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Section 2 Eligibility and Enrollment <br />2.1 Eligible Employees. Employees must work a minimum of 22 hours per week to be eligible for <br />coverage. Employees become eligible for coverage on the first day of the month following the date <br />of hire for continuous employment. <br />2.2 Eligible Family Members. The eligible employee must enroll to include coverage for eligible family <br />members. The Policyholder or Company may require proof of eligibility periodically. <br />2.2.1 The spouse of the Member or the domestic partner of the Member is eligible for coverage <br />as a Dependent. <br />2.2.2 A Child is eligible for coverage as a Dependent to age 26. <br />2.2.3 A Child is eligible as a Dependent beyond the limiting age if all of the following conditions <br />are met: <br />a. The Child is and continues to be incapable of self-sustaining employment by reason of <br />a developmental disability or physical handicap. <br />b. The Child is and continues to be chiefly dependent upon the Member (or Member's <br />spouse or Member's domestic partner) for support and maintenance. <br />c. The Policyholder provides proof of such incapacity and dependency to the Company <br />no later than 31 days after the Child's attainment of the limiting age Proof may be <br />requested annually. <br />2.3 Initial Enrollment Period. The eligible employee must submit an enrollment application to the <br />Policyholder for himself/herself and any eligible family members to be covered no later than 31 <br />days after attaining initial eligibility. Coverage begins on the date the eligible employee attains <br />initial eligibility. Eligible employees and their eligible family members who do not enroll during the <br />initial enrollment period may enroll only during an open enrollment period or a special enrollment <br />period. <br />2.4 Open Enrollment Period. Eligible employees and their eligible family members may enroll during <br />the open enrollment period by submitting an enrollment application to the Policyholder. Coverage <br />will begin on the anniversary date of this Contract. <br />2.5 Special Enrollment Period. A special enrollment period is granted for employees and their eligible <br />family members after the triggering events described below. <br />2.5.1 Birth or Adoption. Eligible employees and their eligible family members may enroll <br />following the birth or adoption of an eligible Child by submitting an enrollment application <br />to the Policyholder. If additional Premium is required the additional Premium must be paid <br />no later than 60 days after the eligible Child's date of birth for a newborn Child or 60 days <br />after the date of placement for adoption. Coverage will begin on the newborn Child s date <br />of birth or on the adopted Child's date of placement for adoption. Coverage for an enrolled <br />newborn Child includes, but is not limited to benefits for Covered Services provided for <br />treatment of congenital anomalies from the date of birth. <br />001 L-WA811(5/20) 4 <br />