EMPLOYEE COVERAGE: Except as stated in "Employee Delayed Effective Date for Coverage," Coverage for an Employee becomes effective on the latest of:

1. the date the Employee becomes eligible for Coverage;
2. the date the Employee signs a payroll deduction order, if any part of the cost for this Plan is paid by Covered Employees, and makes written application for Coverage; or
3. the date the Employee enrolls through a Special Enrollment Period.

EMPLOYEE SPECIAL ENROLLMENT PERIOD: An individual who did not enroll in a Company's group health plan when first eligible due to the existence of other coverage may enroll, if the individual:

1. had other coverage when the Employee Plan was initially offered;
2. stated in writing that the other coverage was the reason for declining enrollment (but only if the Company required such a statement);
3. had COBRA coverage that was exhausted, or other health plan coverage that was terminated due to loss of eligibility or termination of employer contributions; and
4. requests enrollment within thirty-one (31) days of exhaustion or termination of coverage.

DEPENDENT COVERAGE: An Employee's Dependent Coverage will become effective on the latest of:

1. the date the Employee becomes eligible for Dependent Coverage;
2. the date the Employee makes written application for Dependent Coverage and signs a payroll deduction order;
3. the date a Qualified Medical Child Support Order is put in place; or
4. the date a Dependent enrolls through a Special Enrollment Period.

If an Employee does not enroll for Dependent coverage when first eligible for Dependent coverage, the Employee can only add Dependent coverage at Open Enrollment or through a Special Enrollment Period.

If an Employee does not enroll a Dependent within thirty-one (31) days of marriage, birth, adoption or placement for adoption, the Employee can only add the Dependent at Open Enrollment or through a Special Enrollment Period.

DEPENDENT SPECIAL ENROLLMENT PERIOD: If your Plan offers Dependent coverage, Dependents have a Special Enrollment Period of thirty-one (31) days if they become Dependents through marriage, birth, Adoption, Placement for Adoption, legal Custody, or a Qualified Medical Child Support Order. If the Employee or spouse is otherwise eligible for enrollment in the Plan, but he/she has not enrolled, the Employee or spouse is also allowed to enroll at the time of birth, Adoption, Placement for Adoption, legal Custody, or a Qualified Medical Child Support Order. Coverage through this Special Enrollment Period is effective on the date of marriage, birth, Adoption, Placement for Adoption, legal Custody, or the date a Qualified Medical Child Support Order is put in place and any required contribution is paid.

If an Employee acquires a new Dependent due to a Qualified Medical Child Support Order (QMCSO), Coverage for this new Dependent will be effective as of the date of the QMCSO or the effective date of Coverage for the Covered Employee, whichever is later. If the Covered Employee does not carry Dependent Coverage, the Plan will enroll the child(ren) named in the QMCSO, and the Covered Employee must pay any required contribution. If the Coverage is for a stepchild and the parent named in the QMCSO is covered under the stepparent=s health plan, the Plan must enroll the stepchild. Age limitations and student status requirements apply.

ROLLOVER PROVISION FOR COVERAGE: If a person covered as a Dependent of a Covered Employee becomes eligible for Employee Coverage under the same Company, we must receive an enrollment application within thirty-one (31) days of his/her hire date. He/she can then be covered as an Employee, with no Waiting Period. Any Deductible, or Out-of-Pocket previously met under this Plan for the current calendar year will be applied.

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