Your Dependents becomes eligible for coverage when you become eligible or, if acquired later, upon becoming your dependent. To qualify for coverage your eligible dependents must be insured under a provincial health plan. Newborn children are eligible for Dependent Life Insurance and Hospital Cash from 15 days of age and for all other coverage from birth, provided you advise the administrator within 31 days of the birth.
You must be a covered Member of the Plan and eligible for benefits in order for your dependents to be covered.
Coverage or any increase in coverage, for your Dependent who is confined for medical treatment in any institution or at home on the date such coverage would otherwise become effective, will not become effective until given a final release by the physician from all such confinement. This shall not postpone the effective date for a child born while the Member’s dependents are insured under the plan.
Dependent means a spouse or unmarried child (over 14 days of age with respect to Hospital Cash and Dependent Life only) who is under 21 years (under 25 years, if regularly attending school and solely dependent upon the employee for support). A Dependent shall not include a person cohabitating with the Member without public representation of married status.
Spouse means a person married to the Member as a result of a valid religious or civil marriage ceremony; except that, a person living with the Member in a common-law relationship for a minimum period of twelve consecutive months will be deemed to be the Member’s spouse, if such a person is publicly represented as the Member’s spouse. If the Member has been married to more than one person, the term spouse shall mean only the person to who the member was most recently married, using the above criteria.
The term Spouse shall not include a person divorced or separated from the member, whether or not separation is pursuant to a court order or legal separation agreement.
Child means:
- Your unmarried children (over 14 days of age with respect to Hospital Cash and Dependent Life Insurance only) and under 21 years of age provided they are not employed on a regular full-time basis.
- Your unmarried children under 25 years of age provided they are not employed on a regular full-time basis and they are in full-time attendance at a university or similar institution. Annual proof of student registration is required after the child attains age 21.
- Your legally adopted children, stepchildren, or children of your common-law spouse, provided your spouse or common-law spouse lives with you and has custody of the child, and provided they meet the requirements set out above.
Children outlined above must be solely dependent upon the Member for support.
Benefits for Functionally Impaired Children
Dependent Life, Extended Health Care and Dental Care coverage will continue beyond the date an unmarried child attains the limiting age for coverage, provided proof is submitted to the Insurance Company within 31 days after such date that such child:
- is incapable of self-sustaining employment by reason of functional impairment;
- became so incapacitated prior to attainment of the limiting age; and
- is wholly dependent upon you for support and maintenance.
Thereafter, such proof must be submitted to the Insurance Company, as required.