To terminate coverage for a dependent, an enrollee must complete an Application for Coverage form, except when termination occurs as a result of employee's termination of employment or when a dependent becomes ineligible due to age. Coverage will be terminated at the end of the month in which the Application for Coverage is received. Retroactive terminations are not allowed. Termination of coverage ends all rights of the participant to benefits under the Plan as of the date coverage ends.
Note: Some limitations may apply for participants of cafeteria (IRS Section 125) plans.