9 Adoption and/or placement papers are required for coverage of legally adopted children and children placed for adoption . C overage of Stepchildren requires submission of the child’s birth certificate and proof of the Emp loyee’s marriage to the child’s biological or adoptive parent. Coverage of other dependents requires submission of guardianship papers or other papers confirming the legal relationship between the Employee and child. Employees must provide a marriage certi ficate to enroll a Spouse. The Fund Office also may ask you for other related information it needs to evaluate the terms of your relationship with a dependent and may periodically request verification of the covered dependent’s status on an ongoing basis. Eligibility for Disabled Children If a dependent child, age 26 or older, is incapable of self - sustaining employment because of mental or physical disability, and the child relies on you for more than one - half of his or her financial support and maintenance , and maintains a permanent residence with you during more than one - half of the calendar year, the child’s coverage may be continued under this Plan if his or her disability began when the child was covered by this Plan, and he or she turned age 26 with th e disability. You must submit proof of your dependent child’s disability to the Fund Office before the child turns 26 and may be required periodically thereafter (proof may be required more often during the first two (2) years). Important Rules for Depende nt’s Eligibility The Fund will not provide coverage for other relatives living in your household (e.g., mother, father, siblings, etc.) regardless of whether they are dependent upon you financially, or for non - biological children living in your household f or whom you are not legally responsible. Also note: • If your eligible dependent child is employed and becomes covered under a group health plan connected to his or her employment, the plan under which he or she is an employee will be considered the primary plan for coverage. This Plan will be secondary. • For adopted children, children placed with you for adoption, or foster children to be considered eligible dependents, you must provide the Fund Office with appropriate legal documentation, satisfactory to the Plan in its sole discretion, such as adoption papers or a court order appointing you as the legal guardian for the child. • For a stepchild to be considered an eligible dependent, the Fund requires that the employee provide a copy of the child’s birth certi ficate and proof of the employee’s marriage to the child’s biological or adoptive parent. The Fund may also require any and all documentation, including paternity papers, court order, state order and/or divorce decree setting forth the relationship with th e child. • If a dependent Spouse is eligible for benefits under this Plan as an active participant, benefits will be payable for the Spouse first as a participant, then as a dependent. In no event will benefits exceed 100% of covered Charges incurred. • If a d ependent child loses eligibility status, the child may regain eligibility only by satisfying all of the requirements included in the Plan’s definition of an eligible dependent and these dependent Eligibility Requirements. The Fund Office will require all p articipants to provide documentation substantiating an individual’s right to status as an eligible dependent. Documentation required by the Fund Office may include: • A marriage certificate (in the English language); • Birth certificate of biological child showing both parents’ names; • Court (legal) documents showing legal guardianship or adoption;
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