Common use of New Dependents Clause in Contracts

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application is received within 60 days from the date of the court order or event.

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days 60‐days from birth. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day 31‐day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days 60‐days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application is received within 60 days from the date of the court order or event.

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application is received within 60 days from the date of the court order or event.. SAMPLE

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application enrollment submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application enrollment to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application enrollment is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application enrollment is received within 60 days from the date of the court order or event.

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application enrollment submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application enrollment to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application enrollment is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal SAMPLE responsibility if the completed Application enrollment is received within 60 days from the date of the court order or event.

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. Continuous coverage selected for a newborn, adopted child or a newly-fostered child through a Special Enrollment Period on a plan purchased through the Marketplace will take effect on the date of birth, adoption or fostering. For continuous coverage selected for a newborn, adopted child or newly-fostered child through a Special Enrollment Period on a plan purchased directly from Community Health Options, you will be given the option to choose the effective date of either the date of birth or adoption, or the first day of the month following the month the child was born, adopted or fostered. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage SAMPLE Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application is received within 60 days from the date of the court order or event.

New Dependents. New Dependents may be added by paying the applicable Premium and completing enrollment for: a. Marriage or beginning of a legal domestic partnership (and the spouse’s/domestic partner’s child(xxx)) Coverage is effective the first day of the month following the completion of the enrollment. A completed Application submission to us or the Marketplace, as applicable, is required within 60 days from the date of marriage or legal domestic partnership. b. Birth, Adoption or Legal Guardianship A newborn is automatically covered for 31 days from the moment of birth unless the Subscriber notifies us that the newborn will not be covered under this Agreement. For continuous coverage beyond 31 days from birth, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. Continuous coverage selected for a newborn, adopted child or a newly-fostered child through a Special Enrollment Period on a plan purchased through the Marketplace will take effect on the date of birth, adoption or fostering. For continuous coverage selected for a newborn, adopted child or newly-fostered child through a Special Enrollment Period on a plan purchased directly from Community Health Options, you will be given the option to choose the effective date of either the date of birth or adoption, or the first day of the month following the month the child was born, adopted or fostered. For purposes of this section, the term “newborn” includes a newly born child of the insured or Subscriber or a newly born child of a Dependent child of the insured or Subscriber. Grandchildren of the Subscriber are not eligible for coverage beyond the initial 31-day period following birth. SAMPLE Coverage for routine newborn care will be attributed to the mother’s coverage until the mother’s discharge. If the newborn remains in the Hospital after the mother is discharged, or if services beyond the scope of routine newborn care are provided, those services will be subject to Deductible and Coinsurance, if applicable, of the newborn. See the Covered Services Section section 4.B. i. Adoption or Placement for Adoption An adopted child or child Placed for Adoption is covered for 31 days from the date of adoption or Placement for Adoption, upon notification. For continuous coverage beyond 31 days from adoption or Placement for Adoption, you must submit a completed Application to us or the Marketplace, as applicable, within 60-days from birth. ii. Legal Guardianship Coverage is effective the date of the court order appointing the guardian if the completed Application is received within 60 days from the date of the court order. iii. Subscriber Becomes Legally Responsible for a Dependent’s Health Care Coverage Coverage is effective the date of the court order or other event creating such legal responsibility if the completed Application is received within 60 days from the date of the court order or event.