Refer to Your Basic Dependent Schedule of Benefits to determine to which coverage this page applies. When applicable, the Dependent Schedule of Benefits will indicate employee premium CONTRIBUTIONS are not required and INDIVIDUAL EFFECTIVE DATE is First of the Month. GC 2510.22 SECTION 20 - DEPENDENT INSURANCE (FOM/Non-Contrib) SECTION 20B - INDIVIDUAL EFFECTIVE DATE SECTION 20 - DEPENDENT INSURANCE SECTION 20B - INDIVIDUAL EFFECTIVE DATE INDIVIDUAL EFFECTIVE DATE--NON-CONTRIBUTORY INSURANCE For amounts of coverage that do not exceed the Guaranteed Issue Amount shown in the Dependent Insurance Schedule of Benefits, the effective date of Dependent Insurance for each Dependent will be: 1) the first day of the Coverage Month; or 2) the first day of the next Coverage Month if You apply for Dependent coverage after the first day of the Coverage Month. To receive any amount of coverage exceeding the Guaranteed Issue Amount, You must make a written request to AUL on a form approved by AUL and the Dependent must undergo medical underwriting. The effective date of Dependent Insurance for an eligible Dependent, subject to the further provisions of this Section, will be after the Dependent submits satisfactory Evidence of Insurability to AUL and the date AUL determines the Dependent is approved for coverage. Satisfactory Evidence of Insurability, at no expense to AUL, must be provided prior to receiving any amount of coverage greater than the Guaranteed Issue Amount. If You have at least one Dependent insured under the policy, insurance amounts for any new Dependent that do not exceed the Guaranteed Issue Amount shown in the Dependent Insurance Schedule of Benefits become effective on the date that Dependent is acquired. Contributions for Dependent Insurance are not required from You. Any Dependent who converted his insurance under the policy to an individual life insurance policy and if that individual life insurance policy is still in force, the Dependent is required prior to becoming insured again under the policy, to undergo medical underwriting and submit satisfactory Evidence of Insurability, at no expense to AUL. If the Dependent does not wish to undergo medical underwriting and submit satisfactory Evidence of Insurability, the Life Amount under the policy will be reduced by the amount of coverage under the individual life insurance policy. No coverage shall begin until the date AUL has approved the request for coverage in writing and the required amount of premium is received from the Employer. If a Dependent is confined in any medical facility, rehabilitation center, convalescent care facility, nursing home, or correctional facility on the date Dependent Insurance would otherwise become effective for that Dependent, the effective date for that Dependent is the date following the Dependent’s final discharge from the medical facility, rehabilitation center, convalescent care facility, nursing home, or correctional facility and the resumption of the usual and customary duties or activities of an individual in good health and of the same age and sex. For the purposes of the policy, a Dependent will not cease to be confined if one confinement is followed by another confinement, within 72 hours, for the same or a related injury or Sickness. Also see Continuity of Coverage, Section 5, if included in the policy. Dependent Insurance will not become effective for a Dependent unless You are insured for Personal Insurance.
Certificate of Insurance: Class 3 Page 38 Page 40