Employee Matters

This column is prepared by staff from the Office of Human Resources. E-mail questions to benefits@ohr.wisc.edu or call 262-5650. For more information, visit Payroll Services and Benefits Services.

Employees’ dependent children are eligible for coverage under the following plans: state group health insurance; state group life insurance; spouse and dependent coverage; individual and family life child coverage; dental and excess medical (EPIC) insurance; Anthem dental insurance; accidental death and dismemberment (AD&D) insurance; the Employee Reimbursement Accounts (ERA) program; and OptumHealth (formerly Spectera) vision insurance.

Eligibility is determined by age, full-time student status, financial dependency and martial status. Each plan defines an eligible dependent differently.

During 2008 has your child:

• Turned age 19 and is no longer enrolled as a full-time student?
• Enrolled or re-enrolled as a full-time college student?
• Graduated from college?
• Dropped out of college?
• Married?
• Turned age 25?

Review your benefits if any of these events occur.

Is your child a full-time student?

A full-time student is enrolled in and attending an accredited institution whose principal activity is education for a specified number of credits. A student is recognized as a full-time student on the first day of classes. Student status includes any intervening vacation period if the child continues to be a full-time student. Contact the institution directly if you are uncertain of your child’s enrollment status.

Where can I find eligibility information?

Dependent eligibility rules are summarized at Coverage End Dates for Dependents.

Does each plan monitor eligibility?

State group health plans, the dental and excess medical (EPIC) plan, and the Anthem dental program send dependent verification forms to verify eligibility. Forms were mailed the week of Oct. 22. The deadline to return the dependent verification form to the plans is Dec. 1. If the plans receive the verification forms after Dec. 1 or not at all, the dependent’s insurance coverage will end as of Dec. 31. You will be required to submit additional paperwork and documentation to pursue reinstatement.

If you carry state group health insurance, dental and excess medical (EPIC) insurance, and Anthem dental insurance, you must return all questionnaires. Be sure to also submit enrollment applications to your department payroll and benefits coordinator to formally remove your dependent from your plans.

You are responsible to monitor your dependents’ eligibility for coverage under any other plans. Contact the Office of Human Resources to help you determine if any action is needed.

Why is reporting changes so important?

Because status changes can affect the premium that you pay; affect the premium the university pays on your behalf; ensure your child can continue coverage when group coverage eligibility is lost; and ensure your dependent can become an eligible dependent again if circumstances change.

How soon should status changes be reported?

Most changes must be made within 30 days of the event. The necessary form(s) are available online.

For more information, visit Payroll Services and Benefits Services or e-mail benefits@ohr.wisc.edu.