Common use of Eligible Person Clause in Contracts

Eligible Person. You You are eligible to enroll if: • you are not currently enrolled in Medicare; and • you reside in Rhode Island. Your Spouse Your spouse is eligible to enroll for coverage if he/she resides in Rhode Island and is not currently enrolled in Medicare and you have selected family coverage. Only one of the following individuals may be enrolled at a given time: • Your legal spouse: according to the laws of the state in which you were married. • Your common law spouse: according to the law of the state in which your marriage was formed. To be eligible, you and your common law spouse need to complete our Affidavit of Common Law Marriage and provide us with the required documentation listed on the affidavit. Please call our Customer Service Department to obtain a copy. • Your civil union partner: according to the law of the state in which you entered into a civil union. Civil Union partners may only be enrolled if civil unions are recognized by the state in which you reside. • Domestic Partner: To be eligible, you and your domestic partner may be required to complete our Declaration of Domestic Partnership form and provide us with the required documentation listed on the form. Please call our Customer Service Department to obtain a copy. • Former Spouse: In the event of a divorce, your former spouse may continue to be eligible for coverage provided that your divorce decree requires it in accordance with state law. Your former spouse will remain eligible on your policy until the earlier of: o the date either you or your former spouse are remarried; o the date provided by the judgment of divorce; or o the date your former spouse has comparable coverage available through his or her own employment.

Eligible Person. You You are eligible to enroll if: •  you are not currently enrolled in Medicareeligible for Medicare coverage which includes dental benefits; and •  you reside in Rhode Island. Your Spouse Your spouse is eligible to enroll for coverage if he/she resides in Rhode Island and is not currently enrolled in eligible for Medicare coverage which includes dental benefits and you have selected family coverage. Only one of the following individuals may be enrolled at a given time: •  Your legal spouse: according to the laws of the state in which you were married. •  Your common law spouse: according to the law of the state in which your marriage was formed. To be eligible, you and your common law spouse need to complete our Affidavit of Common Law Marriage and provide us with the required documentation listed on the affidavit. Please call our Blue Cross Dental Customer Service Department to obtain a copy. •  Your civil union partner: according to the law of the state in which you entered into a civil union. Civil Union partners may only be enrolled if civil unions are recognized by the state in which you reside. •  Domestic Partner: To be eligible, you and your domestic partner may be required need to complete our Declaration of Domestic Partnership form and provide us with the required documentation listed on the form. Please call our Blue Cross Dental Customer Service Department to obtain a copy. •  Former Spouse: In the event of a divorce, your former spouse may will continue to be eligible for coverage provided that your divorce decree requires it in accordance with state law. Your former spouse will remain eligible on your policy until the earlier of: o the date either you or your former spouse are remarried; o the date provided by the judgment of divorce; or o the date your former spouse has comparable coverage available through his or her own employment.