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 - Adult Children

Adult children up to age 26, regardless of marital, student or tax dependent status, may remain eligible for the Plan's medical coverage. The extended coverage includes dental and vision. Members need to complete the Adult Child Enrollment form at the time the dependent child turns age 19 if they wish to continue coverage for an Adult Child to age 26.

When your dependent child turns 26, the child is no longer eligible for coverage under the Health & Welfare Plan. The child may be eligible for COBRA Coverage for up to 36 months.

Plan Checklist

• Continuation Coverage can continue for up to thirty-six months provided timely payments are made.

Also Consider...

Contact the Plan Office if you have any questions.