The Key Parts of LM Healthworks Plan

Dependent Eligibility Requirements

  • Medical IconHealth plan dependent eligibility requirements are strictly enforced.

  • Docfind IconRandom monthly audits ensure that dependent information you provide is accurate.

Please note that, beginning Jan 1, 2017, same-sex domestic partners are no longer eligible for coverage. 

To elect coverage for your dependents (including medical, dental, vision, life and accident), you must ensure each dependent meets the plan’s definition of an eligible dependent, shown below. It’s important to know that the plan’s eligibility requirements are strictly enforced. If any of your dependents are not eligible for coverage at the time you enroll them or if they become ineligible at a future date while still enrolled, their coverage will be terminated.

An “eligible dependent” is defined as:*

  • Your lawful spouse (same- or opposite-sex)
  • Your children up to age 26 (with no student, marital or financial requirements) if they are:
    • your natural children
    • your legally adopted children
    • children placed with you for legal adoption
    • your stepchildren (natural or legally adopted children of your legal spouse)
  • You may also be able to cover your grandchildren who live with you in a parent-child relationship, but only if you have court-appointed legal guardianship. Acceptable proof of court appointed legal guardianship will be required before you can enroll a grandchild for the first time and from time to time upon request.
  • Your disabled children age 26 and older who, when they first became disabled, would have met the definition of an eligible dependent and who are incapable of self-sustaining employment because of mental retardation, serious mental illness, physical sickness or injury. Coverage may continue to age 65 as long as your child remains incapacitated and is otherwise eligible for coverage. To extend this coverage, you must show proof of your child’s incapacity within 30 days after regular coverage ends or within 30 days of your child’s initial eligibility date, if later. Extended coverage ends when:
    • Your child age 26 and older marries
    • Your child age 26 and older becomes capable of self-support
    • Your child fails to report for a scheduled physical exam
    • Proof of incapacity is requested and not presented; or
    • Coverage terminates for reasons other than reaching the age limits described earlier

Dependents do not include any individual who is also covered as an employee, former employee, or retiree under any other Company-sponsored plan or a plan where the Company is a participating employer. Dependents do not include any person (including but not limited to nieces or nephews) for whom you are the court-appointed legal guardian, unless that person is your child (as defined above) or your grandchild.

Important: Dependent eligibility requirements are strictly enforced. While you may not be required to provide proof of eligibility during Annual Enrollment, random monthly audits will be conducted to make sure the information you provide about your dependents is accurate, particularly in regard to the eligibility requirements described above. Also, you will be required to certify eligibility for all of your dependents. Be sure you understand these requirements before you enroll your dependents. For more information, refer to the applicable Summary Plan Description, available via LMPeople > Pay and Benefits > General Benefits Information.

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