Disabled Child A disabled dependent child is an eligible employee’s child or grandchild regardless of marital status, who was covered and then disabled prior to the limiting age or any other limiting term required for dependent coverage and who continues to be incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability, and is chiefly dependent upon the employee for support and maintenance, provided proof of such incapacity and dependency must be furnished to the health carrier by the employee or enrollee within thirty one (31) days of the child’s attainment of the limiting age or any other limiting term required for dependent coverage. The disabled dependent is eligible to continue coverage as long as s/he continues to be disabled and dependent, unless coverage terminates under the contract.
Family Member Eligibility For purposes of this section, “eligible family member” shall be defined by the Public Employees’ Medical and Hospital Care Act and includes domestic partners that have been certified with the Secretary of State’s office in accordance with AB 26 (Chapter 588, Statutes of 1999).
Member Eligibility Verify Member eligibility contemporaneous with the rendering of services. BCBS will provide systems and/or methods for verification of eligibility and benefit coverage for Members. This is furnished as a service and not as a guarantee of payment;
Dependent Eligibility To be eligible to enroll as a Covered Dependent, a person must be:
Spousal Eligibility a. For employees hired on or after August 1, 2003: If the spouse of an employee is covered by any PEBTF health care plan, and he/she is eligible for coverage under another employer’s plan(s), the spouse shall be required to enroll in each such plan, which shall be the spouse’s primary coverage, as a condition of the spouse’s eligibility for coverage by the PEBTF plan(s), without regard to whether the spouse’s plan requires cost sharing or to whether the spouse’s employer offers an incentive to the spouse not to enroll.
Special Parental Allowance for Totally Disabled Employees (a) An employee who:
Benefit Eligibility For purposes of the Benefit Plan entitlement, common-law and same sex relationships will apply as defined.
Leave for Family Illness In the case of illness of a member of an employee’s immediate family, meaning spouse, son, daughter, father, mother, or person to whom the employee is legal guardian when no one at home other than the employee can provide for the needs of the ill person, the employee may be granted, after notifying her immediate management supervisor, leave with pay up to five (5) working days per fiscal year, for the purpose of making such arrangements as are necessary to permit the employee’s return to work. The immediate management supervisor may require proof of the need for such leave as she considers necessary.
Service Eligibility A bonus authorized by subsection (a) may be paid to a person or offi- cer only if the person or officer agrees under subsection (d)—
Pension Contributions While on Short Term Disability Contributions for OMERS Plan Members When an employee/plan member is on short-term sick leave and receiving less than 100% of regular salary, the Board will continue to deduct and remit OMERS contributions based on 100% of the employee/plan member’s regular pay.
