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responsibility under both coverage types. Premiums for the cost of dependent coverage for active employees are paid through payroll deductions.

Special Rules for When Both Spouses are Employees If both husband and wife are eligible employees, they may be covered by the Plan as employees but not as a dependent of their spouse. In addition, dependent children may be covered as dependents of only one of the parents/stepparents. At no time may a dependent be covered under more than one contract under this Plan.

If one spouse terminates employment, he may be added as a dependent under the remaining employee’s coverage. In order for the terminated spouse to be added as a dependent, the remaining employee must complete an Application for Coverage form within 31 days of their spouse losing coverage under the Plan.

Plan Enrollment Periods Enrollment periods for retirees and surviving spouses can be found in the Retiree Eligibility and Medical Coverage section.

Open Enrollment for Active Employees Each October during the annual open enrollment period, an employee may choose to elect coverage for himself or his eligible dependents. The coverage elected during open enrollment takes effect on January 1st of the following calendar year. Coverage elected during an open enrollment period is subject to an 18-month pre-existing condition exclusion period. A participant will receive credit for prior creditable coverage that occurred without a break in coverage of 63 days or more.

An employee may choose either Base Coverage or Select Coverage during open enrollment. An employee may also apply for High Option for Children at this time, if covering dependent(s) under the age of 18.

Open Enrollment for COBRA Participants Each October during the annual open enrollment period, a COBRA participant may choose to elect coverage for his eligible dependent(s). The coverage elected during open enrollment takes effect on January 1st of the following calendar year. Coverage elected during an open enrollment period is subject to an 18-month pre-existing condition exclusion period. A participant will receive credit for prior creditable coverage that occurred without a break in coverage of 63 days or more.

A COBRA participant may choose either Base Coverage or Select Coverage during open enrollment. A COBRA participant may also apply for High Option for Children at this time, if covering dependent(s) under the age of 18.

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