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.
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/or 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.
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.
30 day letters are prepared and saved at the same time of the 90 day letters and are printed and mailed directed to the employee only on the 1st of the month in which their birth date occurs.
- 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.
- Copies of COBRA notices will be mailed to the institution: Age 26 90 Day Letter Doc
ACTIONS REQUIRED BY INSTITUTIONS:
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.
- Child Loses Dependent Status Due to Age chart
- Dental Wisconsin Continuation Form
- EPIC Benefits+ Continuation Form
- VSP Continuation Form
- State Group Health Continuation-Conversion Notice