11 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. • In order 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. • In order for a stepchild to be considered an eligible dependent, the Fund requires that the employee provide a copy of the child’s birth certificate 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 the 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 dependent 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 participants 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; • Acknowledgement of paternity; • Receipt of a Qualified Medical Child Support Order pursuant to terms of the Fund; or • Notarized affidavits. The date a person becomes a dependent means: • With respect to a newborn child, the date of birth; • With respect to a stepchild, the date of your marriage to your stepchild’s parent; • With respect to a foster child, the date the child is placed with you for foster care; • With respect to a child named in a QMCSO, the later of the date specified in the court order or the date it is qualified; • With respect to an adopted child, the date of adoption or placement for adoption; or • With respect to a Spouse, the date of the marriage; • With respect to a child for whom you are legal guardian, the date the guardianship papers are signed by the Court.
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