Your older child’s dental, vision coverage may end with school year • The end of the month in which
By LORRAINE SIMPKINS If your child is age 19 or older, but not
yet 25, and is completing his or her studies in May or June, then he or she may lose eligibility for coverage as a dependent child under your dental and vision plans. You must notify your agency’s health
benefits administrator of your child’s change in student status, and you should request information about how to continue their dental and vision coverage. The federal Patient Protection and
Affordable Care Act requires insurers to offer children coverage as dependents on their parents’ health insurance plan up to age 26, but that only applies to medical care, not dental or vision care. Under the EmblemHealth (formerly
GHI) Preferred Dental Plan and the NYS Vision Plan, your unmarried dependent children ages 19 through 24 are eligible for coverage if they are full-time students. They continue to be eligible until the earliest of the following dates: • The end of the third month following
the month in which they complete a semester;
The dental and vision care benefits
attendance at school ends, if the semester is not completed and proof of the last day of attendance for the semester is provided, or the end of the third month following the month that the last semester was completed, whichever is later; • The starting date of the semester if
the semester is not completed and no proof of attendance is provided, or the end of the third month following the month that the last semester was completed, whichever is later; • The end of the third month following
the month in which they complete course requirements for graduation; or • The end of the month in which they
reach age 25. The federal Consolidated Omnibus
Budget Reconciliation Act (COBRA) requires most employers sponsoring group health plans to offer employees and their covered dependents the opportunity for temporary “continuation coverage” at group rates in certain instances where coverage under the employer-sponsored plan would otherwise end.
your dependent may continue are the same benefits you receive as an active employee. COBRA requires that your child have the opportunity to continue coverage for up to 36 months. The cost of COBRA coverage is the full premium (both the employer’s and employee’s shares) plus a 2 percent administrative fee. The 2013 monthly COBRA rates for individual coverage are: $28.69 for the GHI Preferred Dental Plan and $3.26 for the NYS Vision Plan. Under COBRA, the employee or
dependent is responsible for informing the Employee Benefits Division (EBD) of the state Department of Civil Service within 60 days of when the dependent loses eligibility. If you do not notify the EBD within that time, regardless of the reason, the dependent will not be entitled to COBRA continuation coverage. For more information about your
child’s eligibility or COBRA continuation of coverage, contact your agency’s health benefits administrator.
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EarWorksAudiology.com Page 12—The Communicator May 2013 PEF Information Line: 1-800-553-2445
Health Notes
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