If You have a Dependent Child covered under this Plan who is under the age of 26 and Totally Disabled, either mentally or physically, that Child's health coverage may continue beyond the day the Child would otherwise cease to be a Dependent under the terms of this Plan. You must submit written proof that the Child is Totally Disabled within 30 calendar days after the day coverage for the Dependent would normally end. The Plan may, for three years, ask for additional proof at any time, after which the Plan may ask for proof not more than once per year. Coverage may continue subject to the following minimum requirements: • The Dependent must not be able to hold a self-sustaining job due to the disability; and • Proof of the disability must be submitted as required (Notice of Award of Social Security Income is acceptable); and • The Employee must still be covered under this Plan. A Totally Disabled Dependent Child older than 26 who loses coverage under this Plan may not re-enroll in the Plan under any circumstances. IMPORTANT: It is Your responsibility to notify the Plan Sponsor within 60 days if Your Dependent no longer meets the criteria listed in this section. If, at any time, the Dependent fails to meet the qualifications of a Totally Disabled Dependent, the Plan has the right to be reimbursed from the Dependent or Employee for any medical claims paid by the Plan during the period that the Dependent did not qualify for extended coverage. Please refer to the COBRA Continuation of Coverage section in this document. Employees have the right to choose which eligible Dependents are covered under the Plan. EFFECTIVE DATE OF EMPLOYEE'S COVERAGE Your coverage will begin on the later of the following dates: • If You apply within 30 days of hire, Your coverage will become effective Your date of hire; or • If You are eligible to enroll under the Special Enrollment Provision, Your coverage will become effective on the date set forth under the Special Enrollment Provision if application is made within 31 calendar days of the event. EFFECTIVE DATE OF COVERAGE FOR YOUR DEPENDENTS Your Dependent's coverage will be effective on the later of: • The date Your coverage under the Plan begins if You enroll the Dependent at that time; or • The date You acquire Your Dependent if application is made within 31 calendar days of acquiring the Dependent; or • The date set forth under the Special Enrollment Provision if Your Dependent is eligible to enroll under the Special Enrollment Provision and application is made within 31 calendar days following the event; or • The date specified in a Qualified Medical Child Support Order or the date the Plan Administrator determines that the order is a QMCSO. A contribution will be charged from the first day of coverage for the Dependent if an additional contribution is required. In no event will Your Dependent be covered prior to the day Your coverage begins. -37- 7670-00-413597