Adult dependents must be:

 §    The subscriber’s biological children, stepchildren, legally adopted children, children for whom the subscriber has assumed a legal obligation for total or partial support, children of the subscriber’s qualified domestic partner, or children specified in a court order or divorce decree.  Adult dependents may also include extended dependents in the legal custody or legal guardianship of the subscriber, or in the legal custody or legal guardianship of the subscriber’s spouse or the subscriber’s qualified domestic partner (once legal guardianship or custody is lost, they are not eligible for adult dependent coverage).

§    Age 20 through age 24.

§    Unmarried (includes legally separated or divorced).

NOTE:  There is no requirement for the adult dependent to live with or have financial ties with the subscriber.

Rates for Adult Dependents are found on the back of the Adult Dependent Enrollment/Change form.