The administrator will update eligibility and provide benefits for the 7-day period (weekly) or 14-day period (bi-weekly) following the Normal Paydate.
Both procedures require the employee to be on Active Service on the effective date, completion of the enrollment process, and submission of premium, for coverage to become effective. The effective date for dependents will be the same as the employee, unless dependent coverage is added at a later date. With respect to Life Insurance only, if a dependent is totally disabled on the effective date, coverage will be deferred until the dependent ceases to be disabled.
Coverage Ends
Coverage will end when the employee no longer qualifies as an eligible Insured, when his or her premium payments are discontinued, or when the group plan ends, whichever comes first. Coverage on a dependent ends on the earlier of the date that they no longer meet the definition of a dependent, the date that dependent coverage is terminated, or the date that the employee’s coverage terminates.