AI Content Chat (Beta) logo

5. ELIGIBILITY, EFFECTIVE DATES AND TERMINATION OF DEPENDENT CHILDREN INSURANCE When are you eligible for Dependent Children Accident Insurance? If you are in an Eligible Class, then you are initially eligible for Dependent Children Accident Insurance on the latest of: · January 1, 2019; · the date you are insured for Employee Accident Insurance; or · the date you acquire your Dependent Children. You are also eligible for Dependent Children Accident Insurance during any Enrollment Period or as a result of a Family Status Change, provided you are in an Eligible Class and have one or more Dependent Children. When must you enroll for Dependent Children Accident Insurance? You must enroll within 90 days of the date you are initially eligible for Dependent Children Accident Insurance or within 31 days of the date of a Family Status Change or during any Enrollment Period. When does Dependent Children Accident Insurance start? For Contributory Dependent Children Accident Insurance, your insurance starts on the latest of the date: · you are eligible for Dependent Children Accident Insurance; · you are first insured under the Policy, for Employee Accident Insurance; · you enroll for Dependent Children Accident Insurance; and · you agree to make any required contribution toward the cost of insurance; if you are Actively at Work on that date. If you are not Actively at Work on that date, your Dependent Children Accident Insurance will not start until you resume being Actively at Work. When can you make changes in Dependent Children Accident Insurance? You may request a change in your Dependent Children Accident Insurance benefit options during any Enrollment Period while the Policy is in force. You may also request a change in Dependent Children Accident Insurance at any time due to a Family Status Change. Such request must be made within 31 days of the date the Family Status Change occurred. When does a change in your Dependent Children Accident Insurance start? If you are Actively at Work, any increase in Dependent Children Accident Insurance or benefits, for reasons other than a Family Status Change, will start: · on the January 1st following the date of change, when you apply for a different coverage option and you agree to make any required contribution toward the cost of insurance; · on the date of the Policy change. If you are not Actively at Work on that date, any increase in Dependent Children Accident Insurance or benefits will not start until you resume being Actively at Work. Whether or not you are Actively at Work, any reduction in Dependent Children Accident Insurance or benefits for reasons other than a Family Status Change, will start: · on the January 1st following the date of change, when you apply for a different coverage option; · on the date of the Policy change. If you are Actively at Work, any increase in Dependent Children Accident Insurance or benefits due to a Family Status Change will start on the latest of: · the date you apply for such change in Dependent Children Accident Insurance and you agree to make any required contribution toward the cost of the insurance; or · the date of your Family Status Change. 16-AC-C-01 Page20

Accident cert - Page 20 Accident cert Page 19 Page 21