Common use of Family Clause in Contracts

Family. If You selected family coverage, then You, Your Spouse or Registered Domestic Partner, and Your Child or Children, as described below are covered. If You selected parent and child/children or family coverage, Children covered under this Agreement include Children who are Your natural Children, legally adopted Children, step Children, or newborn children. Coverage lasts until the end of the month in which the Child turns 26 years of age. Coverage also includes Children for whom You are a legal guardian if the Children are chiefly dependent upon You for support and You or Your Spouse have been appointed the legal guardian by a court order. Xxxxxx Children and grandchildren are not covered. The attainment of age 26 shall not operate to terminate the coverage of a Dependent child while the child is and continues to be (1) incapable of self-sustaining employment by reason of physically or mentally disabling injury, illness, or condition; and (2) chiefly dependent upon the Subscriber for support and maintenance. In other words, eligibility will continue past the age limit only for those already enrolled Dependent Children who cannot work to support themselves by reason of a intellectual or physical disability. A Dependent Child’s coverage will terminate upon attainment of the limiting age unless You submit proof that the Dependent Child is incapable of self-sustaining employment by reason of a physically or mentally disabling injury, illness, or condition; or that the Dependent Child is chiefly dependent upon You for support and maintenance, to the plan within 60 days of receiving such a request from Us. We will send this notice at least 90 days prior to the date the Child attains the limiting age. Newborn and Adopted Child(ren) of the Subscriber or Subscriber’s Spouse will be covered for an initial period of thirty-one (31) days from the date of birth or adoption. We have the right to request and be furnished with such proof as may be needed to determine eligibility status of a prospective or covered Subscriber and all other prospective or covered Members in relation to eligibility for coverage under this Agreement at any time. Coverage under this Agreement will begin as follows: 1. If You, the Subscriber, elect coverage before becoming eligible, or within 30 days of becoming eligible for other than a special enrollment period, coverage begins on the date You become eligible, or on the date determined by Your Group. 2. If You, the Subscriber, do not elect coverage upon becoming eligible or within 30 days of becoming eligible for other than a special enrollment period, You must wait until the Group’s next open enrollment period to enroll, except as provided below. 3. If You, the Subscriber, marry or enter into a domestic partnership while covered, and We receive notice of such marriage within 60 days thereafter, coverage for Your Spouse and Child starts on the first day of the month following such marriage. If We do not receive notice within 60 days of the marriage, You must wait until the Group’s next open enrollment period to add Your Spouse or Child. 4. Immediate coverage under this Group Health Plan is provided from and after the moment of birth, to each newborn infant of Yours or Your Covered Spouse’s.