Children. The following are eligible for coverage as children under the Plan. 5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married Xxxxxx. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or 5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) years, and incapable of self-sustaining employment by reason of mental retardation or physical handicap, and is therefore primarily dependent on the Subscriber for support and maintenance and has been continuously dependent since reaching age twenty-six (26); or 5.2.3.3 Child under court order. A biological child, adopted child, or child placed for adoption with the Subscriber who does not reside with the Subscriber, provided that a court having jurisdiction over the parties and the subject matter has issued an order requiring the Subscriber to provide such child with health coverage. If such coverage is effected through this Plan, such coverage shall continue only so long as the order remains in effect, and such child is and remains otherwise eligible; or
Appears in 3 contracts
Samples: Group Health Insurance Agreement, Group Health Insurance Agreement, Group Health Insurance Agreement
Children. The following are eligible for coverage as children under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married Xxxxxx. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) years, and incapable of self-sustaining employment by reason of mental retardation or physical handicap, and is therefore primarily dependent on the Subscriber for support and maintenance and has been continuously dependent since reaching age twenty-six (26); or
5.2.3.3 Child under court order. A biological child, adopted child, or child placed for adoption with the Subscriber who does not reside with the Subscriber, provided that a court having jurisdiction over the parties and the subject matter has issued an order requiring the Subscriber to provide such child with health coverage. If such coverage is effected through this Plan, such coverage shall continue only so long as the order remains in effect, and such child is and remains otherwise eligible; or
Appears in 3 contracts
Samples: Group Health Insurance Agreement, Group Health Insurance Agreement, Group Health Insurance Agreement
Children. The following are eligible for coverage as children under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married XxxxxxSpouse. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) years, and incapable of self-self- sustaining employment by reason of mental retardation or physical handicap, and is therefore primarily dependent on the Subscriber for support and maintenance and has been continuously dependent since reaching age twenty-six (26); or
5.2.3.3 Child under court order. A biological child, adopted child, or child placed for adoption with the Subscriber who does not reside with the Subscriber, provided that a court having jurisdiction over the parties and the subject matter has issued an order requiring the Subscriber to provide such child with health coverage. If such coverage is effected through this Plan, such coverage shall continue only so long as the order remains in effect, and such child is and remains otherwise eligible; or
Appears in 2 contracts
Samples: Group Health Insurance Agreement, Group Health Insurance Agreement
Children. The following are eligible for coverage as children under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married XxxxxxSpouse. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) years, and incapable of self-sustaining employment by reason of mental retardation or physical handicap, and is therefore primarily dependent on the Subscriber for support and maintenance and has been continuously dependent since reaching age twenty-six (26); or
5.2.3.3 Child under court order. A biological child, adopted child, or child placed for adoption with the Subscriber who does not reside with the Subscriber, provided that a court having jurisdiction over the parties and the subject matter has issued an order requiring the Subscriber to provide such child with health coverage. If such coverage is effected through this Plan, such coverage shall continue only so long as the order remains in effect, and such child is and remains otherwise eligible; or
Appears in 1 contract
Samples: Group Health Insurance Agreement
Children. The following are eligible for coverage as children under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married Xxxxxx. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) years, and incapable of self-self- sustaining employment by reason of mental retardation or physical handicap, and is therefore primarily dependent on the Subscriber for support and maintenance and has been continuously dependent since reaching age twenty-six (26); or
5.2.3.3 Child under court order. A biological child, adopted child, or child placed for adoption with the Subscriber who does not reside with the Subscriber, provided that a court having jurisdiction over the parties and the subject matter has issued an order requiring the Subscriber to provide such child with health coverage. If such coverage is effected through this Plan, such coverage shall continue only so long as the order remains in effect, and such child is and remains otherwise eligible; or
Appears in 1 contract
Samples: Group Health Insurance Agreement
Children. The following are eligible for coverage as children A child under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married Xxxxxx. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) yearswho is one of the following: born of the Subscriber; or legally placed for adoption with the Subscriber; or legally adopted by the Subscriber; or a child for whom the Subscriber or his Spouse has been granted legal custody or provisional custody by mandate, or a child for whom the Subscriber or his Spouse is a court appointed tutor/xxxxxx; or a child supported by the Subscriber pursuant to a Qualified Medical Child Support Order (QMCSO) or National Medical Support Notice (NMSN); or a stepchild of the Subscriber; or a grandchild residing with the Subscriber, provided the Subscriber has been granted legal custody or provisional custody by mandate of the grandchild; or the Subscriber’s child or grandchild who is in the legal custody of and incapable of self-sustaining employment by reason of mental retardation or physical handicapresiding with the Subscriber, and who is therefore primarily dependent covered on the Subscriber for support and maintenance and has been continuously dependent since reaching Plan before turning age twenty-six (26); or
5.2.3.3 Child under court order, and is able to remain covered on the Plan once turning age 26 because he meets the definition and requirements of an Over-Age Dependent. Applications, changes and terminations must be made to Company. Company will determine and verify eligibility to enroll in this Benefit Plan and establish an Effective Date for coverage. Application for enrollment must be made to Company during the Group’s annual Open Enrollment Period each year. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A biological childqualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. Every Eligible Person may enroll for coverage under this Benefit Plan and may include any Eligible Dependents on such enrollment form. The Group will submit any such enrollment forms to the Company as a prerequisite to coverage under this Benefit Plan. No person will be covered under this Benefit Plan unless the Company has accepted the enrollment form and has been issued an identification card or other written notice of acceptance. Payment of premiums to the Company for any person will not effectuate coverage unless and until the Company's identification card or other written acceptance has been issued, adopted childand in the absence of such issuance, the Company's liability will be limited to refund of the amount of premiums paid. This Group Dental Benefit Plan and coverage under it will not be issued or child placed renewed unless the percentage of Eligible Persons specified in the Application for adoption with Group Coverage is enrolled. The classes of coverage defined below are available subject to the selection of class or classes of coverage by the Group as shown on the Application for Group Coverage. The Group has the right to change the classes of coverage selected when needed. Subscriber Only coverage means coverage for the Subscriber who does not reside with only. Subscriber and Spouse coverage means coverage for the Subscriber and his Spouse. Subscriber and Family coverage means coverage for the Subscriber, provided that a court having jurisdiction over the parties his Spouse, and the subject matter has issued an order requiring one or more Dependent children. Subscriber and Child(ren) coverage means coverage for the Subscriber and one or more Dependent children. When an enrollment form has been accepted and any premiums for coverage have been paid, coverage will begin on the following applicable Effective Date, subject to provide any Eligibility Waiting Period: If a person is an Eligible Person on the Group's Benefit Plan Date and enrolls for coverage for self or for self and any eligible Dependent(s) on or before such child with health date, this Group's Benefit Plan Date will be the Effective Date of coverage. If such coverage is effected through a person becomes an Eligible Person after this Plan, such coverage shall continue only so long as the order remains in effectGroup's Benefit Plan Date, and such enrolls for coverage for self or for self and any eligible Dependent(s) and the enrollment form is received by the Company within thirty (30) days of the eligibility date, the Effective Date of coverage will be the eligibility date. If an Eligible Person’s application for coverage for self or for self and any eligible Dependent(s) is not received by Us within thirty (30) days of the eligibility date or Special Enrollment Period as described If a child is born to a Subscriber holding coverage which includes Dependent children (Subscriber and remains otherwise eligible; orFamily coverage or Subscriber and Child(ren) coverage), and the enrollment form is received by the Company within one hundred eighty (180) days of the date of birth, the Effective Date of coverage will be the date of birth.
Appears in 1 contract
Samples: Limited Benefit Contract
Children. The following are eligible for coverage as children A child under the Plan.
5.2.3.1 Subscriber's biological or adopted children or children placed for adoption. Eligible children include the Subscriber's biological or adopted children or children placed with the Subscriber for adoption by the Subscriber, and children under legal guardianship of the Subscriber; and children of the Subscriber's lawfully married Xxxxxx. The Plan may not deny enrollment of a child on the grounds that the child is not claimed as a Dependent on the Subscriber's Guam Tax Return or on the grounds that the child does not reside with the Subscriber or in the Plan's Service Area. If a Subscriber is required, by a court or administrative order, to provide health care for a child, as defined above, the Plan shall permit the Subscriber to enroll, under family coverage, the child and himself/herself, provided the child is otherwise eligible, without regard to any open enrollment season or open enrollment restriction;; or
5.2.3.2 Incapacitated child. An unmarried, dependent biological child, adopted child, or child placed for adoption with the Subscriber or the Subscriber's lawfully wedded spouse, which child is over the age of twenty-six (26) yearswho is one of the following: born of the Subscriber; or legally placed for adoption with the Subscriber; or legally adopted by the Subscriber; or a child for whom the Subscriber or his Spouse has been granted legal custody or provisional custody by mandate, or a child for whom the Subscriber or his Spouse is a court appointed tutor/xxxxxx; or a child supported by the Subscriber pursuant to a Qualified Medical Child Support Order (QMCSO) or National Medical Support Notice (NMSN); or a stepchild of the Subscriber; or a grandchild residing with the Subscriber, provided the Subscriber has been granted legal custody or provisional custody by mandate of the grandchild; or the Subscriber’s child or grandchild who is in the legal custody of and incapable of self-sustaining employment by reason of mental retardation or physical handicapresiding with the Subscriber, and who is therefore primarily dependent covered on the Subscriber for support and maintenance and has been continuously dependent since reaching Plan before turning age twenty-six (26); or
5.2.3.3 Child under court order, and is able to remain covered on the Plan once turning age 26 because he meets the definition and requirements of an Over-Age Dependent. Applications, changes and terminations must be made to Company. Company will determine and verify eligibility to enroll in this Benefit Plan and establish an Effective Date for coverage. Application for enrollment must be made to Company during the Group’s annual Open Enrollment Period each year. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A biological childqualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. Every Eligible Person may enroll for coverage under this Benefit Plan and may include any Eligible Dependents on such enrollment form. The Group will submit any such enrollment forms to the Company as a prerequisite to coverage under this Benefit Plan. No person will be covered under this Benefit Plan unless the Company has accepted the enrollment form and has been issued an ID card or other written notice of acceptance. Payment of premiums to the Company for any person will not effectuate coverage unless and until the Company's ID card or other written acceptance has been issued, adopted childand in the absence of such issuance, the Company's liability will be limited to refund of the amount of premiums paid. This Group Dental Benefit Plan and coverage under it will not be issued or child placed renewed unless the percentage of Eligible Persons specified in the Application for adoption with Group Coverage is enrolled. The classes of coverage defined below are available subject to the selection of class or classes of coverage by the Group as shown on the Application for Group Coverage. The Group has the right to change the classes of coverage selected when needed. Subscriber Only coverage means coverage for the Subscriber who does not reside with only. Subscriber and Spouse coverage means coverage for the Subscriber and his Spouse. Subscriber and Family coverage means coverage for the Subscriber, provided that a court having jurisdiction over the parties his Spouse, and the subject matter has issued an order requiring one or more Dependent children. Subscriber and Child(ren) coverage means coverage for the Subscriber and one or more Dependent children. Subscriber and Dependent coverage means coverage for the Subscriber and one Dependent. When an enrollment form has been accepted and any premiums for coverage have been paid, coverage will begin on the following applicable Effective Date, subject to provide any Eligibility Waiting Period: If a person is an Eligible Person on the Group's Benefit Plan Date and enrolls for coverage for self or for self and any eligible Dependent(s) on or before such child with health date, this Group's Benefit Plan Date will be the Effective Date of coverage. If such coverage is effected through a person becomes an Eligible Person after this Plan, such coverage shall continue only so long as the order remains in effectGroup's Benefit Plan Date, and such enrolls for coverage for self or for self and any eligible Dependent(s) and the enrollment form is received by the Company within thirty (30) days of the eligibility date, the Effective Date of coverage will be the eligibility date. If an Eligible Person’s application for coverage for self or for self and any eligible Dependent(s) is not received by Us within thirty (30) days of the eligibility date or Special Enrollment Period as described If a child is born to a Subscriber holding coverage which includes Dependent children (Subscriber and remains otherwise eligible; orFamily coverage or Subscriber and Child(ren) coverage), and the enrollment form is received by the Company within one hundred eighty (180) days of the date of birth, the Effective Date of coverage will be the date of birth.
Appears in 1 contract
Samples: Limited Benefit Contract