Domestic Partner

Your domestic partner and his/her children are eligible for COBRA coverage. Your domestic partner is eligible for coverage as long as he/she:

• Shares your permanent residence;
• Has resided with you for no less than 12 months;
• Is no less than 18 years of age and is not related to you by blood in a manner that would bar marriage under applicable state laws;
• Is financially interdependent  with you and has proven such interdependence by providing documentation of at least two of the following arrangements:

• • Joint mortgage or lease for a residence.
  • Joint ownership of a motor vehicle.
  • Joint bank or investment account, joint credit card or other evidence of joint financial responsibility.
  • A will and/or life insurance policies which designates the other as primary beneficiary, beneficiary for retirement benefits, assignment of durable power of attorney or healthcare proxy.

To add a domestic partner, a participant must register, under applicable state or municipal laws or provide a duly sworn Affidavit of Domestic Partnership confirming the eligibility above. In addition, the definition of domestic partner will be met as long as neither partner:

• Has signed an Affidavit of Domestic Partnership or declaration with any other person within 12 months before designating each other as domestic partner;
• Is not legally married to another person; or,
• Does not have any other domestic partner, spouse, or spouse equivalent of the same or opposite sex.

 

Children

Children can include natural born children, stepchildren, adopted children and children for whom you have been appointed legal guardian. Children of your domestic partner are eligible for coverage only if the domestic part.

Over 26 Years of Age

A provision in the Patient Protection and Affordable Care Act (PPACA) Healthcare Reform allows for a participant’s adult child to be covered under the participant’s healthcare plan until they reach age 26. Coverage applies regardless of the adult child’s status as a student or marital status. There is no requirement to cover children of dependent children. This provision went into effect on March 30, 2011. For the full definition of an eligible child, view the FSA FAQs at www.tasconline.com. Dependents who reach age 26 are covered through the end of the calendar year in which they reach age 26. As covered dependents, you are offered the opportunity to continue your health, dental and vision coverage for up to 36 months from the first of January following the year you turn 26.

Newborn Child

A natural born child, adopted child, the child of your Domestic Partner, or a child for whom you have been appointed legal guardian who is born or becomes eligible while a policy is in effect will be covered from date of birth/event. However, coverage is not automatic. You must request a change in status form within 30 days of the event and add your newborn child(ren)’s information.

 

Note: Your newborn will be covered free of charge for the first 31 days.

 

However, you must call and request a change in status (CIS) form within the 30 days for coverage to become active.

• If you request your dependent’s coverage be terminated within the first 31 days, the termination is effective the day you request it, but no later than the 31st day. You will have to submit your cancellation in writing.
• If you do not submit your dependent’s termination of coverage in writing, your dependent will remain actively enrolled and you will be billed from the 32nd day. You will pay the daily newborn rate until the day prior to the next month.
• If you add your dependent after the 31st day but within 60 days from birth/event,  your dependent will be effective retroactive to the day of birth and you will be charged the full coverage amount.

Disabled Children

Coverage may be kept in force beyond the age limit for any child who becomes totally disabled while covered under any of the plans. Proof of disability (Social Security disability documentation) must be provided to the Office of Risk and Benefits Management.

Grandchildren

A newborn child of a covered dependent is eligible from birth until the end of the month in which the child reaches 18 months of age. However, if the parent becomes ineligible during the child’s 18 month eligibility period, coverage for both the parent and child will terminate.

Adult Child

A provision in the new Patient Protection and Affordable Care Act (PPACA) Healthcare Reform allows for a participant’s dependent to be covered under the participant’s healthcare plan until they reach age 26. However, the School Board will continue to provide coverage for regular dependents until the end of the calendar year in which they reach the age of 26. The dependent will be deemed an Adult Child the following calendar year. For the full definition of an eligible child, view the FSA FAQs at www.tasconline.com. Under Florida law, a dependent adult child ages 26-30 may be considered an eligible dependent for the purposes of “health” insurance.

 

For medical coverage offered under the M-DCPS plan, you may add or continue to cover your dependent until the end of the calendar year in which the child reaches the ages of 26-30, if the adult child:

• Is dependent upon you for support;
• Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group, blanket, or franchise health insurance policy or individual health benefits plan, or is not entitled to benefits under Title XVIII of the Social Security Act.

 

In addition, the following dependent eligibility documents must be submitted with your completed enrollment form prior to the adult child dependent being added to your healthcare coverage:

• Affidavit of Eligibility (See Dependent Information section)
• Birth Certificate or court documents of adoption/guardianship/legal custody
• Social Security number
• Driver’s license

 

Note: A currently covered adult child will not automatically remain covered for next year; they must be re-enrolled.