Dental Coverage 206. Each employee covered by this agreement shall be eligible to participate in the City's dental program.
Individual Coverage If you have Individual Coverage, only your own health care expenses are cov ered, not the health care expenses of other members of your family. FAMILY COVERAGE Under Family Coverage, your health care expenses and those of your enrolled spouse and your (and/or your spouse's) enrolled children who are under the limit ing age specified in the BENEFIT HIGHLIGHTS section of this Certificate will be covered. All of the provisions of this Certificate that pertain to a spouse also apply to a party of a Civil Union unless specifically noted otherwise. “Child(ren)” used hereafter in this Certificate, means a natural child(ren), a step child(xxx), adopted child(xxx), xxxxxx child(xxx), a child(ren) for whom you are the legal guardian or a child(xxx) for whom you have received a court order requiring that you are financially responsible for providing coverage under 26 years of age. a child(xxx) who is in your custody under an interim court order prior to finaliza tion of adoption or placement of adoption vesting temporary care, whichever comes first, child(xxx) for whom you are the legal guardian under 26 years of age, regardless of presence or absence of a child's financial dependency, residency, student status, employment status, marital status, eligibility for other coverage or any combination of those factors. In addition, enrolled unmarried children will be covered up to the age of 30 if they: • Live within the service area of the Plan network for this Certificate; and • Have served as an active or reserve member of any branch of the Armed Forces of the United States; and • Have received a release or discharge other than a dishonorable discharge. Coverage for children will end on the last day of the calendar month in which the limiting age birthday falls. If you have Family Coverage, newborn children will be covered from the moment of birth. Please notify the Plan within 31 days of the birth so that your member ship records can be adjusted. Your Group Administrator can tell you how to submit the proper notice through the Plan. Children who are under your legal guardianship or who are in your custody under an interim court order prior to finalization of adoption or placement of adoption vesting temporary care, whichever comes first, and xxxxxx children will be cov ered. In addition, if you have children for whom you are required by court order to provide health care coverage, those children will be covered. Any children who are incapable of self‐sustaining employment and are dependent upon you or other care providers for lifetime care and supervision because of a disabled condition occurring prior to reaching the limiting age will be covered regardless of age as long as they were covered prior to reaching the limiting age specified in the BENEFIT HIGHLIGHTS section. This coverage does not include benefits for grandchildren (unless such children have been legally adopted or are under your legal guardianship). Coverage under this Certificate is contingent upon timely receipt by the Plan of necessary information and initial premium. MEDICARE ELIGIBLE COVERED PERSONS A series of federal laws collectively referred to as the ``Medicare Secondary Payer'' (MSP) laws regulate the manner in which certain employers may offer group health care coverage to Medicare eligible employees, spouses, and in some cases, dependent children. Reference to spouse under this section do not include a party to a Civil Union with the Eligible Person or their children. The statutory requirements and rules for MSP coverage vary depending on the basis for Medicare and employer group health plan (“GHP”) coverage, as well as certain other factors, including the size of the employers sponsoring the GHP. In general, Medicare pays secondary to the following:
ADDITIONAL COVERAGES We cover the following in addition to the limits of liability:
