Dependent Eligibility

Your Dependents

A spouse is also eligible for Trust coverage for the duration of the marriage, as long as you remain enrolled in the plan.

In order for dependent children to be eligible for Trust coverage they must meet all five eligibility requirements.

1. Relationship

Children are defined as natural or legally adopted, stepchild (child of your current spouse), a child placed with you for legal adoption who is under age 18 or a child by legal guardianship.

2. Age

Children may be eligible until the end of the calendar month in which they reach age 26. They are not subject to this restriction if they are determined to be permanently and totally disabled prior to the end of the calendar month in which they reached age 26.

3. Marital Status

Children must not be married.

4. Residency

Children must live with you as a member of the household, or you must have legal responsibility for providing health care coverage for the child and the child must reside with the custodial parent.

5. Dependency

Children must be dependent on you, which means you can claim an exemption on your federal income tax return unless you are responsible for their medical coverage due to a divorce decree or Qualified Medical Child Support Order (QMCSO).

Adding Dependents

Only retirees (not surviving spouses) can add dependents to Trust coverage. To add a dependent, contact Retiree Health Care Connect (RHCC) (866-637-7555). You will need to provide the dependent’s date of birth, date of the event (such as marriage, birth or adoption, court order/Qualified Medical Child Support Order (QMCSO), etc.) and Social Security number. After a dependent is added, proof of eligibility documentation will be requested. Requested proof could include copies of marriage certificates, driver’s licenses, birth certificates, front page of federal income tax returns, court orders, signed affidavits or other specified documents. Failure to provide all required documentation, including proof of dependent status and Social Security number, may result in the denial or cancellation of dependent coverage. 

When does coverage begin?

You should contact Retiree Health Care Connect to add your new dependent within 30 days from the date of the event. If the request is made within 30 days of the event, coverage will begin on the date of the event. If reported more than 30 days after the event, coverage will begin the first day of the month following notification to Retiree Health Care Connect and after all required proof is submitted.

Identification cards for the new dependent are typically received within 7-10 business days after the health plan carrier receives the information.

 

Removing Dependents

Dependents who no longer meet the five eligibility tests must be removed from coverage. Additionally, spouses must be removed in the event of divorce. It is your responsibility to contact RHCC when a dependent or spouse become ineligible for coverage. Failure to drop an ineligible dependent or spouse may result in financial responsibility to you – equal to all health care costs inappropriately paid by the Trust on behalf of the ineligible dependent or spouse.

Audits

Periodically, the Trust will request that you validate the eligibility of dependents covered under your health plan. In the event of a dependent audit, you may be required to provide documentation such as birth certificates, death certificates, tax return copies and/or marriage certificates. You’ll want to make sure you respond to all requests for documentation; if you ignore this request, your dependent(s) may lose coverage.