Covered Dependents Clause Samples
The "Covered Dependents" clause defines which family members or individuals related to the primary insured are eligible to receive benefits under an insurance policy or employee benefit plan. Typically, this includes spouses, children, and sometimes other dependents such as domestic partners or disabled adult children, provided they meet specific criteria outlined in the policy. By clearly specifying who qualifies as a covered dependent, this clause ensures clarity in benefit eligibility and helps prevent disputes or misunderstandings regarding coverage.
Covered Dependents. Upon the loss of a Covered Dependent’s eligibility except as described in the following paragraphs 1) and 2), coverage will terminate on the date eligibility is lost, or the last day of the month for which the monthly Premium was paid and during which the Covered Dependent was eligible for coverage, as set forth in the Group Master Application.
1) Covered Dependent children who reach age 26 and are not otherwise eligible for coverage, will cease to be covered on the last day of the month during which the child turns 26.
2) Covered Dependent children who reach age 30 and are not otherwise eligible for coverage, will cease to be covered on the last day of the calendar year during which the child turns 30.
Covered Dependents. Upon the loss of a Covered Dependent’s eligibility, coverage will terminate on the last day of the month for which the monthly Premium was paid, and during which the Covered Dependent was eligible for coverage.
Covered Dependents a. An employee who has a domestic partner, and has a notarized City provided “Declaration & Understanding of Partnership Status for City of Sacramento Employee Health Benefits” dated on or before December 5, 2017, may cover the domestic partner under the employee's City-sponsored medical plan. The employee’s contribution for the premium cost for the domestic partner coverage will be made on an “after tax” basis.
b. An employee who has a domestic partner, and is registered with the Secretary of State of the State of California, may cover the domestic partner and/or the domestic partner's children, under the employee's City-sponsored medical plan. Employees with registered State of California domestic partners shall receive the City contributions as specified in Section 8.3.
c. The following eligible dependents qualify to be enrolled on a City medical, dental, or vision plan: lawfully married spouse or registered domestic partner; children up to age 26 who are an employee’s natural child, stepchild, adopted child, or the natural or adopted child of an employee’s spouse or registered domestic partner; children up to age 26 who are placed under the legal guardianship of an employee, the employee’s spouse, or employee’s registered domestic partner; children under the age of 26 in which the City has received notice of a Qualified Domestic Relations Order of Required Coverage; and disabled unmarried children over the age of 26 who reside with the employee. The definition of a dependent child for purposes of medical insurance shall also be in accordance with the Patient Protection and Affordable Care Act.
d. An employee covered as a dependent of another City employee may not enroll in a City medical plan but may enroll in a City dental or vision plan.
Covered Dependents. An employee may include all eligible dependents under Federal tax law as a dependent, under the employee’s Agency-sponsored health plan.
Covered Dependents a. An employee who has a domestic partner, and has a notarized City provided “Declaration & Understanding of Partnership Status for City of Sacramento Employee Health Benefits” dated on or before January 23, 2018, may cover the domestic partner under the employee's City-sponsored medical, dental, or vision plan. The employee will pay for the premium difference for the domestic partner coverage as an out-of-pocket employee cost. In no event will the City's monthly health and welfare contribution be used to pay for the cost of the domestic partner's coverage.
b. An employee who has a domestic partner, and is registered with the Secretary of State of the State of California, may cover the domestic partner and/or the domestic partner’s children, under the employee’s City sponsored medical, dental or vision plan. Employees with registered State of California domestic partners shall receive the City contribution as specified in Section 9.3.
c. The following eligible dependents qualify to be enrolled on a City medical, dental, or vision plan: lawfully married spouse or registered domestic partner; children up to age 26 who are an employee’s natural child, stepchild, adopted child, or the natural or adopted child of an employee’s spouse or registered domestic partner; children up to age 26 who are placed under the legal guardianship of an employee, the employee’s spouse, or employee’s registered domestic partner; children up to the age of 26 in which the City has received notice of a Qualified Domestic Relations Order of required coverage; and disabled unmarried children over the age of 26 who reside with the employee. The definition of dependent child for purposes of medical insurance shall also be in accordance with the Patient Protection and Affordable Care Act (PPACA).
d. An employee covered as a dependent of another City employee may not enroll in a City medical plan but may enroll in a city dental and/or vision plan.
Covered Dependents. A Contractholder may terminate coverage of a Covered Dependent by providing prior written notice to AvMed. In such case, coverage for the Covered Dependent will terminate at the end of the month during which such notice is received.
Covered Dependents.
a. The following eligible dependents qualify to be enrolled on a City medical, dental, or vision plan: lawfully married spouse or registered domestic partner; children up to age 26 who are an employee’s natural child, stepchild, adopted child, or the natural or adopted child of an employee’s spouse or registered domestic partner; children up to age 26 who are placed under the legal guardianship of an employee, the employee’s spouse, or employee’s registered domestic partner; children up to the age of 26 in which the City has received notice of Qualified Domestic Relations Order of required coverage; and disabled unmarried children over the age of 26 who reside with the employee. The definition of a dependent child for the purposes of medical insurance shall also be in accordance with the Patient Protection and Affordable Care Act.
b. An employee covered as a dependent of another City employee may not enroll in a City medical plan but may enroll in a City dental or vision plan.
Covered Dependents. (i) If the Covered Dependent is the Subscriber’s spouse:
(A) Death of Subscriber; or
(B) Termination of Subscriber’s employment, except for reasons of gross misconduct; or
(C) Reduction of Subscriber’s hours to fewer than the minimum required for eligibility for coverage under this Contract; or
(D) Divorce or legal separation from Subscriber; or
(E) Subscriber’s Medicare entitlement.
(ii) If the Covered Dependent is the Subscriber’s child:
(A) Child ceases to be a Dependent; or
(B) Death of Subscriber; or
(C) Termination of Subscriber’s employment, except for reasons of gross misconduct; or
(D) Reduction in Subscriber’s hours to less than the minimum required to be eligible as a Subscriber under this Contract; or
(E) Subscriber becomes entitled to Medicare; or
(F) Parents become divorced or legally separated. The Group must provide notice to the Subscriber and to Covered Dependents, as applicable, of the right to elect COBRA continuation coverage. A Covered Dependent whose coverage is terminated due to divorce, legal separation or cessation of eligibility for Dependent coverage must provide the Group notice of such event within 60 days of its occurrence. An election of continuation coverage must be made within 60 days beginning on the later of the date of the Qualifying Event or the date the Subscriber receives notice of election rights. The COBRA election by a Subscriber or covered spouse is deemed an election by all others who would lose coverage as a result of the same Qualifying Event unless otherwise specified in the election or the Covered Beneficiary independently elects COBRA continuation coverage. If election of COBRA continuation coverage is timely, the coverage begins on the date of the Qualifying Event and ends on the earlier of:
(a) Eighteen months after the Subscriber’s employment termination or reduction in hours.
(b) Twenty-nine months after the Qualifying Event for
(i) a Qualified Beneficiary who is determined to be disabled under the Social Security Act at anytime during the first 60 days of COBRA coverage and who notifies the Group of such determination within the first 18 months of COBRA coverage; and for
(ii) any nondisabled Qualified Beneficiaries with respect to the same Qualifying Event.
Covered Dependents.
a. An employee who has a domestic partner, and has a notarized City-provided affidavit as of January 23, 2018, may cover the domestic partner under the employee’s City-sponsored health plan. The employee will pay for the premium difference for the domestic partner coverage as an out-of-pocket employee cost. There shall be no new enrollees in this program, however, an employee promoting into this Unit who has a domestic partner covered by this Section in another bargaining unit agreement shall remain eligible for this benefit.
b. The following eligible dependents qualify to be enrolled on a City medical, dental, or vision plan: lawfully married spouse or registered domestic partner; children up to age 26 who are an employee’s natural child, stepchild, adopted child, or the natural or adopted child of an employee’s spouse or registered domestic partner; children up to age 26 who are placed under the legal guardianship of an employee, the employee’s spouse, or employee’s registered domestic partner; children up to the age of 26 in which the City has received notice of a Qualified Domestic Relations Order of required coverage; and disabled unmarried children over the age of 26 who reside with the employee. The definition of a dependent child for the purposes of medical insurance shall also be in accordance with the Patient Protection and Affordable Care Act.
c. An employee covered as a dependent of another City employee may not enroll in a City medical plan but may enroll in a City dental or vision plan.
Covered Dependents a. An employee who has a domestic partner, and is registered with the City Clerk, may cover the domestic partner under the employee's City-sponsored health plan. The employee will pay for the premium difference for the domestic partner coverage as an out-of-pocket employee cost. In no event will the City's monthly health and welfare contribution be used to pay for the cost of the domestic partner's coverage.
b. The definition of dependent child for purposes of health and dental insurance shall be an unmarried dependent child from birth to age 24 if the child qualifies as an exemption under Internal Revenue Service (IRS) rules and regulations. Dependent child includes a grandchild living in the employee grandparent’s home, step-children, adopted children, wards and ▇▇▇▇▇▇ children provided they qualify as the subscriber’s or subscriber’s lawful spouse’s dependent under IRS rules and regulations.