4. ELIGIBILITY, EFFECTIVE DATES AND TERMINATION OF SPOUSE INSURANCE When are you eligible for Spouse Critical Illness Insurance? If you are in an Eligible Class, you are initially eligible for Spouse Critical Illness Insurance on the latest of: · January 1, 2019; · the date you are eligible for Employee Critical Illness Insurance; or · the date you acquire a Spouse. You are also eligible for Spouse Critical Illness Insurance during any Enrollment Period or as a result of a Family Status Change, provided you are in an Eligible Class and have a Spouse. When must you enroll for Spouse Critical Illness Insurance? You must enroll within 90 days of the date you are initially eligible for Spouse Critical Illness Insurance otherwise you will be considered a Late Entrant. If you refuse your Spouse insurance or do not enroll when you are eligible, then you will not be allowed to enroll your Spouse until the next Enrollment Period or until a Family Status Change. When does Spouse Critical Illness Insurance start? For Contributory Spouse Critical Illness Insurance, your insurance starts on the latest of the date: · you are eligible for Spouse Critical Illness Insurance; or · you are insured under the Policy for Employee Critical Illness Insurance; or · you enroll for Spouse Critical Illness Insurance and you agree to make any required contribution toward the cost of insurance; and you are Actively at Work on that date and your Spouse is not Confined on that date. If you are not Actively at Work on that date, your Spouse Critical Illness Insurance will not start until you resume being Actively at Work. If your Spouse is Confined on the date your Spouse Critical Illness Insurance would normally start, your Spouse Critical Illness Insurance will not start until your Spouse is no longer Confined. When can you make changes in Spouse Critical Illness Insurance? You may request a change in your Spouse Insurance Amount or benefit elections during any Enrollment Period after you are covered under the Policy and Actively at Work. You may also request a change in Spouse Critical Illness 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. Any amount or increase in Spouse Critical Illness Insurance is subject to the Pre-existing Conditions limitation. A pre-existing condition will be considered to have occurred in relation to the effective date of the change, not the original effective date of your coverage. You may only increase or decrease your Spouse Insurance Amount within the limits shown in the Benefit Highlights. When does a change in Spouse Critical Illness Insurance start? If you are Actively at Work, any increase in your Spouse Insurance Amount 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. Your Spouse must not be Confined on the date of the increase in benefits. If you are not Actively at Work on that date, any increase in Spouse Critical Illness Insurance or benefits will not start until you resume being Actively at Work. 16-SD-C-01 Page14
Critical Illness cert Page 13 Page 15