Human Resources & Workforce Diversity
Child Loses Dependent Status
For State Group Health Insurance, VSP Vision Insurance, EPIC Benefits+, Dental Wisconsin and Anthem DentalBlue Dental Insurance, your child loses eligibility to be covered as your dependent at the end of the month in which the child turns 26; however, permanently disabled dependents may remain eligible indefinitely. To continue the adult child’s coverage, you or your dependent must take action.
Health insurance coverage for your dependent children will end on the date your coverage ends or at the end of the month in which they turn age 26.
A child does not need to be unmarried, dependent upon you for care or support or be a full-time student in order to be eligible as a dependent under State Group Health Insurance.
See ETF’s 2012 Dependent Eligibility Information for additional eligibility information if you have a child over age 19 and under age 26.
Coverage for a grandchild ends at the end of the month in which your child (parent of grandchild) ceases to be an eligible dependent or becomes age 18, whichever occurs first. The grandchild is then eligible for continuation coverage. This does not impact your child’s eligibility for coverage.
If you divorce, coverage for your spouse and stepchildren under your plan terminates at the end of the month in which the divorce is entered.
If your child is disabled when coverage would otherwise end, you may be able to keep him or her insured under your plan. Consult your staff benefits office.
Continuation of Coverage: Children who lose eligibility under your health insurance can continue in the group plan as single subscribers for up to 36 months through COBRA provisions by paying the full premium.
Once you inform your employer of the dependent's loss of eligibility, your employer is required to provide your child with a notice of his or her eligibility to continue coverage. Your child can continue coverage by filing an application with the Department of Employee Trust Funds within 60 days of receipt of that notice. If, at the end of 36 months, your child wishes to convert the coverage to an individual policy, he or she should contact the plan provider.
If coverage is continued, they can change health plans during the It’s Your Choice period or if they live or move out of the service area.
If you choose to voluntarily terminate coverage for an eligible adult dependent child, he/she will not be eligible to continue coverage.
What to do. . .
Loss of dependent status can occur for many different reasons, and your employer may not know when this happens. Therefore, you are required to notify your staff benefits office within 60 days of the event or the loss of coverage, whichever is later. If you fail to do so, your child may lose eligibility for COBRA continuation coverage and you could be responsible for reimbursing the University or the provider for premiums or claims paid in error.
Once you inform your employer of the loss of dependent status, your employer is required to provide your child with a notice of his or her eligibility to continue coverage. Your child can obtain the coverage by filing an application with the Department of Employee Trust Funds within 60 days of receipt of that notice.
If, at the end of 36 months, your child wishes to convert the coverage to an individual policy, he or she should contact the plan provider.
EPIC Benefits+ and Dental Wisconsin
You should know. . .
Coverage for your child will end on the earlier of the date that your coverage ends or at the end of the month in which the child turns age 26.
Your eligible child may continue group coverage through COBRA provisions for 36 months by submitting a continuation application directly to EPIC Life Insurance Company and paying premiums.
What to do. . .
Notify your staff benefits office within 60 days of the date your child's eligibility ends. Your staff benefits office can provide an application for continuation coverage. When your child is no longer eligible for coverage, you should review your coverage level to determine if you need to submit an application (Benefits+, Dental Wisconsin) to change to single or limited-family coverage. You are required to notify your staff benefits office within 60 days of the event or the loss of coverage, whichever is later. If you fail to do so, your child may lose eligibility for COBRA continuation coverage and you could be responsible for reimbursing the University or the provider for premiums or claims paid in error.
Anthem Dental Blue and VSP Vision Insurance
You should know. . .
Coverage for your child will end on the date that your coverage ends or at the end of the month in which the child turns age 26.
If your child has lost eligibility for coverage as your dependent, he or she may continue group coverage through COBRA provisions for up to 36 months by applying to continue coverage and paying premiums.
What to do. . .
Notify your staff benefits office within 60 days of the date your child's eligibility ends. Your staff benefits office can provide an application for continuation coverage. When you child is no longer eligible for coverage, you should review your coverage level to determine if you need to submit an application (Anthem DentalBlue, VSP Vision) to reduce your coverage level. You are required to notify your staff benefits office within 60 days of the event or the loss of coverage, whichever is later. If you fail to do so, your child may lose eligibility for continuation coverage and you could be responsible for reimbursing the University or the provider for premiums or claims paid in error.
You should know. . .
Your child's insurance through the State Group Life Insurance plan terminates at the end of the month in which he or she marries, the end of the calendar year in which the child ceases to be dependent on you for at least 50% of support, or turns age 19 (age 25 if a full-time student), or when your coverage terminates, whichever is earliest.
The child can convert coverage to an individual policy with Minnesota Life by filing a timely application and paying premiums. Evidence of insurability is not required.
What to do. . .
Conversion policies are usually more expensive than group life insurance plans or term life insurance that is available on the open market. If the child will need insurance coverage when the State Group Life Insurance coverage ends, take time to investigate other insurance alternatives.
However, if your child is not insurable, conversion to an individual policy may be a good option. A conversion application, ET-2306, is available from your staff benefits office. It must be filed with Minnesota Life within 30days after the end of regular coverage.
If you have no other child and no spouse to insure, cancel your Spouse and Dependent coverage by filing a cancellation form with your staff benefits office.
Individual and Family Life Insurance
You should know. . .
Coverage for your child under the Individual and Family Life Insurance plan terminates at the earliest of the following dates:
- At the end of the month in which the child is no longer dependent on insured employee for financial support;
- At the end of the month in which the child marries;
- At the end of the year in which the child turns 25.
The child can convert coverage to an individual policy with the insurance company by filing a timely conversion application and paying premiums. Evidence of insurability is not required.
What to do. . .
Conversion policies are usually more expensive than group life insurance plans or term life insurance that is available on the open market. If the child will need insurance coverage when the Individual and Family Life Insurance coverage ends, take time to investigate other insurance alternatives.
However, if your child is not insurable, conversion to an individual policy may be a good option. An application must be filed with the insurance company within 31 days after the end of regular coverage.
Accidental Death and Dismemberment Insurance
You should know. . .
Coverage for your child under the AD&D Insurance plan terminates at the earliest of the following dates:
- At the end of the month in which the child is no longer dependent on insured employee for financial support;
- At the end of the month in which the child marries;
- At the end of the year in which a child turns 19 if not a full-time student;
- At the end of the year in which the child is no longer a full-time student;
- At the end of the year in which the child turns 25 if a full-time student.
Conversion to an individual policy is not available to the child. A family conversion policy is available to you when your coverage ends.
Employee Reimbursement Account (ERA)
You should know . . .
Medical Expense Account: You may contribute to the ERA Medical Expense Program to help pay for non-covered medical expenses for your child or for certain other individuals if they are eligible dependents under the IRS definition of dependent found in IRC §152. Medical expenses incurred for the child may only must be reimbursed if the child is considered either your qualifying child or qualifying relative.
An individual is considered a qualifying child if they are not someone else's qualifying child and:
- are a U.S. citizen, national or a resident of the U.S., Mexico or Canada;
- have one of the following relationships to you: son, daughter, stepson, stepdaughter, foster child, legally adopted child, grandchild, niece, nephew...;
- live in your household for more than half of the taxable year;
- are less than 19 years old or younger (less than 24 if a full-time student) at the end of the taxable year and be younger than the taxpayer claiming such individual; and
- have not provided more than one-half of their own support during the taxable year.
An individual is considered a qualifying relative if they:
- are a U.S. citizen, national or a resident of the U.S., Mexico or Canada;
- have the following specified family-type relationship to you: son/daughter, stepson/daughter, foster child, legally adopted child or a descendent of any such individual (grand/great grandchild), brother/sister, niece/nephew, half brother/sister, or stepbrother/sister, parent (or ancestor of either), stepparent, aunt/uncle, certain in-laws(son-, daughter-, father-, mother-, sister- and brother)
- are not someone else's qualifying child;
- receive more than one-half of their support from you during the taxable year; or
- if no specified family-type relationship to you exists, are a member of and live in your household (without violating local law) for the entire taxable year and receive more than one-half of their support from your during the taxable year.
Note: There is no age requirement for a qualifying child if they are physically and/or mentally incapable of self-care.
Dependent Care Account: Dependent care expenses generally cease when the child turns age 13 or when your spouse or another relative provides the care.
When the individual loses dependent status, you may be eligible to decrease your ERA contributions.
See UWSA’s ERA page for detailed eligibility information.
What to do. . .
- If you want to change your contribution elections under the ERA program, contact Fringe Benefits Management (FBMC) at 608-592-2020 to see whether the loss of dependent status qualifies as a status change. If it does, you must file a Change of Status form with FBMC within 30 days after the event.
Beneficiary Designations
You should know. . .
When your family changes, you should review your beneficiary designations to be sure that they are still appropriate.
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This document was last revised on February 17, 2012
