94 • Medical and dental treatment (including orthodontic and oral surgery treatment) involved in the management of birth defects for cleft lip and cleft palate. Adopted Children A child will be considered adopted from the earlier of: (1) the moment of placement in your home; or (2) the date of an entry of an order granting custody of the child to you. The child will continue to be considered adopted unless the child is removed from your home prior to issuance of a legal decree of adoption. Your Dependent’s Effective Date will be the date of the adoption or placement for adoption if you send the Employer the completed application / change form within 31 days of the event. To continue coverage beyond the 31 day period you should submit an application / change form to the Employer, within 31 days following the adoption or placement for adoption. Adding a Child due to Award of Legal Custody or Guardianship If you or your spouse is awarded legal custody or guardianship for a child, an application must be submitted within 31 days of the date legal custody or guardianship is awarded by the court. Coverage will be effective on the date the court granted legal custody or guardianship. Qualified Medical Child Support Order If you are required by a qualified medical child support order or court order, as defined by ERISA and/or applicable state or federal law, to enroll your child in this Plan, the Plan will permit the child to enroll at any time without regard to any Open Enrollment limits and will provide the benefits of this Plan according to the applicable requirements of such order. However, a child's coverage will not extend beyond any Dependent Age Limit listed in the Schedule of Benefits.
2025 Retiree Indemnity Plan Booklet Page 94 Page 96