Disabled Dependent Sample Clauses
The 'Disabled Dependent' clause defines the criteria under which a dependent, such as a child or spouse, is considered disabled for the purposes of eligibility under an insurance or benefits plan. Typically, this clause outlines the specific conditions or documentation required to establish a dependent's disability status, such as medical certification or evidence of inability to engage in gainful employment. Its core function is to ensure that individuals who are unable to support themselves due to a disability can continue to receive coverage or benefits, thereby providing financial protection and continuity of care for families with disabled members.
Disabled Dependent. This is an enrollee's dependent who is (a) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability; and (b) chiefly dependent on the enrollee for support and maintenance. The enrollee must give us a written request for coverage of a disabled dependent. The request must include written proof of disability and must be approved by us, in writing. We must receive the request within 31 days of the date an already enrolled dependent becomes eligible for coverage under this definition. We reserve the right to periodically review disability, provided that after the first two years, we will not review the disability more frequently than once every 12 months. Emergency Accidental Dental Services. These are services required immediately, because of a dental accident.
Disabled Dependent. This is an enrollee's dependent who is (a) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability; and (b) chiefly dependent on the enrollee for support and maintenance. The enrollee must give us a written request for coverage of a disabled dependent. The request must include written proof of disability and must be approved by us, in writing. We must receive the request within 31 days of the date an already enrolled dependent becomes eligible for coverage under this definition. We reserve the right to periodically review disability, provided that after the first two years, we will not review the disability more frequently than once every 12 months. Emergency Accidental Dental Services. These are services required immediately, because of a dental accident. Emergency Health Care Service. This means a health care service necessary to treat a medical condition in which the absence of immediate medical attention could reasonably be expected to result in a condition described below:
Disabled Dependent. This Plan covers disabled dependents. A disabled dependent is a person who is and continues to be both: (a) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability; and (b) chiefly dependent upon you for support and maintenance. Disabled dependents are not subject to any pre-existing condition limitations, or insurability, eligibility, or health underwriting approval.
Disabled Dependent. The Contract covered disabled dependents. A disabled dependent is a person who is and continues to be both: (a) incapable of self-sustaining employment by reason of developmental disability, mental illness, or disorder, or physical disability, and (b) chiefly dependent on you for support and maintenance. Disabled dependents are not subject to any pre-existing condition limitations, or insurability, eligibility, or health underwriting approval. Emergency Service. This means a health care service necessary to treat a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in:
Disabled Dependent. 1. An employee may enroll his/her per- manently disabled child when first eligible or an enrolled permanently disabled dependent turning age twenty-six (26) years and may continue coverage beyond age twenty-six (26) years, provided the following documentation is submitted to the plan prior to the end of the month of the dependent’s twenty-sixth birth- day for the enrolled permanently disabled dependent or within thirty-one (31) days of enrollment of the permanently disabled child:
A. Evidence from the Social Security Administration (SSA) that the permanently disabled dependent or child was entitled to and receiving disability benefits prior to turn- ing age twenty-six (26) years; and
B. A benefit verification letter dated within the last twelve (12) months from the SSA confirming the child is still considered disabled.
2. If a disabled dependent or child over the age of twenty-six (26) years is determined to be no longer disabled by the SSA, coverage will terminate the last day of the month in which the disability ends or never take effect for new enrollment requests.
3. Once the disabled dependent’s cover- age is cancelled or terminated, s/he will not be able to enroll at a later date.
Disabled Dependent. The Contract covers disabled dependents. A disabled dependent is a person who is and continues to be both: (a) incapable of self-sustaining employment by reason of developmental disability, mental Illness, or disorder, or physical disability, and (b) chiefly dependent on you for support and maintenance. Disabled dependents are not subject to any pre-existing condition limitations, or insurability, eligibility, or health underwriting approval. Emergency Medical Condition. This is a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: Emergency Service. This means a Health Care Service necessary to treat an Emergency Medical Condition including: Enrollee. This is a person who (1) resides in the service area; (2) is eligible and accepted by us as a Member per a signed enrollment form; and (3) is responsible for payment of enrollment payments.
Disabled Dependent. This is a Covered Employee's dependent as referred to in Child and Qualified Grandchild above, who is beyond the limiting age and is physically or mentally disabled, and dependent on the Covered Employee for the majority of his/her financial support. The disability must have come into existence prior to the attainment of the limiting age as described in Child and Qualified Grandchild above. Disability does not include pregnancy. “Disabled” means incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability. The Covered Employee must give the Plan Manager a written request for coverage of a disabled dependent. The request must include written proof of disability and must be approved by the Plan Manager, in writing. The Plan Manager must receive the request within 30 days of the date an already enrolled dependent becomes eligible for coverage under this definition, or when adding a new disabled dependent eligible under this definition. The Plan Manager reserves the right to periodically review disability, provided that after the first two years, the Plan Manager will not review the disability more frequently than once every 12 months.
Disabled Dependent. 1. A new employee may enroll his/her permanently disabled dependent or a current- ly enrolled permanently disabled dependent turning age twenty-six (26) may continue coverage beyond age twenty-six (26), provid- ed the following documentation is submitted to the plan prior to the dependent’s twenty- sixth birthday for the currently enrolled per- manently disabled dependent or within thirty- one (31) days of enrollment of a new employee and his/her permanently disabled dependent:
A. Evidence that the permanently dis- abled dependent was entitled to and receiving disability benefits prior to turning age twen- ty-six (26). Evidence could be from the Social Security Administration, representa- tion from the dependent’s physician, or by sworn statement from the subscriber;
B. A letter from the dependent’s physician describing the current disability and verifying that the disability predates the dependent’s twenty-sixth birthday and the disability is permanent; and
C. A benefit verification letter dated within the last twelve (12) months from the Social Security Administration (SSA) con- firming the dependent is still considered dis- abled by SSA.
2. If a disabled child over the age of twenty-six (26) is determined to be no longer disabled by the SSA, coverage will terminate the last day of the month in which the dis- ability ends.
3. Once the disabled dependent’s cover- age is cancelled or terminated, s/he will not be able to enroll at a later date.
Disabled Dependent. 1. A new employee may enroll his/her permanently disabled dependent or a current- ly enrolled permanently disabled dependent turning age twenty-six (26) years and may continue coverage beyond age twenty-six (26) years, provided the following documentation is submitted to the plan prior to the depen- dent’s twenty-sixth birthday for the currently enrolled permanently disabled dependent or within thirty-one (31) days of enrollment of a new employee and his/her permanently dis- abled dependent:
A. Evidence that the permanently dis- abled dependent was entitled to and receiving disability benefits prior to turning age twenty- six (26) years. Evidence could be from the Social Security Administration, representation from the dependent’s physician, or by sworn statement from the subscriber;
B. A letter from the dependent’s physi- cian describing the current disability and ver- ifying that the disability predates the depen- dent’s twenty-sixth birthday and the disability is permanent; and
C. A benefit verification letter dated within the last twelve (12) months from the Social Security Administration (SSA) confirm- ing the dependent is still considered disabled by SSA.
2. If a disabled child over the age of twenty-six (26) years is determined to be no longer disabled by the SSA, coverage will ter- minate the last day of the month in which the disability ends or never take effect for new enrollment requests.
3. Once the disabled dependent’s cover- age is cancelled or terminated, s/he will not be able to enroll at a later date.