The following table summarizes who may be enrolled in the Plan as an eligible dependent and the documentation required by the Administrative Office to process the enrollment. An eligible dependent may be covered under all benefits available to the Participant. Eligibility for benefits will continue in the case of dependent children up to the limiting age shown in the table below; eligible dependent children will continue to be covered for dependent life insurance benefits to age 26. An eligible Dependent includes any child for whom the Participant is the legal guardian or foster parent or for whom the eligible Spouse of a Participant is the legal guardian or foster parent. A detailed explanation of the eligibility requirements under the Plan follows this table.

Under this Plan, eligible Dependents are the legal spouse (this Plan does not recognize a common law spouse unless the common law marriage was established in a jurisdiction which permits the creation of common law marriages) of the Participant as described in the following section and the Participant's children (including a step child or a legally adopted child) under 26 years of age. As required by law, an eligible Dependent will include a child under age 18, when placed with an Employee for adoption by a County or an adoption agency directive a child under age 18 who has been placed with the participant or the Participant’s spouse by directive of a County department for temporary guardianship, or order of a Court for permanent guardianship, or by directive by a County department responsible for foster child placement. Coverage for a Participant’s children will terminate at the end of the month in which the child reaches age 26, unless otherwise extended under the provisions of this Plan. An eligible Dependent includes any stepchild of the Participant, who is under 26 years of age, who depends upon the Participant for support and lives with the Participant in a regular parent-child relationship and is a dependent of the Participant within the meaning of Internal Revenue Code Section 152.

Participants must provide written proof to the Administrative Office of their legal dependents in order for Dependents to be eligible for the benefits of this Plan. For example, a copy of your marriage certificate for a spouse, a copy of a birth certificate for a child and a copy of a directive from a County or adoption agency placing the child with the Participant or the Participant’s spouse for adoption, a County directive or order of temporary or permanent guardianship, or a placement directive for full supervision and care by a County department responsible for foster child placement. The Participant must update the Administrative Office with all final Court orders and agency directives regarding the status of the child placed with the Participant or the Participant’s spouse as an adopted child, foster child or under temporary or permanent guardianship. Once enrolled, coverage for the Participant's children under age 26 and the Participant's lawful spouse shall continue so long as such Dependents qualify as eligible Dependents under the rules of this Plan. Notwithstanding the foregoing, the Board of Trustees, in its sole and absolute discretion, may permit the cancellation of coverage for, or the disenrollment of, an eligible Dependent pursuant to a court order, or in accord with the written request of the Participant and Dependent, subject to the following conditions:

1. The Participant and Dependent, who is competent and has attained age 18, must each submit a written, signed and notarized document, on a form approved by the Board of Trustees, requesting cancellation of the Dependent's coverage under the Plan and providing evidence satisfactory to the Board of Trustees that the Dependent has other health coverage available and that the Trustees find, in their sole and absolute discretion, that there is good cause to permit cancellation of the Dependent's health coverage under this Plan. If the Dependent has not yet attained age 18, or is not legally competent to consent to a cancellation of health coverage, such written request must be signed and notarized by the Dependent's legal guardian or conservator, who has provided sufficient proof of the guardianship or conservatorship satisfactory to the Trustees.
2. The Participant and Dependent, or the Dependent's guardian or conservator, must provide a written and notarized waiver and release to the Trustees acknowledging the cancellation of coverage or disenrollment of the Dependent on a form approved by the Board of Trustees.
3. Once disenrolled, the Dependent may not re-enroll in health coverage in this Plan for a minimum of twelve (12) months. Re-enrollment shall be contingent on the participant's eligibility and the Dependent meeting the definition of eligible Dependent under this Health Plan. The re-enrollment of a Dependent shall follow the same enrollment procedures as the initial enrollment of a Dependent.

Nothing in this Article is intended to modify the carrier’s coordination of benefits provisions.

Dependent children of eligible participants are covered for life insurance benefits from birth to age 26.

If a child covered by this Plan becomes totally and permanently disabled prior to reaching his/her 26th birthday while dependent upon his/her parents for support, his/her eligibility shall be continued for the duration of his/her disability, under the member's eligibility.

Upon dissolution, divorce, legal separation or annulment, a spouse ceases to be an eligible Dependent on the first day of the month following the month in which the Judgment terminating the marital relationship or providing for legal separation is issued. However, a former spouse may continue to be eligible as a qualified beneficiary under this Plan if COBRA continuation coverage is timely elected as more fully set forth in the COBRA provisions of this Plan. In order to avoid the loss of prospective eligibility, you should notify the Administrative Office of a dissolution, divorce, legal separation or annulment as soon as it occurs. Should neither the Participant nor the former spouse notify the Administrative Office within sixty (60) days of the issuance of the Judgment or termination of marital status, the Participant, former spouse and the spouse’s dependents who are no longer the Participant’s dependents under the Plan are penalized. The Participant’s Hours Bank Reserve shall be charged 120 hours times the number of months thereafter until notice is received. The former spouse and lawful dependents who are no longer your dependents under the Plan lose all COBRA rights (see Article 16.1 COBRA, subpart D). Insurance companies and/or HMO providers may also seek legal damages for the failure to provide prompt notification and the Fund, through the Board of Trustees, shall hold the individual Participant liable for any damages incurred and pursue legal relief against the Participant.