Who's Eligible

Dependent definitions
Special rules about children's coverage

You are eligible to enroll in the plan if you are an active, full-time employee working on a full-time basis (20 hours per week or more). You are not eligible for coverage if you are a temporary, leased, or seasonal employee, or an independent contractor, consultant, or individual who is not on the company payroll.

You may enroll your eligible family members under the plan at the same time you enroll yourself. Dependents may not be covered by the plan if you, the employee, are not enrolled or if they are enrolled as employees.

The Company reserves the right to request proof of marriage, dissolution of marriage, proof of partnership, dissolution, termination of partnership, birth, adoption, disability, or any other documentation that demonstrates eligibility for benefits.

For medical coverage, eligible family members include:

Your legally married spouse or qualified domestic partner.
Your or your spouse's child who is under age 26, including a natural child, stepchild, a legally adopted child, a child placed for adoption, or a child for whom you or your spouse are the legal guardian. Children for whom you are required to provide health coverage under a qualified medical child support order are also considered eligible—see Qualified Medical Child Support Order.
An unmarried child age 26 or over who is or becomes disabled and dependent upon you (periodic proof of their handicap may be required); see Special Rules Regarding Your Children's Coverage.

For dental and vision coverage, eligible family members include:

Your legally married spouse or qualified domestic partner.
Your unmarried children who rely on you for more than 50% of their financial support. Such children include a natural child, stepchild, a legally adopted child, a child placed for adoption or a child for whom you or your spouse/domestic partner are the legal guardian who meet the following criteria:
- Children under age 19.
- Children ages 19 up to 25, provided they are full-time students taking 12 or more units at an accredited school (9 units for graduate school).
- Children who are physically or mentally incapacitated regardless of age (periodic proof of their handicap may be required); see Special Rules Regarding Your Children's Coverage. For new hires, your unmarried mentally or physically disabled children are eligible, provided these children were covered under the coverage you had immediately before your date of hire and you enroll yourself and these children in the plan within 30 days of your date of hire.

Important Notes About Eligibility

Your dependents may not enroll in a Company medical or dental plan unless you are also enrolled.

If you and your spouse/domestic partner both work for Canon Medical Systems, you may each be enrolled as an employee or be covered as a dependent of the other person, but not both. In addition, if you and your spouse/domestic partner are both covered under the Company medical plan as an employee, only one parent may enroll your child as a dependent.

If your spouse or child no longer qualifies as an eligible dependent, please contact the Benefits Department to remove him or her from your coverage. You will be financially liable for any benefits paid for ineligible dependents. To ensure that your child qualifies for full-time student status, the Company and its health care providers will periodically contact you directly for proof of your child's continued student status. All claim payments will be suspended until the information is received.

Dependent Definitions

Children

Children include your natural children, stepchildren, legally adopted children (including pre-adoptive children from date of placement in your home), and children for whom you or your spouse/domestic partner are the legal guardian.

Domestic Partner

A domestic partner is an individual of the same or opposite sex with whom you have established a domestic partnership as described below.

A domestic partnership is a relationship between an employee and one other person of the same or opposite sex. Both persons must:

Not be so closely related that marriage would otherwise be prohibited;
Not be legally married to, or the domestic partner of, another person under either statutory or common law;
Be at least 18 years old;
Live together and share the common necessities of life;
Be mentally competent to enter into a contract; and
Be financially interdependent

The Employee and domestic partner must jointly sign an affidavit of domestic partnership provided by Human Resources upon your request.

Special Rules About Children's Coverage

Disabled Children

If you have a dependent child who is physically or mentally disabled, his or her health care coverage may continue beyond the maximum age for coverage, as long as you continue to pay the required contributions and you provide the Plan Administrator with proof that your child is:

Unable to earn a living because of a physical or mental disability,
Dependent on you for support and maintenance, and
Unmarried.

You must provide such proof within 31 days of the date your child reaches the maximum age of coverage, and then each year thereafter for as long as your child's disability continues. The Plan Administrator may also require doctor examinations. Note that to be eligible for this coverage, your child must meet the applicable medical plan's definition of disability.

Under this situation, your child's coverage will continue until any of the following occur:

The child is no longer disabled as determined by the Plan Administrator,
You do not provide proof to the Plan Administrator of your child's disability when requested to do so, or
Your eligibility for coverage under this plan ends.

Depending on the circumstances, coverage for your child may be available through COBRA (see Continuation of Coverage).

Qualified Medical Child Support Order

A qualified medical child support order (QMCSO) is a judgment, decree, or order issued by a court that requires a parent to provide medical coverage, regardless of with whom the child resides.

Child support orders should be sent to the Plan Administrator. Upon receipt, the Plan Administrator will review it to determine if it meets the requirements of a QMCSO. If the order is qualified, you may cover your children under the plan.

You may obtain, without charge, a copy of the procedures governing QMCSOs from the Plan Administrator.

Note: A National Medical Support Notice will be recognized as a QMCSO if it meets the requirements of a QMCSO.