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<br />j'eat'~5 fr'olll the t inlE such C':lvet'ed Pet'son's cover'age becomes effect i ve cmdet' <br />th i"5 Conti'act. <br /> <br />Extended Coverage for Handicapped Children <br /> <br />Coverage of an unmarried Family Dependent child who is incapable of self- <br />support because of mental disability or physical handicap will be continued <br />beyond the specified limiting age, provided that (1) the child becomes so <br />incapacitated prior to attainment of the limiting age, <2) the child is <br />chiefly deper,dent upor-, the Em'ollee for suPPOt't and McÜnterlance, and (3) <br />proof of such incapacity and depe~de~cy is furnished to Health Plan within <br />thit,tj'-o;¡:'::'> (31.: days or t.h~ child!s attainment ,:¡f the limiting age. <br />Coverage will be continued so long as the child continues to be so <br />incapacitated and dependent, unless otherwise terminated in accordance with <br />the terms of this Contract. <br /> <br />Bef,:¡re granting this extension, Health Plan may reasonably require that the <br />child be examined at Health Plan's expense by a Physician designated by <br />Health Plan. Health Plan may require at reasonable intervals thereafter <br />satisfactot'y pt'oof of the child's c(jntinued incapacity and dependency, <br />including medical examinations at Health Plan's expense. However, such <br />proof will not be required more often than once a year following the <br />child's attainment of the limiting age. <br /> <br />Continuation of Coverage Option <br /> <br />Upon the loss of eligibility for coverage due to a "Qualifying Event" an <br />Erit'ollee andh)r dependents may be el igible fQr cont inuat ion Qf coverage. <br />Contact the Enrolling Unit for verification of eligibility and procedures <br />to follow if one of the following qualifying events occurs: <br /> <br />A. <br /> <br />Qualifying Events: <br /> <br />1. <br /> <br />Death of the Enrollee or retirèment of the Enrollee; <br /> <br />'" <br />Co. <br /> <br />Tet'minatil::>n, I::>ther' than for gross misconduct, I:)r t'eduction I:)f <br />hours of employment of the Enrollee; <br /> <br />3. <br /> <br />D i VQt'ce <br />sp':IIJ.se j <br /> <br />I:)r <br /> <br />legal separatiQn of the Enrollee from the Enrollee's <br /> <br />4. <br /> <br />Entitlement of the EnrQllee to Medicare benefits; <br /> <br />5. <br /> <br />A dependent child ceases to meet the definition ,:)f "dependent <br />child" in Section I of this CQntract. <br /> <br />SECTI ON V II <br />RELATIONSHIP BETWEEN PARTIES <br /> <br />The relationship between Health Plan and Participating Providers is a <br />contractual relatiQnship between independent contractors. Participating <br />Pt',:,videt's are nl:,t agents I:)r empllJyees of Health PlaY1 nor is Health Plan I:)r <br />any employee of Health Plan an agent or employee of Participating <br />Pr'OV i det";;. <br /> <br />GM-12-15 <br />