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 largely centralized with the majority of administrative functions being completed by the UWSC. This document focuses on the responsibilities of the institutions.
Under the federal COBRA law, employees and their qualified beneficiaries may continue health insurance coverages. 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.
- The UW Service Center will run the “AGE_26_SQL” query during the last week of each month, 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 the employee. They are mailed to the employee’s last known address with the expectation the parent will forward the information to the dependent.
30 day letters are prepared and saved at the same time the 90 day letters are produced. They will be printed and mailed 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 an adult child.
- ETF will automatically remove any Age 26 adult children from the health plan at the end of the month in which 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 faxed copy of the 30 day letter from the UW Service Center. (This letter is replacing the State Group Health application.)
- The electronic files to VSP and EPIC will update the same information for these plan providers.
- Copies of COBRA notices will be mailed to the institution. See: Age 26 90 Day Letter Doc
ACTIONS REQUIRED BY INSTITUTIONS:
1. Review the 90 day and 30 letters and the COBRA notices for accuracy and file them in the employee’s benefit folder. Follow your campus' Record Retention policy.
- If an error is found, the institution is responsible for creating an amended COBRA Notice and mailing it to the employee/dependent. (Links to the COBRA notices can be found at the bottom of this document.)
- File a copy of the amended COBRA Notice in the employee benefit folder. The UW Service Center does not retain copies of these notices.
2. If the employee contacts the institution with a corrected birthdate, the Benefit Administrator must obtain a birth certificate from the employee.
- Update the birthdate on the HRS Benefits > Employee/Dependent Information > Update Dependents/Beneficiary screen (See: BN - Add/Update Dependents ) and re-enroll the dependent on the HRS Benefits > Enroll In Benefits > Health Benefits screens (See BN - Enrolling, Changing, or Canceling Coverage Using On Demand Event Maintenance ).
- Fax a copy of the birth certificate to the UW Service Center Benefits Team. The UWSC will update the birthdate with the vendors.
3. If the employee contacts the institution asking about having their adult child approved as either:
- A disabled adult – follow KB: BN - Adult Child Disability Process
- A full-time student called to Federal Active Duty while under the age of 27 and while 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. (Please contact the UW Service Center Benefits Team for required documentation.)
- BN - Add/Update Dependents
- BN - Enrolling, Changing, or Canceling Coverage Using On Demand Event Maintenance
- BN - Adult Child Disability Process
- 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
- Age 26 90 Day Letter Doc