Participating in a Medical Plan

Special Enrollment Event

If you decline enrollment for yourself or your Dependents (including your spouse) because of other health insurance coverage, you may be able to enroll yourself or your Dependents in the medical plan provided you request enrollment within 31 days after your other medical coverage ends. In addition, if you have a new Dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your Dependents provided that you request enrollment within 31 days after the marriage, birth, adoption or placement for adoption..

Verification of relationship is required for any dependent being added for the first time to your coverage. Documentation may include a marriage certificate or domestic partnership statement to add a new spouse or domestic partner. Documents for a new dependent child may include a birth certificate or adoption papers, or other appropriate legal documents may be provided. Return a copy of the required documents to the Benefits Office within 31 days of the special enrollment event.

Your new coverage starts on the first of the month following the receipt of the change form and Dependent Documentation based on the special enrollment event. In case of birth or adoption of a child, the new coverage starts on the date of the event if the change form and Dependent Documentation were received within 31 days of such event.

While this Summary Plan Description summarizes the major provisions of this plan, it does not provide you with every plan detail. The plan documents, which govern this plan, provide full details. If there are any discrepancies between this Summary Plan Description and the legal plan documents, the legal plan documents control.