Family Members — In order to qualify as a member of a family, the members must be related to you in one of the following ways:

• your legal spouse
• your unmarried child through the end of the billing period in which the child
  becomes age 25 (At that time, the child is automatically removed from the
  Family provision.)
• your unmarried child over age 25 who was enrolled as a dependent at the time
  of reaching the age limit, and who is medically certified as disabled and
  chiefly dependent upon you for support and maintenance (Such condition must
  be certified by a physician and the Administrator. Also, a child may continue to
  be eligible for coverage under a “Family” Policy beyond the dependent age limit
  only if the condition began before or during the month in which the child would
  lose coverage due to his/her age status. Proof of incapacity and dependency
  must be furnished to the Administrator within 120 days of the dependent’s
  25th birthday. The Administrator may request subsequent proof of incapacity
  and dependency but no more often than on an annual basis after a two-year
  period following attainment of the limiting age. A child who is no longer your
  eligible dependent and therefore not able to continue coverage under your
  “Family” policy, but who meets the criteria for continued coverage under the
  Pool, may apply for his/her own Pool Policy.

Children — A child is considered to be a specific age on the first day of the
month following his/her birthday, and includes your unmarried:

• natural or legally adopted child
• child under age 18 placed in your home for purposes of adoption
• stepchild who depends upon you for support and maintenance and resides with
  you in a parent-child relationship

Note: If three or more children family members, as defined above, are members of the Pool program, they can qualify as a family even if you or your spouse are not covered. However, if a child qualifying as part of a family has his or her own child, the newborn child may not qualify as part of the same family. The newborn, if eligible, must switch to his/her own Policy and the additional premium for the newborn must be paid.

Family members covered under the Pool program must each meet the eligibility provisions of this Policy. The Administrator may require acceptable proof (such as copies of income tax forms, legal adoption or legal guardianship papers, or court orders) that an individual qualifies as a family member. Unless listed as an eligible family member, no other relative or person is eligible for coverage as a family.

If a child is under the age of 15, his/her parent, legal guardian, or other responsible party must submit the application for coverage on the child’s behalf. Also, for any child covered under a Pool Policy, any obligations of the policyholder set forth in this benefit booklet, any endorsements, addenda, or riders will be the obligations of the parent, legal guardian, or other responsible party applying for coverage on the child’s behalf.

You may not apply for a Pool Policy on behalf of a non-disabled adult child without obtaining authorization from the child to enter into a health insurance contract; therefore, an application for any such coverage of an adult child, whether as a dependent or as the subscriber, must be signed by the child. If the adult child is
disabled and unable to sign the application, his/her legal guardian may apply for coverage on his/her behalf and, by doing so, accepts any obligations of the subscriber set forth in the Policy, including any endorsements, addenda, or riders.  You may be required to provide a copy of a power of attorney for an adult child.