|
 |
Who is eligible as a dependent?
If you select family coverage, your eligible dependents are your spouse and unmarried children. Unmarried children are eligible for coverage to the end of the year in which they turn age 19 or age 25 if they are full-time students and are dependent upon you and/or the other parent for at least 50% of their support, meet the support tests as a dependent for federal income tax purposes (whether or not the dependent is claimed) and are:
- Your natural children
- Adopted children and pre-adoption placements. Coverage will be effective on the date that a court makes a final order granting adoption by the subscriber or on the date the child is placed for adoption with the subscriber, whichever occurs first. These dates are defined by Wisconsin Statute 632.896. If the adoption of a child is not finalized, the insurer may terminate coverage of the child when the adoptive placement ends.
- Legal wards that became wards of the subscriber before age 19. Coverage will be effective on the date that a court awards permanent guardianship to the subscriber.
- Stepchildren
- Grandchildren born to insured dependent children may be covered until the end of the month in which your insured dependent (your grandchild's parent) turns age 18. Your child's eligibility as a dependent is unaffected by the birth of the grandchild. The grandchild may be eligible for coverage as a continuant.
I have a change in status of a subscriber/dependent. What am I supposed to do?
Report changes to your benefits/payroll/personnel office within 30 days of the change. Failure to report changes on time may result in loss of benefits or delay payment of claims.
How do I know if my dependent is eligible?
Physicians Plus reviews dependent eligibility status (ages 19-25) each year. A form is sent to the subscriber each December. The subscriber must complete the form, sign and date it. If the dependent is no longer eligible for coverage, the subscriber should complete the Employer Enrollment/Change Form, available through your benefits/payroll/personnel office.
|
|
