Important: Always refer to your employee booklet for the most accurate and relevant information related to the specifics of your coverage!
If you are covered under an Employee Benefits plan, chances are this coverage also applies to your dependents. It's vital that when you enroll for your benefits plan that you include all dependent information so that they can be added immediately and you can avoid problems later.
Below we'll talk about how this coverage works, when it starts, ends, and also discuss how you can maintain coverage for your child-dependent even after they have become an adult.
Note: If you are enrolling today and don't include your child-dependent in your signup, you may not be able to add them later on. This is because insurance companies typically don't allow insureds to add dependents at-will, but require them to be added during your "open enrollment" when you first join the plan. There are some exceptions to this which we won't cover here. The main thing to remember is that adding dependents later may not be possible, or you may be required to submit medical evidence information in order for coverage to be approved.
As a Member of a benefits plan and with few exceptions, your children also receive coverage from your provider. The time to add your child dependents are when you first enroll, when your child is born, or when you become to primary guardian of a child.
Submit claims for you children - You can submit claims for your dependents the same way you submit your own claims. You can even give your dependent access to submit their own claims with the Member App, just ensure to include an email address for their account when you enroll them.
Covered until age 21 - Your child-dependent is eligible as long as they are under the age of 21 years old. When your child turns 21, they are considered an "overage dependent" and are no longer eligible to submit new claims with a couple notable exceptions - let's go over those now. Simply Benefits will notify you when your dependent is close to termination so you don't need to try to remember this.
Overage Dependent Coverage
Student-Dependent Status Dependent-Children who are enrolled full-time (minimum 9 credit-hours) at a recognized educational system may be eligible to retain coverage as an overage-dependent - this is referred to as "Student-Dependent Status". You will need to submit student declaration information to Simply Benefits which then needs to be approved by the insurer. This needs to be submitted each year from the date you first submit it. Your child's Student-Dependent status can remain as long as they are a student or until they reach age 25. To get started, contact your employer's Plan Administrator, or contact firstname.lastname@example.org.
Disabled-Dependent Status If you are the primary caregiver of an eligible disabled dependent, they will be covered under your employee benefits plan. Eligibility for this can be complicated, but our team is ready and able to help you understand whether this is an option for you. Although this article is focused on coverage for your dependent-children, it's important to note that not only children are eligible for disabled-dependent coverage. If your child is faced with a disability, contact your employer's Plan Administrator, or contact email@example.com and we will be ready to help!
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