Dependent Definitions

• legally married spouse of the opposite sex; and
• unmarried children until the end of the month in which they attain 19 years of age.

Any other unmarried child to the end of the month in which the child reaches age 25, who goes to school on a full-time basis, the child is not employed on a regular full-time basis by one or more employers for a total of 30 or more hours per week; and depends solely on you for support will be covered as a dependent.

If your child is physically or mentally incapable of self-support after reaching age 19, you may continue coverage for that dependent. To continue coverage, the child's physical or mental handicap must start before he or she reaches age 19 (or 25 if a student) and you must provide satisfactory proof of the disability to Aetna within 31 days of when the child's coverage would normally end.

Your children include:

• Your biological children.
• A stepchild.
• A legally adopted child, including a child placed with you for purposes of adoption or for whom legal adoption proceedings have been started, and legally dependent on you for care and support.
• A grandchild or foster child or any other child, provided you have legal custody of the child, have legally adopted the child, or are the legal guardian of the child.
• Any child you are required to provide health coverage for as a result of a Qualified Medical Child Support Order (QMCSO)

In the case of divorce and the dependent child(ren) was covered under this Plan immediately prior to the divorce, you may continue to cover the child(ren) even if that child(ren) no longer resides with you.

No person may be covered both as an employee and dependent and no person may be covered as a dependent of more than one employee.

Domestic Partner means each of two people of the same sex, one of whom is an employee of the Policyholder, who represent themselves publicly as each other’s domestic partner and have:

• registered as domestic partners or members of a civil union with a government agency or office where such registration is available; or
• submitted a domestic partner declaration.

The domestic partner declaration must establish that:

• each person is 18 years of age or older;
• neither person is married;
• neither person has had another domestic partner within 6 months prior to the date they enrolled for insurance for the Domestic Partner under the Group Policy;
• they have shared the same residence for at least 6 months prior to the date they enrolled for insurance for the Domestic Partner under the Group Policy;
• they are not related by blood in a manner that would bar their marriage in the jurisdiction in which they reside;
• they have an exclusive mutual commitment to share the responsibility for each other’s welfare and financial obligations which commitment existed for at least 6 months prior to the date they enrolled for insurance for the Domestic Partner under the Group Policy, and such commitment is expected to last indefinitely; and
• 2 or more of the following exist as evidence of joint responsibility for basic financial obligations:
• a joint mortgage or lease;
• designation of the Domestic Partner as beneficiary for life insurance or retirement benefits;
• joint wills or designation of the Domestic Partner as executor and/or primary beneficiary;
• designation of the Domestic Partner as durable power of attorney or health care proxy;
• ownership of a joint bank account, joint credit cards or other evidence of joint financial responsibility; or
• other evidence of economic interdependence.

QUALIFYING EVENTS

A person will not be considered a Late Enrollee if you experience a qualified life status change, which includes one or more of the following, and you change your Plan election within 31 days of the following event:

• Marriage, divorce, legal separation or annulment.
• Birth or adoption of a child.
• Death of a spouse or child.
• Loss of medical coverage due to a change in spouse's employment status.
• Qualified Medical Child Support Order.
• Change in place of residence resulting in inaccessibility of Aetna's coverage area.
• Change in employment status, including an increase or reduction in hours which affects the eligibility under the Plan.
• • An event causing a child to satisfy or cease to satisfy the eligibility requirements for dependent coverage (i.e. due to age,student status, or a similar event).

Birth

Marriage

USG HR Admin - QE can be anything - Enrollment needs to be within 31 days of event

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