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BENEFIT BASICS & ELIGIBILITY

What is a Family Status Change? Eligible Dependents
A family status change is a life event that may allow an Your dependent must meet one of the following
Employee to add or drop coverage. The change must be definitions:
consistent with the event and documentation must be
provided to Human Resources within 30 days. Spouse: Your legally married husband or wife

Family status changes are: Child(ren): Children to age 26 (married or unmarried)
• Marriage
• Divorce Children include natural children, stepchildren, legally
• Birth adopted children, children placed for adoption, and
• Adoption children who you are legally appointed as guardian.
• Death
• Child reaching age 26 Disabled Child: unmarried child who is mentally or
• Child’s loss of eligibility on another plan physically handicapped (handicap sustained before the
• Spouse’s gain or loss of other coverage age of 25) and incapable of engaging in self-sustaining
employment due to such incapacity, Dependent on your
NOTE: A family status change allows a plan change (i.e., IRS tax return.
Plan A to Plan B)
A child is automatically terminated from medical, dental,
All payroll deductions/refunds due resulting from plan vision and life insurance coverages the last day of the
changes will be taken on the next paycheck. Deductions and month he/she attains age 26.
refunds are based on the effective date of the change.

Eligible Documents Required Due
Dependents for Enrollment Date

Spouse Marriage License 30 Days
*Child/Stepchild Birth Certificate 30 Days

Adoption Documents & Birth
*Adopted Child 30 Days
Certificate
Placement Documents & Birth
*Child Placed for Adoption 30 Days
Certificate
Notification from State Attorney
*Qualified Medial Support Order As directed by AG’s notice
General
Child age 26 or over incapable
of self-sustaining employment Attending Physician Statement 30 Days
due to a mental or physical
disability
*Dependents must be less than 26 years old

Note: Enrolling someone who is not qualified as a dependent is considered insurance fraud.

2023 Rangers Baseball LLC (the Texas Rangers) Benefit Guide Page 4