Page 4 - Hussmann- Bridgeton OE Guide 2015 Plan Year
P. 4
Annual
Enrollment
General Beneits Eligibility
You are eligible for the beneits Definition of Dependent
described in this guide if you are a As a reminder, you can also choose to cover certain dependents under
full-time employee who works an Hussmann’s health and welfare beneits. Your eligible dependents
average of 20 hours per week. include:
Your coverage under the plans X Your legal spouse
described in this guide is effective the X Eligible children including:
irst day immediately following 90
days of full-time employment. Z You, your legal spouse’s biological, adopted (or placed for
adoption) or foster children, or your stepchildren, who are
under the age 26;
Z An unmarried grandchild under age 26 who is primarily
dependent on you for support by court order;
Z Any other unmarried child under age 26 who lives with you in
a parent-child relationship based on IRS guidelines and who is
primarily dependent on you, for support (for more information
on the IRS guidelines, go to www.IRS.gov);
Z Any other child under age 26 which you, are required to cover
because of a divorce decree or qualiied medical child support
order (QMCSO); and
Z A covered child who, as of the date his or her coverage would
have otherwise ended, is mentally or physically incapable of
self-support and primarily dependent upon you, for inancial
support. To continue covering a disabled child because of
mental or physical disability beyond the age coverage would
otherwise end, you must provide satisfactory proof of the
incapacity and notify Hussmann within 30 days of the date the
child would otherwise lose coverage because he or she is no
longer eligible.
Hussmann will be validating your 2015 dependent(s) eligibility upon
close of Open Enrollment. Documentation will be requested during
the validation period.
4
Enrollment
General Beneits Eligibility
You are eligible for the beneits Definition of Dependent
described in this guide if you are a As a reminder, you can also choose to cover certain dependents under
full-time employee who works an Hussmann’s health and welfare beneits. Your eligible dependents
average of 20 hours per week. include:
Your coverage under the plans X Your legal spouse
described in this guide is effective the X Eligible children including:
irst day immediately following 90
days of full-time employment. Z You, your legal spouse’s biological, adopted (or placed for
adoption) or foster children, or your stepchildren, who are
under the age 26;
Z An unmarried grandchild under age 26 who is primarily
dependent on you for support by court order;
Z Any other unmarried child under age 26 who lives with you in
a parent-child relationship based on IRS guidelines and who is
primarily dependent on you, for support (for more information
on the IRS guidelines, go to www.IRS.gov);
Z Any other child under age 26 which you, are required to cover
because of a divorce decree or qualiied medical child support
order (QMCSO); and
Z A covered child who, as of the date his or her coverage would
have otherwise ended, is mentally or physically incapable of
self-support and primarily dependent upon you, for inancial
support. To continue covering a disabled child because of
mental or physical disability beyond the age coverage would
otherwise end, you must provide satisfactory proof of the
incapacity and notify Hussmann within 30 days of the date the
child would otherwise lose coverage because he or she is no
longer eligible.
Hussmann will be validating your 2015 dependent(s) eligibility upon
close of Open Enrollment. Documentation will be requested during
the validation period.
4
