New Employee Benefits Enrollment - Dow Corning

BENEFITS ELIGIBILITY ____
In order to cover dependents on your benefits, they must meet the eligibility criteria as outlined below.
DEPENDENT CHILD
You can cover:
� Your natural, legally adopted or step child
� A child for whom the court has issued a QMCSO (Qualified Medical Child Support Order)
� Your grandchild, if the parent of the grandchild is also your eligible dependent
� A child for whom you or your spouse or domestic partner is the legal guardian
For your child to be covered, your child must be:
� Under the age of 25
� Unmarried
� A full time student (12 credit hours or more), if working more than 30 hours per week
� Dependent on you for primary support (50% or more)
SPOUSE/DOMESTIC PARTNER
You can cover:
� Your legal spouse
� Your eligible domestic partner of same or opposite sex. Specific eligibility criteria must be met
and a notarized affidavit is required prior to enrollment.
If you have a domestic partner that you would like to add to your benefit plans, contact the HR
Service Center prior to your first day of employment to request the domestic partner eligibility
criteria and forms. These forms will need to be completed and submitted for review prior to adding
your domestic partner as an eligible dependent.
NOTE: If your spouse or domestic partner has access to an employer-subsidized plan and works
greater than 17.5 hours per week, he or she must enroll for primary coverage under that plan and
may be enrolled only for secondary coverage under your Dow Corning Plan.
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