Prior to 2012 Renewal
Q. What is included in the State’s definition of a dependent?
- Health plans will cover dependents on the parent’s policy until the dependent turns age 27 or is married—whichever comes first. Financial support from parents is not required, and full-time student status is not required, except in certain cases of military service.
- If the dependent is offered coverage through an employer that is more expensive than the coverage under a parent’s plan, the dependent can remain eligible for coverage under the parent’s plan.
- A dependent who is under age 27 when called to federal active duty, can be reinstated to the parent’s plan upon return from active duty. Further, dependents returning from duty after age 27 can be reinstated to their parents’ plan if they were a full-time student before military service and they re-enroll as a full-time student after military service.
- A dependent who is incapable of self-support because of a physical or mental disability that can be expected to be of long-continued or indefinite duration as determined by the health plan and is dependent on either parent for at least 50% of their support and maintenance as demonstrated by the support test for federal income tax purposes, whether or not the child is claimed.
After 2012 Renewal
Q. What is included in the State’s definition of a dependent?
Health plans will cover dependents on the parent’s policy until the dependent turns age 26, regardless of marital status. Financial support from parents is not required, and full-time student status is not required, except in certain cases of military service
- A dependent who is under age 26 when called to federal active duty, can be reinstated to the parent’s plan upon return from active duty. Further, dependents returning from duty after age 26 can be reinstated to their parents’ plan if they were a full-time student before military service and they re-enroll as a full-time student after military service.
- A dependent who is incapable of self-support because of a physical or mental disability that can be expected to be of long-continued or indefinite duration as determined by the health plan and is dependent on either parent for at least 50% of their support and maintenance as demonstrated by the support test for federal income tax purposes, whether or not the child is claimed.
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Q. What is included in the Federal definition of a dependent (part of the Patient Protections and Affordable Care Act of 2010)?
A. The Federal definition varies from the State of Wisconsin's definition in that a dependent is eligible for insurance coverage until he/she turns age 26 regardless of marital status. Effective January 1, 2012, the State Dependent Mandate has been revised to closely match the Federal Dependent Mandate as it relates to the minimum required age for plans to cover dependents. As such, starting with 2012 renewals and new business, a dependent is covered on the parent's policy until the dependent turns age 26, regardless of marital status.
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Q. When can I add my newly qualified dependent to my policy?
A. Dependents not currently covered on your policy, but who now meet the new definition of a dependent, may be added to your coverage when your policy is renewed. Please contact your employer for more information on adding a dependent at renewal time.
For members on an individual policy (a policy not offered through an employer), dependents may be added upon their next renewal. Dean Health Plan will notify them of this benefit during the renewal process – approximately 30-45 days prior to the renewal date.
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Q. What do I need to do to add my dependent to my policy?
- If coverage is through your employer, and your eligible adult child is not currently insured on the policy, you should submit an application to your employer prior to the renewal date to change from single to family coverage or to add your adult child. Coverage for your child will be effective upon your renewal date as long as it’s received by Dean Health Plan within 30 days of the effective date. Example: If your group renews January 1st, the application must be submitted to Dean Health Plan prior to January 31, to be considered timely. Your employer should be able to help you with the specifics your company’s application process.
- If coverage is through an individual policy, you’ll need to submit an application directly to Dean Health Plan to add your dependent. Coverage for your child will be effective upon your renewal date as long as it’s received by us within 30 days of the effective date. If your premium rate is affected, we’ll let you know with the next billing statement.
NOTE: After the renewal date, you can add your adult child if there is a qualifying event. If there is no qualifying event, you can still add your adult child, but coverage is subject to a late enrollee waiting period. Establishing full-time student status is not considered a qualifying event since it’s no longer a required dependent criteria. Loss of other coverage or increase in premium cost for other coverage are examples of qualifying events.
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Prior to 2012 Renewal
Q. If my dependent turns 26 before my renewal, will you terminate him/her?
A. No, we will not terminate your current dependents. If you wish to remove him/her from the plan, you will have to notify your employer or Dean Health Plan.
After 2012 Renewal
Q. If my dependent turns 26 before my renewal, will you terminate him/her?
A. Coverage for dependents who turn 26 prior to group renewal will end the on the group renewal. For example, coverage for a 26 year old dependent whose group renews March 1, 2012 will end on February 28, 2012.
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Q. Do I have to include my dependent on my policy?
A. No. The new mandates require insurance companies to provide coverage based on the new definition, but parents are not required to cover their adult dependents unless they choose to do so.
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Q. My adult child is on COBRA continuation coverage. Can I cover him/her on my insurance?
A. Yes, as long as your adult child meets the eligibility requirements.
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Prior to 2012 Renewal
Q. Does this change include my disabled dependent?
A. Yes. We will have no need to confirm the disabled status of your dependent until he/she turns age 27.
After 2012 Renewal
Q. Does this change include my disabled dependent?
A. Yes. We will have no need to confirm the disabled status of your dependent until he/she turns age 26.
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Prior to 2012 Renewal
Q. Can my dependent be covered on my policy after returning from active duty in the military?
A. A dependent under age 27 and called to federal active duty can be reinstated to the parent’s plan upon return from active duty. Further, dependents returning from duty after age 27 can be reinstated to their parents’ plan if they were a full-time student before military service and they re-enroll as a full-time student after military service.
After 2012 Renewal
Q. Can my dependent be covered on my policy after returning from active duty in the military?
A. A dependent under age 26 and called to federal active duty can be reinstated to the parent’s plan upon return from active duty. Further, dependents returning from duty after age 26 can be reinstated to their parents’ plan if they were a full-time student before military service and they re-enroll as a full-time student after military service.
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Prior to 2012 Renewal
Q. If my dependent gets married, can he/she stay on my policy?
A. No. Dean Health Plan will cover dependents on the parent’s policy until the dependent turns age 26 regardless of marital status. In order to remain covered until age 27, the dependent cannot be married.
After 2012 Renewal
Q. If my dependent gets married, can he/she stay on my policy?
A. This depends on plan design. Please check your member certificate.
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Q. I’ve heard there could be tax consequences of keeping my adult dependent on the plan. Is this true and what are they?
A. There are tax consequences of covering a dependent beyond the Federal eligibility requirements because the IRS only recognizes the Federal eligibility requirements for dependents as qualifying for tax exempt benefits under the parent’s plan. If an adult dependent remains on the parent’s plan beyond the end of the calendar year in which he/she turns age 26, there will be tax implications and tax advice should be sought.
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Q. Why didn’t I receive a dependent verification form this year?
A. Since the verification process was largely based on validating full time student status and support from parents, it is no longer needed.
We may have to confirm full-time student status in limited cases where the military service provision may apply but we will do that on a case by case basis.
Note: State and Local government (Employee Trust Funds program) employees are required to provide additional student verification. For more information, please see the Department of Employee Trust Funds website. Federal employees should also refer to their benefit materials for information on dependent coverage guidelines.
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Q. Can the spouse of a married adult dependent be covered on this plan as well?
A. No, the adult dependent only, can be covered under the parent's plan.
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