Common use of FEDERALLY DEFINED ELIGIBLE INDIVIDUAL Clause in Contracts

FEDERALLY DEFINED ELIGIBLE INDIVIDUAL. An Eligible Person, as defined: for whom, as of the date on which he or she seeks coverage under this Contract, the aggregate of the periods of Creditable Coverage is 18 or more months during which time the Eligible Person has not had any significant break in coverage (significant break in coverage means a break in coverage of 63 days or more during which time the Eligible Person has no Creditable Coverage); whose most recent prior Creditable Coverage was under a Group Health Plan, Governmental Plan, Church Plan, or health insurance coverage offered in connection with any such plan; who is not eligible for coverage under a Group Health Plan, Part A or Part B of Title XVIII of the federal Social Security Act (Medicare), or a State plan under Title XIX of the federal Social Security Act (Medicaid) or any successor program and who does not have another Health Benefits Plan, or hospital or medical service plan; with respect to whom the most recent coverage within the period of aggregate Creditable Coverage was not terminated based on a factor relating to nonpayment of premiums or fraud; who, if offered the option of continuation coverage under a COBRA continuation provision or similar State continuation option, elected that continued coverage; and who has elected continuation coverage described in item “e” above, and has exhausted that continuation coverage.