Back to School – A Possible Impact to Over-Age Dependent Coverage

Sep 02, 2014

The beginning of the school season can be a stressful time for many families. During this time, parents, students, and plan administrators have lengthy ‘to do’ lists. Hopefully, one of the crucial tasks on the lists includes updating the over-age dependent coverage in the benefits plan.

An over-age dependent is defined as any child who has reached the dependency status age as listed in the policy contract and still remains a legal dependent. Below are the typical age-related restrictions:

Dependency Status Under age 21
A child under age 21 must not be working more than 30 hours a week. This restriction helps ensure that coverage is given only to those children actually dependent on the plan member. An exception is made if the child under age 21 is a full-time student.

Dependency Status Age 21 or older
If the child is age 21 or older they must be either:
• a full-time student under age 25
• or be incapacitated for a continuous period that began before age 21, or while they were a full-time student under age 25.

Coverage for the over-age student dependent is not automatic. Most insurers terminate their coverage by the end of August each year, unless they receive proof of confirmation of qualifying students for the school year.

Plan members with dependents age 21 and older need to complete the ‘Request for Over-age Dependent Student Coverage’ form by September 1st and submit it to either the plan administrator or directly to insurance carrier. Student updates should be provided every year, even if a dependent is a returning student.

This ensures that the over-age student dependent continues to receive uninterrupted health and dental coverage for each school year (September 1 to August 31) that they are enrolled. For the year that the over-age dependent graduates, coverage will terminate on August 31 or on their 25th birthday, whichever is earlier.

For students going to school away from their home province, plan members must also furnish proof of confirmed provincial health insurance coverage for their over-age student dependent for the duration of their time away.

There is no increase in premiums for continuation of coverage for eligible over-age dependent students.

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