Dependents



An employee may carry their dependents under their Health Plan. To be eligible to enroll as a dependent a person must:

A.

Be the legal spouse or Common Law spouse of the subscriber.

B.

Be a child; and

 

Be a son or daughter born to the Subscriber or Subscriber’s spouse; or be the Subscriber’s grandchild; or be the stepchild of the Subscriber, or be the legally adopted child of the Subscriber or Subscriber’s spouse with legal adoption evidenced by a decree of adoption by a Texas court or the equivalent thereof by a court of another state; or be a child the Subscriber is seeking to adopt and Subscriber is a party in a lawsuit to effect such adoption; or be a child for whom the Subscriber or Subscriber’s spouse is ordered to provide medical support by an order issued under Section 14.061, Texas Family Code, or court order enforceable by a Texas Court.

Dependent children will be covered to age 25 as long as their permanent legal residence is the same as the Subscriber’s. Permanent legal residence will be defined as the address at which the dependent intends to live for the contract year.

Be a child of any age if the child is incapable of self-sustaining employment by reason of mental retardation or physical handicap and is chiefly dependent upon Subscriber for support and maintenance and medical certification acceptable to SWHP is provided at the time of enrollment.

Dependent must not be eligible as a Subscriber to procure other health coverage.

Dependent must not be married.

C.

Be a newborn dependent son or daughter of the Subscriber or Subscriber’s spouse. A newborn child is entitled to coverage for thirty-one (31) days when born. Coverage may be continued beyond the thirty-first (31st) day after the date of birth provided SWHP receives enrollment form from Subscriber to enroll the newborn child. Notification must be received during the sixty (60) day period following birth.

D.

Be a grandchild of the Subscriber. The subscriber may enroll their grandchild(ren) if the child lives with the Subscriber. The grandparent must complete an Affidavit stating that the grandchild is a dependent for Federal Income Tax purposes.


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