Page 5 - Guide
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General Benefits Eligibility 2017 Beneits Enrollment
Your coverage under the plans described in this guide is effective on January 1, 2017
or on your irst date of hire (your irst day of active employment).
X 20 to 29 hours—eligible for life, AD&D, and STD
X 30+ hours—eligible for life, AD&D, medical, dental, vision, lexible spending
account, disability, STD, LTD, and health savings account (depending on medical
plan selection)
Your coverage under the plans described in this guide is effective on your date of
hire (your irst day of active employment).
Definition of Dependent
You can also choose to cover certain dependents under Hussmann’s health and
welfare beneits. Your eligible dependents include the following.
X Your legal spouse
X Your or your spouse’s child who is under age 26, including a natural child,
stepchild, a legally adopted child, a child placed for adoption or a child for whom
you or your spouse are the legal guardian
X An unmarried child age 26 or over who is or becomes disabled and dependent
upon you
X A child for whom healthcare coverage is required through a Qualiied Medical
Child Support Order or other court or administrative order
Hussmann validates your dependent(s) eligibility upon close of enrollment.
Documentation will be requested during the validation period.
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Your coverage under the plans described in this guide is effective on January 1, 2017
or on your irst date of hire (your irst day of active employment).
X 20 to 29 hours—eligible for life, AD&D, and STD
X 30+ hours—eligible for life, AD&D, medical, dental, vision, lexible spending
account, disability, STD, LTD, and health savings account (depending on medical
plan selection)
Your coverage under the plans described in this guide is effective on your date of
hire (your irst day of active employment).
Definition of Dependent
You can also choose to cover certain dependents under Hussmann’s health and
welfare beneits. Your eligible dependents include the following.
X Your legal spouse
X Your or your spouse’s child who is under age 26, including a natural child,
stepchild, a legally adopted child, a child placed for adoption or a child for whom
you or your spouse are the legal guardian
X An unmarried child age 26 or over who is or becomes disabled and dependent
upon you
X A child for whom healthcare coverage is required through a Qualiied Medical
Child Support Order or other court or administrative order
Hussmann validates your dependent(s) eligibility upon close of enrollment.
Documentation will be requested during the validation period.
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