Useful Links
& Forms

Health & Welfare SPD

• Article V - Dependent Eligibility
• Article V, Section 5.2 - Dependent Coverage upon Death of Participant
• Article VII, Section 7.2 - COBRA Events, Beneficiaries and Maximum Coverage Periods.

Forms

• Enrollment Form for Active Members
• Enrollment Form to Add an Adult Child Age 19 Through 25

Life Event - Dependent Child Turns 19

Effective August 1, 2010 adult children up to age 26, regardless of marital, student, or tax-dependent status, may remain eligible for medical coverage. Effective April 1, 2011, dental and vision coverage were extended to all adult children to age 26. A special Adult Child Enrollment form is required to maintain dependent coverage under the Plan.

Plan Checklist

• When your child turns 19, you must submit a completed Adult Child Enrollment form to maintain dependent coverage under the Plan.

Also Consider...

Contact the Plan Office if you have any questions.