BN - Age 26 Dependent COBRA Continuation Notification Process
This document outlines the Age 26 Adult Child COBRA Notification process for state group health, dental and vision benefits continuation. This process has been centralized with the administrative functions being completed by the UWSC. This document focuses on the responsibilities of the UWSC.
Overview of the Age 26 Adult Child COBRA Continuation Process providing an understanding of the entire process, but focusing on the responsibilities of the UWSC.
Under federal law, known as COBRA, the employee and their qualified
beneficiaries may continue this coverage. The maximum period of
continuation coverage for a qualifying event is:
- 18 months after employee’s termination for the employee, spouse, Chapter 40 domestic partner or dependent child (ren);
- 36 months after employee’s divorce/termination of Chapter 40 domestic partnership for the spouse/domestic partner or dependent child(ren);
- 36 months after employee’s death for the spouse/domestic partner or dependent child;
- 36 months after the dependent child's loss of eligibility under the plan.
Once an employee’s adult child is no longer considered their dependent for benefit purposes, actions must be taken to remove the child from the employee’s benefit plans. Adult child (ren) who are no longer eligible for health, dental and vision are removed from the plans at the end of the month they turn age 26.
UWSC during the last week of each month will run the query “AGE_26_SQL” and prepare letters and cobra notices for all campuses. We produce two set of letters.
1. 90 day letters & cobra notices are prepared and mailed 90 days in advance, on or before the 1st of the month. These letters are directed to both the dependent and employee, and mailed to the employee’s address, with the expectation the parent will forward the information to the dependent.
2. 30 day letters are prepared and saved at the same time of the 90 day letters. The 30 letters are directed to only the employee. The 1st of the month in which the birthdate occurs the 30 letters are printed and mailed to the employee.
See Process Schedule below.
- Empl ID or
- Employee First and Last Name (not the preferred method)
- Adult Child’s Name
- 90 day letters, COBRA notices and the 30 day letters are sent out. Copies will be mailed to the institution.
- No applications are required for any of the insurances in order to remove the adult child.
- ETF is automatically removing Age 26 adult children from the health coverage at the end of the month they turn 26.
- If the final adult child/dependent is dropping from the health plan, ETF will not change the health coverage from family to single until they receive a fax copy of the 30 day letter from the UWSC. (This letter is replacing the SGH application.)
- The interfaces with VSP and EPIC are updating the data with these plan providers.
- The process flow chart is intended for the UW Service Center Benefits Team and
provides a visual workflow for the Age 26 Dependent COBRA Continuation
- Copies of COBRA notices will be mailed to the institution: Age 26 90 Day Letter Doc
NOTE: The first time you run the process - you will want to make a copy of the Current Version folder saved under S://UW Benefits/Age 26 Dependent Process/Documents-SQL for the Age 26 Monthly Process/Current Version/2016 Age 26 internal process/v# folder to your C drive. Rename to “2016 Age 26 Process”. Do not run the query and macro from the share drives. The macros to merge the data causes problems if ran on a share drive.
a. Within the Current Version folder on your C drive - Open the age_26_excutor_2016_internalProcess.xlsx.
b. Update the path for the buttons in Column B. Click on the button in Column B and select the correct file from the browser with the new location on the C drive. The Path on the C column will automatically update. Do not change the name of the tabs at the bottom or you will break the marcos.
i. PATH = C:\Users\bkwilliams\Desktop\2016 Age 26 Process\xxxxxxxx
ii. Row 3 = PATH\age26_90 day letter_template_2015.docm
iii. Row 4 = PATH\sgh_continuation_form_12-22-15-v2.docm
iv. Row 5 = PATH\Epic_continuationv2.docm
v. Row 6 = PATH\DenWI_continuation.docm
vi. Row 7 = PATH\VSP_continuation_2016.docm
vii. Row 8 = age26_30 day letter_template_2015 Final.docm
c. At beginning of the calendar year create sub-folders in folder: C:\Users\bkwilliams\Desktop\2016 Age 26 Process as follows: Export1-2016, Export2-2016, Export3-2016 … Export12-2016
i. These will be the folders where the merge documents will be saved each month. Once you have created your documents, save them to the appropriate Export period on the C drive. Once you have saved all your documents for that period, move the Export#-2016 folder to the S:\UW Benefits\Age 26 Dependent Process\201X. (Records Retention requires that we save these Export folders for 7 years.)
1) Open the SQL Query Developer program. Click on the HRS data under Connections.
2) Open up SQL Query saved in Notepad – C:\Users\bkwilliams\Desktop\2016 Age 26 Process\AGE_26_SQL.sql
a. Open the Note file by right clicking over the file > Open with Notepad
b. Change the dates at the top of the query:
i. VAR_coverage_start_date should be the first of the month following the end of your birthdate range you are running (i.e. On 4/1/16 when running birthdates for June, you are going to enter 01-July-16)
ii. VAR_birthdate_range_begin should be three months prior to 26 birthday. See Process Schedule. (i.e. On 4/1/16 you will run the query for the birthdate range of 01-June-90 to 30-June-90. ) See Process Schedule
c. Save the updates in the Notebook SQL so you know which dates you used the month prior.
d. Copy and paste from the Notepad into Oracle SQL Developer Worksheet area; click on the green triangle – Run Query
e. Export into Excel (.xlsx), by placing your cursor in the Query Result area, right click, Export,
i. Format: Excel 2003+
ii. File: C:\Users\bkwilliams\Desktop\2016 Age 26 Process\Export4-2016.xlsx (the month you are doing the Export for)
iii. Click on Next
iv. Click on Finish – verify file was saved to appropriate address on the C drive and close the SQL Developer program.
3) Open Export4-2016.xlsx file – this will be used by the UWSC to run macro for preparing the letters and notices. Custom Sort the data by UW_BUSINESS_UNIT, then by LAST_NAME.
4) Open macro executor for the Age 26 process:
a. C:\Users\bkwilliams\Desktop\2016 Age 26 Process\Age_26_executor_2016_internalProcess.xlsb.
b. Update Sheet 1 field B2 “EXCEL file browse” button with the correct file address for this month’s export file (I.e. Export4-2016.xlsx). Hover over B2 button, left click on mouse and select correct file from browse screen. Field C2 will automatically change to the correct Path.i. The letter templates shouldn’t change unless there was a change to a form.
c. Update field B9 “Date Employer Notified” and B13 “Date Notice Provided” to today’s date. (Or 1st of month if doing a few days early. (I.e. 4/1/2016.)
i. These dates normally should be the same.
d. Hit “Execute Merge” button – this starts the macros that generates all the letters and notices. 6 Word documents will be created and opened on your computer.
i. Letter 1 = 90 Day Letter and COBRA notices, Rename 90DayJuneBirthdates
ii. Letter 2 = 30 Day Letters, Rename 30DayJuneBirthdates
iii. Letter 3 = Health COBRA, Rename SGHJuneBirthdates
iv. Letter 4 = EPIC Benefits + COBRA, Rename EPICJuneBirthdates
v. Letter 5 = Dental WI COBRA, Rename DentalJuneBirthdates
vi. Letter 6 = VSP COBRA, Rename VSPJuneBirthdates
e. The Export4-2016 file created in step 3 needs moved to C:\Users\bkwilliams\Desktop\2016 Age 26 Process\Export4-2016 folder after the executor has been run.
f. Save all 6 Word documents to the appropriate Export folder under : C:\Users\bkwilliams\Desktop\2016 Age 26 Process\Export4-2016
g. An Excel file titled age_26 has been created. Rename it age_26JuneBirthdates and move to C:\Users\bkwilliams\Desktop\2016 Age 26 Process\Export4-2016
h. Open the Excel file age_26AprilBirthdates.xlsx and go to tab UW_Madison
i. Right Click on UW_Madison tab at the bottom of the worksheet, click on Move or Copy, check the Create a Copy box, in the To book field select (new book) from the drop down and click on OK button.
5) Review the 90 day letters for accuracy and print all the 2-sided letters from this file.ii. A new worksheet is created. File > Share > Email > Send file to email@example.com - Subject: Age 26 Dependents with April Birthdates
CC: Meghan McKenna.
UWMSN will be making the HRS entries for the Dep/Beneficiary screen and the Health Enrollment/Base Benefits screen for their campus. The UWSC will be creating the letters & notices, and mailing those items
a. Set aside to combine with COBRA Notices.6) Review the 30 day letters for accuracy and close the file. Do not print at this time. (I.e. The 30 day letter created in April are for June birthdates and will be printed and mailed on 6/1.)
7) Review the 4 COBRA files - SGH (2-sided), VSP (1-sided), Dental (1-sided) & EPIC (1-sided) and print all from the files.
a. Combine the 90 day letters with the corresponding COBRA Notices.
b. Make 1 set of copies. The copies are mailed to the Benefit Office at the various campuses. Set these aside until we finish up with the 30 day letters in Step 8. f.
c. Take the original set of 90 day letters and COBRA notices and add the SGH application to the letters that include SGH coverage.
d. On/or around the 1st of the month mail the originals to the Employee.
Note: Since it can take a few minutes to print the SGH 4 page document, send that file to the printer in the mailroom (DOITPR-660WW-MAILRM-HP-CLJ 4700). When getting ready to make copies also use the printer in the mailroom. If you wish, you may use the folding machine in the mailroom.
e. Move the entire Export4-2016 folder to S:\UW Benefits\Age 26 Dependent Process\2016\Export 4-2016 folder. This is the official electronic file we must maintain for 7 years.8) 30 day letter - based on the Process Schedule above, go into the appropriate Export folder and open the 30 Day letter file. (I.e. April 1 you are going to go into 2-2016 Export folder and open the 30DayAprilBirthdates file.)
a. Review the 30 day letters for accuracy.
i. Change letter date if necessary.
ii. Verify that the employee has not terminated or dropped the coverage between the creation date and printing date. If termed, add a text box in the letter indicating term information. Toss this when printed, we do not want to mail. Go into the Export File (C:/Users/bkwilliams/Desktop/2016 Age 26 Process/Export4-2016.xlsx) and highlight terminated employee in red. This will be kept for record retention reasons.
iii. Review the Pending Disability Applications. If there is an application for that employee, add additional wording to letter at the bottom between the 2nd to the last paragraph “If either of the above situations applies…” and the last paragraph “You may contact your institutional….”.
“Our records indicate you have started the disability review process for your adult child. If we have not received a decision from the health provider, by the month your dependent turns age 26, we will remove the dependent from your coverage. If and when the approval of your request is received, your adult child will be added back to the appropriate plans based on the effective date provided in the approval letter. Please remember that this disability approval process is only for your health, vision, Dental Wisconsin and Benefits + plans. An application for each plan you wish your adult disabled child reinstated on, must be submitted to your campus benefits office within 30 days of the health provider’s approval.”
iv. Save the updates to the file.
b. Print the 30 day letters (2-sided), and make a complete set of copies.
c. Mail the original set of 30 day letters to the employee on/or around the 1st of the month.
d. From the set of copies, make an additional copy of all the 30 day letters that indicates the SGH coverage is changing from family to single.
i. Prepare our standard MyETF fax sheet and fax the coversheet and the 30 day letters with single coverage to ETF requesting that ETF makes the entry into MyETF to change the coverage level from Family to Single. Verify after a couple of days that ETF updated the coverage to single in MyETF.
ii. Once the updates are completed in MyETF, file the letters with the other SGH applications.
e. From the set of copies, make the necessary entries into HRS for the Dependent/Beneficiary screen and the Health Enrollment/Base benefits screens. (See Process Outputs for complete HRS instructions.)
f. When you are done updating the HRS Health Enrollment/Base benefits screens, if this is the last dependent, review the HRS Life Enrollment/Base benefits screens. If the employee has SGL S/D coverage, I&F Spouse and/or Dependent coverage; and/or ADD Family coverage – prepare Wiscit for campus benefit administrator. Include the Life information instructing the campus to reach out to the employee to verify if the employee needs to update his/her life insurance coverage.
g. Mail the copies of the 30 day letters and 90 day letters created in Step 7b to the individual campuses.
Process Steps in HRS for UWSC Benefits Team
1. The UWSC will update the Relationship to Employee to “Adult child”. This will prevent the adult child accidentally being added back to the employee’s insurances through the Health Benefits screens (base benefits).
Refer to KB 18182 BN – Add/Update Dependents
2. The UWSC will remove the adult child from the Health Benefits screens (base benefits) by creating an ADM event > Remove Dependent > Age 26 Dependent.
Refer to KB 16483 BN-Adding or Removing a Dependent for Insurance.
Actions Required by Institution Benefit Administrator:
1. Review the 90 day and 30 letters and COBRA notices for accuracy and file in the employee’s benefit folder. Follow Record Retention policy.
- If an error is found, the institution is responsible to create an amended COBRA Notice and mail to the employee/dependent. (Links to the COBRA notices are at the bottom of this document.)
- File copy of amended COBRA Notice in the employee benefit folder. The UWSC does not need a copy.
2. If employee contacts institution with a corrected birthdate, the benefit administrator must collect a birth certificate.
- Update the birthdate on the HRS Benefits > Employee/Dependent Information > Update Dependents/Beneficiary screen and re-enroll the dependent on the HRS Benefits > Enroll In Benefits > Health Benefits screens (base benefits).
- Fax copy of the birth certificate to the UWSC Benefits team requesting us to update the birthdate with ETF.
3. If the employee contacts the institution asking about having their adult child approved for either:
- A disabled adult – follow KB BN - Adult Child Disability Process
- As full-time student that was called to federal active duty when he/she was under the age of 27 years and while he/she was attending, on a full-time basis, an institution of higher education. The adult child must apply to an institution of higher education as a full-time student within 12 months from the date the adult child fulfilled his or her active duty obligation. Contact the UWSC Benefits Team on required documentation.
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Related Policies, Job Aids and Forms
Related Job Aids
- BN - Adult Child Disability Process
- Document 18590 is unavailable at this time.
- Document 31455 is unavailable at this time.
Note: Each plan has its own dependent eligibility guidelines. Additional information can be found at: https://www.wisconsin.edu/ohrwd/benefits/famchng/child-loss-dep-status/