Sun Life group plans can keep covering an unmarried dependent child past the usual age limit when the child cannot hold self-sustaining employment because of a mental or physical disability. GDIFM-11136 is how the parent applies: the employee completes the first page and the dependent's physician certifies the disability, its nature, the age it began and the prognosis on the second.
The employee completes Sections 1 to 3 with policy, dependent and marital details and signs. The dependent's physician completes Section 4, Physician assessment of disabled Dependent, and signs the Section 5 certification.
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Certification of Continued Coverage for a Disabled Dependent
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Section 4 asks for the name and address of the dependent's primary care physician, and that physician signs Section 5. The signature certifies that the dependent is incapable of self-sustaining employment because of the disability described and authorizes release of information about the certification.
Per the form's instructions, the child must be unmarried, incapable of self-sustaining employment because of mental or physical disability, and principally dependent on the parent for support, meaning more than 50%. Coverage lasts as long as these conditions hold and the parent remains insured.