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(a) The Employee or Dependent was covered under a croup health plan or had health insurance <br /> coverage at the time coverage under this Plan was previously offered to the individual. <br /> (b) If required by the Plan Administrator, the Employee stated in writing at the time that coverage <br /> was offered that the other health coverage was the reason for declining enrollment. <br /> (c) The coverage of the Employee or Dependent who had lost the coverage was under COBRA and <br /> the COBRA coverage was exhausted, or was not under COBRA and either the coverage was <br /> terminated as a result of loss of eligibility for the coverage(including as a result of legal <br /> separation, divorce,death,termination of employment or reduction in the number of hours of <br /> employment)or employer contributions towards the coverage were ternunated. <br /> (d) The Employee or Dependent requests enrollment in this Plan not later than 31 days after the date <br /> of exhaustion of COBRA coverage or the termination of coverage or employer contributions, <br /> described above.Coverage will begin no later than the first day of the first calendar month <br /> following the date the completed enrollment form is received. <br /> If the Employee or Dependent lost the other coverage as a result of the individual's failure to pay premiums or <br /> required contributions or for cause(such as making a fraudulent claim),that individual does not have a Special <br /> Enrollment right. <br /> (2) Dependent beneficiaries.If: <br /> (a) The Employee is a participant under this Plan (or is eligible to be enrolled under this Plan but <br /> for a failure to enroll during a previous enrollment period), and <br /> (b) A person becomes a Dependent of the Employee through marriage,birth, adoption or placement <br /> for adoption, � <br /> then the Dependent(and if not otherwise enrolled, the Employee) may be enrolled under this Plan as a <br /> covered Dependent of the covered Employee.In the case of the birth or adoption of a child, the Spouse <br /> of the covered Employee may be enrolled as a Dependent of the covered Employee if the Sgouse is <br /> otherwise eligible for coverage. <br /> The Dependent Special Enrollment Period is a period of 31 days and begins on the date of the marriage, <br /> birth,adoption or placement for adoption. . <br /> The coverage of the Dependent enrolled in the Special Enrollment Period will be effective: <br /> (a) in the case of marriage,the date of the Qualifying Event,if application is made within 31 days <br /> of the marriage; <br /> (b) in the case of a Dependent's birth,as of the date of birth; or <br /> (c) in the case of a Dependent's adoption or placement for adoption,the date of the adoption or <br /> placement for adoption. <br /> EFFECTIVE DATE <br /> Effective Date of Employee Coverage.An Employee will be covered under this Plan as of the first day that the <br /> Employee satisfies all of the following: <br /> (1) The Eligibility Requirement. <br /> (2) The Active Employee Requirement. <br /> (3) The Enrollment Requirements of the Plan. <br /> 7 <br />� <br />