Dependent Eligibility and Enrollment

Eligible Dependents

Employees that participate in a National IAM Benefit Trust Fund dental plan may elect family coverage and enroll their eligible dependents in the plan. Eligible dependents include lawful spouses and children under age 26 who are the employee's biological children, adopted children or children placed for adoption, legal stepchildren and other children under legal guardianship.

Enrolling Dependents

To enroll your eligible dependents for dental coverage, you must fill out an Enrollment Form. For any dependent child whose last name differs from yours, or who is not your biological child, you must also complete an Eligible Dependent Certification (EDC) Form (PDF) and provide copies of legal documents that confirm dependency. Submit completed forms and any necessary documentation to the Fund Office.

Disabled dependent children age 26 and over are also eligible for coverage, provided the disability occurred prior to age 26 and can be satisfactorily documented. If you cover a disabled dependent age 26 or older, he or she must be incapable of self-sustaining employment and be chiefly dependent on the employee for support. If you are adding a disabled dependent to the Benefit Trust Fund dental plan, you must fill out the Disabled Dependent Certification Form (PDF) and the child’s physician must complete the Physician Certification of Disability Form (PDF). Submit the completed forms to the Fund Office. The Fund reserves the right to periodically request proof of continued disability to verify eligibility for coverage for a dependent age 26 or older.

You can mail or fax completed forms and the required documentation to the Fund Office as follows:

Qualifying Events

You may experience a qualifying event that permits you to add or remove covered dependents from your Benefit Trust Fund dental plan. Examples of qualifying events recognized by the Fund include:

• Marriage
• Divorce or Legal Separation
• Birth of a child
• Adoption or placement for adoption
• Death

If a qualifying event permits you to make a dependent change, you must fill out a new Enrollment Form and any necessary certification forms and submit them to the Fund Office for consideration, along with any other documentation required by the plan. You should also provide your employer with a copy of your completed Enrollment Form to ensure the proper contribution amount is submitted to the Fund.

When adding a new dependent, you must submit an Enrollment Form and necessary documentation to the Fund Office within thirty days in order for coverage to take effect. Coverage for new dependents begins on the date in which they qualify as eligible dependents, which includes:

• With respect to a newborn child, the date of birth; or
• With respect to a step-child, the date of your marriage to your step-child's parent; or
• With respect to a foster child, the date the child is placed with you for foster care; or
• With respect to a child named in a Qualified Medical Child Support Order (QMCSO), the date specified in the court order; or
• With respect to an adopted child, the date of adoption or placement for adoption.

Documentation

Employees are required to submit a completed Eligible Dependent Certification (EDC) Form for any child whose last name differs from the employee's last name, for stepchildren, or for other covered children.

Other documentation is required when enrolling certain dependents. For example:

• Adoption documentation (or adoption placement documentation) are required for coverage of legally adopted children and children placed for adoption.
• Coverage of stepchildren requires submission of the child's birth certificate and proof of the employee's marriage to the child's biological or adoptive parent.
• Coverage of other dependents requires submission of guardianship documents or other documents confirming the legal relationship between the employee and child.
• The Fund Office may also ask you for other related information it needs to evaluate the terms of your relationship with the child.
• Adding coverage for a new spouse requires submission of a marriage certificate.