Health Plan Administrators, Inc

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Eligibility and Effective Date of Coverage:

Eligibility:

Secure STM is offered to members, their spouses and their dependent children under age 19 (or under age 25 if a full-time student) who have a social security number and can answer "no" to the health questions on the application. Children age 19 and over should apply separately. Child-only coverage is available for ages 2 through 18.

Child Only Coverage:

When applying for coverage ONLY on the child(ren), the minimum age is 2 years old. The 2-19 premium rate (male or female, based on the gender of the child applicant) for the youngest child is used; then the per child rate for each of the other siblings to be insured on the plan. Please enter the youngest child as the applicant, and all other child(ren) as the dependents. The parent or legal guardian must sign and date the application. Children age 19 and older must apply separately.

Effective Date of Coverage:

The insurance can be effective as early as 12:01 a.m. the next day after the transmission date. However, the applicant can choose a later effective date not to exceed 60 days from transmission date. Coverage ends on termination date listed in your policy.

If your payment is by credit card, the hard copy application does not have to be mailed to HPA, but the applicant should print a hard copy for his/her records. The acknowledgment of the applicant's name for credit card payment suffices as a signature under e-commerce law.

If your payment is by check, money order, or automatic check withdrawal, the hard copy of the application does not have to be mailed to HPA. However, the initial payment must be mailed in by check along with a voided check. Please note social security number on initial payment check. The initial payment must be received within 10 days from the transmission date or coverage is void.

Coverage under this policy will end on the termination date listed in the Schedule of Benefits.

Coverage will be considered void if payment is not received.