Agmt94 Managed Health Network - Laserfiche WebLink

Browse Search

ADDENDUM ONE ELIGIBILITY PREREQUISITES 1. Eligibility. This Addendum contains a complete and detailed statement of the eligibility prerequisites of this plan. Every Member must work or permanently reside in California and satisfy the - provisions of this Addendum in order to be eligible to enroll in this plan. 1.1 Eligible Employees. An individual who is a regular full-time or part-time employee. 1.2 Eligible Family Members: If Family Members of Subscribers meet the criteria outlined below and work or reside in California, they may enroll in this plan. Eligible Family Members are: a. Spouse. The legal spouse of the Subscriber. b. Unmarried dependent children who are 18 years of age or less, 22 years of age or less if full-time students or over the age of 18 and are incapable of self-sustaining employment by reason of mental retardation or physical handicap. The term "children" includes stepchildren, adopted children, foster children, and natural children, provided such children are dependent upon the eligible individual for support and maintenance. Children in the military service are not eligible. 2. Loss of eligibility. Coverage for a Subscriber who ceases to be eligible according to the provisions of this Group Agreement, shall stop for the Subscriber and any of his or her enrolled Family Members on midnight of the last day of the month in which the loss of eligibility occurs. Coverage for an individual Family Member who ceases to be eligible according to the provisions of this Group Agreement, shall stop on the last day of the month in which the loss of eligibility occurs. - 9 - ,,,",' ,< "----.'"', '-r---"'«"'" ,,', «'"