Dependent
Eligibility
IU-sponsored
Medical and Dental Plans
Eligibility
Guidelines for IU-sponsored Coverage
Eligible
Employees
Persons
employed by Indiana University as full-time appointed staff or academic
employees are eligible for plan membership.
Eligible
Dependents
Dependents
that are eligible for coverage are:
-
The employee’s spouse as defined by Indiana law; registered
same sex domestic partners, and
-
the employee’s unmarried biological and/or adopted children
or stepchildren through age 18, or until the child turns 24 if
a full-time student.
Points
to Remember:
-
Tax
dependent status - in order to be eligible, the employee’s
child must meet the IRS support test as a qualified dependent
of the employee or spouse.
-
Disabled child eligibility - a fully disabled
child may be eligible to continue coverage after reaching age
24. Contact a campus human resource office for information on
how to apply for continued coverage.
-
Newborn
eligibility - in most cases, a newborn is covered for
the first 31 days, but in order to continue coverage the newborn
must be enrolled through a campus human resource office within
60 days of birth. After 60 days, the next opportunity to add
the newborn is Open Enrollment for the next year.
-
Midyear
changes - the elections made during Open Enrollment
must stay in effect for the entire year unless an IRS-defined
“change in status” is experienced, such as marriage,
a birth, or a spouse’s loss of other employer coverage.
Changes
must be made within 60 days of the date of the change in status.
After that time, the employee must wait until the next Open
Enrollment.
-
Duty
to notify of ineligibility - the employee is responsible
for notifying the university in writing within 60 days of any
change that affects the employee’s dependent eligibility,
for example, marriage or divorce. A medical or dental plan member
ceases to be a covered dependent on the date the member no longer
meets the definition of a dependent, regardless of when notice
is given to the university. Failure to provide timely notice
to the university can jeopardize COBRA benefits and result in
additional cost to the employee.
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