Noblesville Schools Medical Plan 69 Section 3: When Coverage Begins What If You Are Eligible for Medicare? Your Benefits may be reduced if you are eligible for Medicare but do not enroll in and maintain coverage under both Medicare Part A and Part B. Your Benefits may also be reduced if you are enrolled in a Medicare Advantage (Medicare Part C) plan but do not follow the rules of that plan. Please see How Are Benefits Paid When You Are Medicare Eligible in Section 8: General Legal Provisions for more information about how Medicare may affect your Benefits. Who Is Eligible for Coverage? The Plan Sponsor determines who is eligible to enroll and who qualifies as a Dependent. Eligible Person Eligible Person usually refers to an employee of the Plan Sponsor who (or other person whose connection with the Plan Sponsor) meets the eligibility rules. When an Eligible Person enrolls, the Claims Administrator refers to that person as a Participant. For a complete definition of Eligible Person, Plan Sponsor and Participant, see Section 9: Defined Terms. You are eligible to enroll in the Plan if you are a regular full-time employee who is scheduled to work at least 30 hours per week or a person who retires while covered under the Plan. Eligible Persons must live within the United States. If both spouses are Eligible Persons under the Plan Sponsor's Plan, each may enroll as a Participant or be covered as an Enrolled Dependent of the other, but not both. Dependent Dependent generally refers to the Participant's spouse and children. When a Dependent enrolls, the Claims Administrator refers to that person as an Enrolled Dependent. For a complete definition of Dependent and Enrolled Dependent, see Section 9: Defined Terms. Dependents of an Eligible Person may not enroll unless the Eligible Person is also covered under the Plan. If both parents of a Dependent child are enrolled as a Subscriber, only one parent may enroll the child as a Dependent. Your eligible Dependents may also participate in the Plan. An eligible Dependent is considered to be: • Your Spouse. • Your or your Spouse's child who is under age 26, including a natural child, stepchild, a legally adopted child, a child placed for adoption or a child for whom you or your Spouse are the legal guardian. • An unmarried child age 26 or over who is or becomes disabled and dependent upon you. To be eligible for coverage under the Plan, a Dependent must reside within the United States. Note: Your Dependents may not enroll in the Plan unless you are also enrolled. In addition, if you and your Spouse are both covered under the Plan, you may each be enrolled as a Participant or be covered as a Dependent of the other person, but not both. In addition, if you and your Spouse are both covered under the Plan, only one parent may enroll your child as a Dependent. A Dependent also includes a child for whom health care coverage is required through a Qualified Medical Child Support Order or other court or administrative order.