Starting January 1, 2009, unmarried children age 20 through age 24—who do not meet PEBB eligibility as students or dependents with disabilities as outlined in Eligibility for Dependent Children—are eligible for "adult dependent" coverage. (If you have an eligible student or disabled dependent, then you should enroll him or her as such in order to take advantage of the lower premium contribution.) Adult dependents do not have to be Internal Revenue Code (IRC) qualified dependents; that is, there is no requirement for the adult dependent to live with or have financial ties with the subscriber.
Unlike other eligible dependents who enroll under your account, adult dependents enroll under a separate account. That is because your adult dependent does not receive the state’s contribution toward his or her health care coverage like your other family members. Your adult dependent must enroll in the same medical and/or dental plan(s) you choose, unless he or she lives outside of your plan’s service area.
The main differences between adult dependents and student dependents are:
Rates for adult dependents are found on the back of the Adult Dependent Enrollment/Change form. Adult dependents of both employees and retirees may opt to enroll in dental only.
While the cost of monthly premiums for Adult Dependent coverage and Continuation of Insurance coverage (COBRA) is the same, the duration of allowable coverage depends on your situation. Adult dependents are eligible for COBRA if they become ineligible as an adult dependent—for instance, if they turn age 25 or prior to age 25, if there is a qualifying event affecting their eligibility. The duration of the continuation of coverage—whether it is 18 or 36 months—is based on the qualifying event. For example, if an adult dependent becomes ineligible because the parent (subscriber) terminates employment, then the adult dependent would be eligible for 18 months. If the adult dependent becomes ineligible because she or he turned age 25, she or he would be eligible for 36 months. See COBRA.
The request to cancel coverage must be in writing and have both the subscriber’s and the adult dependent’s signature. An adult dependent would only be able to re-enroll if a special open enrollment event occurred or during the annual open enrollment.
If you have any questions about eligibility, or about the process of enrolling an adult dependent in health coverage, contact the Public Employees Benefits Board.
PEBB General Information and Issues: Adult Dependents
Medical & Dental
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