Page 3 - 2017 Benefits Enrollment
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Lanter Delivery Systems, Inc.
Qualified Family Status Eligibility for
Change
You may only make changes to your beneit plan elections during the plan Benefits
year if you have a qualifying family status change. Qualiied family status
changes include the following. Employees
You may enroll in the beneit plans if
X Marriage, death of a spouse, divorce, legal separation, or annulment you are a regular full-time employee
X Birth, placement for adoption, adoption of a child, or a court issues a who is actively working a minimum of
qualiied medical child support order (QMCSO) requiring the plan to 30 hours per week.
provide medical coverage for your dependent child Dependents
X Change in your spouse’s or dependent’s employment status including Eligible dependents include your
termination, change from full-time to part-time (or vice versa), or legally married spouse and children
unpaid leave of absence up to age 26 for medical, dental, and
X Your dependent loses coverage under any group health plan vision plans. Children may include
natural, adopted, step-children, as
X Signiicant change in the cost of your current coverage or the options well as children obtained through
being offered court-appointed legal guardianship.
Children will be covered until the
X Death of a covered dependent end of the month in which they turn
X Your spouse’s employer’s medical plan, in which you are currently age 26. Disabled dependents may be
eligible beyond age 26.
enrolled, ceases its contributions to the plan’s cost or has an open
enrollment (does not apply to FSA)
X A dependent becomes eligible or ineligible for coverage, which could
put you in a different coverage category
If you experience a qualiied family status change, you must notify
Human Resources within 30 days of the change. Depending on the
type of change, you may need to provide proof of the change. It is your
responsibility to notify Human Resources when a dependent is no longer
eligible for beneit coverage.
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Qualified Family Status Eligibility for
Change
You may only make changes to your beneit plan elections during the plan Benefits
year if you have a qualifying family status change. Qualiied family status
changes include the following. Employees
You may enroll in the beneit plans if
X Marriage, death of a spouse, divorce, legal separation, or annulment you are a regular full-time employee
X Birth, placement for adoption, adoption of a child, or a court issues a who is actively working a minimum of
qualiied medical child support order (QMCSO) requiring the plan to 30 hours per week.
provide medical coverage for your dependent child Dependents
X Change in your spouse’s or dependent’s employment status including Eligible dependents include your
termination, change from full-time to part-time (or vice versa), or legally married spouse and children
unpaid leave of absence up to age 26 for medical, dental, and
X Your dependent loses coverage under any group health plan vision plans. Children may include
natural, adopted, step-children, as
X Signiicant change in the cost of your current coverage or the options well as children obtained through
being offered court-appointed legal guardianship.
Children will be covered until the
X Death of a covered dependent end of the month in which they turn
X Your spouse’s employer’s medical plan, in which you are currently age 26. Disabled dependents may be
eligible beyond age 26.
enrolled, ceases its contributions to the plan’s cost or has an open
enrollment (does not apply to FSA)
X A dependent becomes eligible or ineligible for coverage, which could
put you in a different coverage category
If you experience a qualiied family status change, you must notify
Human Resources within 30 days of the change. Depending on the
type of change, you may need to provide proof of the change. It is your
responsibility to notify Human Resources when a dependent is no longer
eligible for beneit coverage.
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