05-13-1992 Additions - Laserfiche WebLink

Home Browse Search

8. In the case of a dependent child, he or she must be under the limiting age of: Dependent Limiting Age: 19 Student Limiting Age: 23 The Dependent is eligible up to the Student Limiting Age if he or she is enrolled full -time in a recognized high school, college, university, trade or vocational school. Any person who does not satisfy the terms listed above will not be eligible for coverage under the Contract. INITIAL ENROLLMENT "Initial Enrollment Period" is a 30 day time period starting with the date an employee and his or her dependents are first eligible to enroll for Medica Choice coverage. An employee must apply within this period for coverage to begin the date he or she was first eligible to enroll. An employee who enrolls during his or her Initial Enrollment Period is accepted without application of health screening or waiting periods. An employee or an employee with dependents who does not enroll during his or her Initial Enrollment Period may enroll for coverage as described below. OPEN ENROLLMENT "Open Enrollment" is a minimum 14 day period set by the Employer and Medica Choice each year during which eligible persons may enroll for coverage without application of health screening or waiting periods. OFF -CYCLE ENROLLMENT Medica Choice will require persons to provide evidence of insurability before enrollment will be accepted at any time other than an Initial Enrollment Period, an Open Enrollment Period or a "Hardship" situation. The following Off -Cycle Enrollment will be allowed without evidence of insurability. An eligible employee who did not previously elect coverage under the Contract (including his or her eligible Dependents), and eligible Dependents of a currently enrolled Subscriber, may enroll within 30 days of a "Hardship" situation which will include: 1. involuntary termination or layoff from employment of the spouse, 2. death or permanent disability of the spouse, 3. divorce or legal separation and other such circumstances as Medica Choice may approve from time to time. For the eligible employee and /or eligible dependents to enroll during a "Hardship" situation, they must have been enrolled for health coverage under the employee's spouse's benefit plan. Upon request, evidence of the hardship must be provided to Medica Choice. NOTIFICATION Subscribers must notify the Employer within 30 days of the effective date of any change of address or name, addition or deletion of Dependents, or other facts identifying the Subscriber or the Subscriber's Dependents. 2 Page 13