Reso 2010-1529 - Laserfiche WebLink

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f) ) Incapable of self-sustaining employment by reason of mental retardation or physical handicap; and Chiefly dependent upon the Subscriber for support and maintenance, provided proof of such incapacity and dependency is furnished to AvMed by Subscriber within 31 days of the child's attainment of the limiting age and subsequently as may be required by AvMed, but not more frequently than arrnually after the 2-year period following the child's attainment of the limiting age. 4.05 During the term of this Contract, no changes in the Subscribing Group eligibility or requirements of participation shall be permitted to effect eligibility or enrollment under this Contract unless such change is agreed to by AvMed. 4.04.02 4.04.01 4.06 Eligible persons must reside within the continental United States, excluding Alaska and Hawaii. 10 V. ENROLLMENT 5.01 Prior to the effective date of this Contract and at a proper time prior to each anniversary thereof, AvMed may allow an open enrollment period of 31 days, in which any eligible employee on behalf of himself and his Dependents may elect to enroll in the Plan. 5.02 Except as provided for newborns, eligible employees and Dependents who meet the requirements of Part IV, Sections 4.01 and 4.02 must enroll within 31 days after becorning eligible by subrnitting application forms acceptable to or provided by AvMed; otherwise, the eligible employees and Dependents rnay not enroll until the next open enrollrnent period of the Subscribing Group. ) 5.03 Special enrollment periods 5.03.01 An eligible ernployee or Dependent may request to enroll in the Plan outside of the initial enrollrnent period and annual open enrollment periods if that individual loses other coverage or acquires a new dependent as outlined below: a) If the eligible employee or Dependent declined coverage under the Plan when it was first offered because of other group health plan coverage or insurance coverage and such coverage has terminated as a result of: 1) Exhaustion of COBRA continuation coverage; 2) Termination of employrnent or reduction in hours of ernployment; 3) Termination of employer contributions; 4) Legal separation, divorce or annulrnent; 5) Change in Dependent status; 6) Death of an employee; 7) Change in legal custody or legal guardianship; 8) Relocation out of an HMO Service Area; 9) Attainment oflifetime rnaxirnum. b) If the eligible employee or Subscriber acquires a new Dependent as a result of: I) Marriage; 10 A V -01 00-2009 MP-5319 (10/09)