Eligibility

Eligible Employees [Enrollee]

Eligible Dependents

Dependent coverage is included in the plan for eligible employees. A dependent is defined as:

  1. The lawful spouse of the Enrollee. All newborn infants whose eligibility begins from and after the moment of birth.  Adopted children, stepchildren, and foster children are eligible from and after the date of placement.  Except as stated above, dependents are eligible for coverage on the date the Enrollee is eligible for coverage or on the day the Enrollee acquires such dependent.
  2. An Enrollee’s dependent, up to age twenty-six (26), irrespective of the dependent’s place of residence, marital, financial, or student status.
  3. Coverage will not terminate while a dependent child is and continues to be (1) incapable of self-sustaining employment by reason of mental retardation or physical handicap; and (2) chiefly dependent upon the Enrollee for support and maintenance provided the Enrollee furnishes proof of such incapacity and dependency to Empathia Pacific, Inc., Employee Assistance Program within thirty (30) days of the child attaining the limiting age set forth in paragraph 2 above, and every two (2) years thereafter, if requested by the Plan.
  4. In addition to the above, all permanent residents of the Enrollee’s household are eligible for Covered Services under the Plan.  Any spouse/former spouse who does not permanently reside with the Enrollee and is ordered by the court that coverage be provided is also eligible.