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Enrollment Rules

DATE DEPENDENT COVERAGE ENDS

Dependent coverage will end on the earliest of the following dates: the date this Plan ends;   the date you become ineligible;   the date you fail to make a required premium contribution;   the date your coverage ends;   the date the person ceases to be a dependent as defined by the Plan;   […]

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WHEN DEPENDENT COVERAGE BECOMES EFFECTIVE

Dependent coverage will become effective on the latest of the following dates the date you apply for Dependent coverage; the date your coverage becomes effective; the date the person becomes an eligible Dependent.

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DEPENDENT ELIGIBILITY PROVISIONS

For eligibility purposes, “dependent” includes only an Employee’s: legal spouse, if not legally separated; and Dependent child, (includes a legally adopted child or a child placed in your care in anticipation of adoption where the adoption is being actively pursued, foster child, child for whom the Employee is a legal guardian, a step-child, a child […]

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FULL SELF-PAYMENT PROVISIONS

If you become ineligible for benefits, you may continue coverage through the Full Self-Payment option for a maximum period of six (6) consecutive months.  You will be responsible for paying the full cost of coverage every month for the Plan level you had when you lost eligibility.  The full self-pay amount is due by the […]

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CONTINUATION OF COVERAGE

If you are an Active member who has hourly contributions paid on your behalf by a signatory employer, and you have met the standards for initial qualification and are eligible for coverage, the Self-Pay options may be available to you.  These options allow you to maintain coverage when you do not have enough Contribution Credits […]

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LIMITATIONS ON THE CONTRIBUTION CREDIT BANK

A member can accumulate a maximum of four (4) months of Benefit Credits/Hours in their Benefit Credit/Hour Bank. If a member works more hours than are necessary to earn the Benefit Credits/Hours required for the level of coverage he/she selected, he/she will accumulate reserve Benefit Credits/Hours in the Benefit Credits/Hour Bank. These Benefit Credits/Hours will […]

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