You are eligible for coverage under this Evidence of Coverage (EOC) if, at the time of application:

You are a citizen or national of the United States, or a non-citizen who is lawfully present in the United States, and are reasonably expected to be a citizen, national, or a non-citizen who is lawfully present for the entire period for which enrollment is sought; and

You are a resident of the state of Illinois; and

You live in the Service Area in which You are applying, and intend to continue living there for the entire period for which enrollment is sought; and

You reside in one of the following Illinois counties at the time of application

Cook
DuPage
Grundy
Kane
Kankakee
Kendall
Will; and

You are not incarcerated other than incarceration pending the disposition of charges; and

You do not reside in an Institution; and

You have submitted a completed and signed application for coverage and have been accepted in writing by Us.

The Subscriber must notify Us of all changes that may affect any Member's eligibility under this EOC.

Other Members may include the following Family Member(s):

Your lawful spouse or partner to a civil union and reside in the Service Area.
Your children who live in the Service Area and have not yet reached age 26.

Your own, Your spouse's, or Your partner to a civil union’s Newborn children are automatically covered from the moment of birth for the first 31 days of life. To continue coverage past that time You must enroll the child as a Family Member by applying for his or her enrollment as a Family Member within 60 days of the date of birth, and pay any additional Premium. Coverage for a newborn dependent child enrolled within 60 days of birth will be retroactive to the date of the child’s birth.

An adopted child, including a child who is placed with You for adoption, is automatically covered for 31 days from the date of the adopted child’s placement for adoption or initiation of a suit of adoption. To continue coverage past that time You must enroll the child as a Family Member by applying for his or her enrollment as a Family Member within 60 days of the date of adoption, and pay any additional Premium. Coverage for an adopted dependent child enrolled within 60 days of adoption will be retroactive to the date of the child’s placement for adoption or initiation of a suit of adoption.

A child who is placed with You for foster care is automatically covered for 31 days from the date of the foster child’s placement. To continue coverage past that time, You must enroll the foster child as a Family Member by applying for his or her enrollment as a dependent within 60 days of the date the child is placed with You for foster care, and pay any additional Premium. Coverage for a foster child enrolled within 60 days of placement for foster care will be retroactive to the date of the child’s placement for foster care.

If a court has ordered a Subscriber to provide coverage for an eligible child (as defined above) coverage will be automatic for the first 31 days following the date on which the court order is issued.

To continue coverage past that time, You must enroll the child as a Family Member by applying for his or her enrollment as a Family Member within 60 days of the court order date, and pay any additional Premium. Court-ordered coverage for a dependent child enrolled within 60 days of the court order will be retroactive to the date of the court order.

Your stepchildren who live in the Service Area and have not yet reached age 26
Your unmarried military veteran dependent who has not yet reached age 30 if the veteran (i) is an Illinois resident, (ii) served as a member of the active or reserve components of any of the branches of the Armed Forces of the United States, and (iii) has received a release or discharge other than a dishonorable discharge. To be eligible, the eligible dependent shall submit to the insurer a form approved by the Illinois Department of Veterans' Affairs stating the date on which the dependent was released from service. Your own, Your spouse's, or Your partner to a civil union’s children, regardless of age, enrolled prior to age 26, who are incapable of self-support due to medically certified continuing intellectual or physical disability, and are chiefly dependent upon the Member for support and maintenance. Cigna Healthcare may require written proof of such disability and dependency within 31 days after the child's 26th birthday.

Note: A child enrolled as a Family Member under this EOC who resides outside of the Service Area, is entitled to receive, while outside the Service Area, only Emergency Services for Emergency Medical Conditions.