Excess Major Medical Coverage

ELIGIBILITY

Eligible Members for group Excess Major Medical Insurance include: Full-time teachers, full-time nurses and full time administrators as defined by the Certificate of Insurance to the Fund’s group Excess Major Medical Insurance Policy.

Eligible Dependents for group Excess Major Medical Insurance include:

• The wife or husband of the member, and

• Any unmarried child of the member who is:

(a)  less than 19 years of age;

(b)  19 years, but under 25 years of age, enrolled as a full-time student in an accredited school, college or university and primarily supported by the member;

• 19 years of age or older, mentally or physically incapable of earning a living and primarily supported by the member, provided the member submits proof of the child’s incapacity and dependency to the Insurance Company within 31 days after the date the child fails to qualify under (a) or (b) above. The Insurance Company has the right, at reasonable intervals during the 2-year period following the date the child fails to qualify under (a) or (b) above, to require proof of continuation of such incapacity and dependency.  After the 2-year period, the Insurance Company may require subsequent proof not more often than once a year.

The term “child” will include a child born of the member, a child legally adopted by the Employee, a proposed adoptive child, in writing, dependent upon the member for support, and a stepchild of the member living with the member in a normal parent-child relationship.

Under the group Excess Major Medical Insurance policy, no one may be a dependent who is eligible for coverage as a member and no one may be a dependent of more than one member.

Retirees are also eligible for coverage under the Fund’s Group Excess Major Medical plan, provided they have been insured persons for 30 days prior to retirement and have made application for coverage within 60 days of termination of active service.