MMC Benefits Handbook
Can I cover my dependent child?
You can cover:
- natural children which includes newborn infants
- step children
- foster children
- adopted children (including a "proposed adopted child") from the moment of placement in the home of the Insured
Note: Any child that meets one of these eligibility requirements and who is incapable of self-sustaining employment by reason of mental illness, developmental disability, mental retardation, as defined in the mental hygiene law, or physical handicap and who became so incapable prior to the attainment of the age limit specified below, and who are chiefly dependent upon the Insured for support and maintenance, may be covered beyond the end of the calendar year in which the child attains age 26. Proof of the dependent child's disability may be requested within 31 days after the child reaches the age limit and on an annual basis. If proof is not provided within 31 days of the request, coverage for the dependent child will not be extended.
For your child to be covered, your child must be:
The Company, along with the Claims Administrator, has the right to require documentation to verify the relationship (such as a copy of the court order appointing legal guardianship). Company Voluntary AD&D coverage does not cover foster children or other children living with you, including your grandchildren, unless you are their legal guardian with full financial responsibility—that is, you or your spouse claims them as a dependent on your annual tax return.
When is my child eligible for coverage?
Newborn infants shall include the Insured's natural newborn infants and newborn infants adopted by the Insured if the Insured: (a) takes physical custody of the infant upon such infant's release from the Hospital; and (b) files a petition pursuant to section 115-c of the domestic relations law within 30 days of birth; and (c) provided further that no notice of revocation to the adoption has been filed pursuant to section 115-b of the domestic relations law and consent to the adoption has not been revoked.
A proposed adopted child will be considered an adopted child during any waiting period prior to finalization of the child's adoption, provided such child is primarily dependent on the Insured for support and maintenance during such waiting period.
Coverage for any newborn infant is effective from the moment of birth provided the payment of any additional premium is made within 30 days from the moment of birth.
How long can I cover my child?
Generally, you can cover your child through the end of the calendar year in which your child reaches age 26. You may be able to extend coverage for your child after age 26:
- if a child is incapable of self-sustaining employment by reason of mental illness, developmental disability, mental retardation, as defined in the mental hygiene law, or physical handicap and who became so incapable prior to the attainment of the age limit specified above, and who are chiefly dependent upon the Insured for support and maintenance.
Once your child reaches the maximum age for coverage or no longer meets the eligibility requirements (whichever comes first), your child's coverage will stop.
If your child no longer meets the eligibility requirements above, you must remove your child from coverage by going to Colleague Connect (https://mmcglobal.sharepoint.com/sites/home). Click Pay & Benefits and select Mercer Marketplace Benefits Enrollment Website under Benefits. No refund of contributions will be paid beyond the date eligibility ceases, and no benefit will be paid if your child dies or becomes dismembered as a result of an accident.
I am divorced and do not have sole custody of my child; can I still cover my child?
You can still cover your child under the Plan as long as the child meets the eligibility requirements.
Can I cover my grandchild?
You can't cover your grandchild under this Plan unless you are the legally appointed guardian or you have legally adopted the child.
Can I cover my disabled child?
You can cover your disabled child over the limiting age. To be eligible for coverage, your child has to be an unmarried child who is incapable of self-sustaining employment by reason of mental illness, developmental disability, mental retardation, as defined in the mental hygiene law, or physical handicap and who became so incapable prior to the attainment of the age limit specified above, and who are chiefly dependent upon the Insured for support and maintenance.
The child also has to have been covered under this Plan before the limiting age.
The child's disability has to begin before the date eligibility would otherwise end.
At time of claim, National Union will request proof of disability to determine eligibility if the child was over age 26.
Can I cover my married child who is still dependent on me?
You can't cover your married child, even if the child is still dependent on you.
My spouse also works for the Company; can we both cover our child?
If both you and your spouse work for the Company, only one spouse may enroll in the family plan option. The other spouse must enroll in the Employee only option. Also, your child has to meet the eligibility requirements.
My child also works for the Company and is enrolled in the plan with Employee Only coverage; can I still cover my child as a dependent under the Family Plan?
If you and your child are eligible to enroll for coverage under this Plan, you may cover your child under the Family Plan as long as they meet the eligibility listed under "Eligible Children." Your child may also elect their own coverage under the plan as an eligible employee. The maximum benefit paid out for both the employee and child will not exceed $2 million.