Spouse
A faculty or staff members spouse, under a legally valid existing
marriage between two persons of the opposite sex, is eligible to be covered on
the insurance policy.
In the event of a divorce, the ex-spouse must be removed from your policy
within 60 days of the divorce being finalized as stated by the date on the
official divorce decree. A copy of the divorce decree must be submitted with
the appropriate status change paperwork to remove the
ex-spouse from your policy. Once the paperwork has been received and processed,
COBRA notification will be sent to offer a continuation
of coverage for the ex-spouse.
Domestic Partner
To enroll a domestic partner, an approved
Affidavit of Domestic Partnership with supporting documentation of a
consecutive 12-month relationship is required. Approved affidavits allow enrollment
in medical, dental, vision, dependent life insurance, and long-term care coverage.
Education benefits are also provided with an approved affidavit.
In the event of a dissolution of the domestic partnership, the
ex-domestic partner must be removed from your policy within 60 days of the
event being finalized as stated by the date on the statement of termination of
domestic partnership. A copy of the
statement must be submitted with the appropriate status
change paperwork to remove the ex-domestic partner from your policy.
Once the paperwork has been received and processed, COBRA
notification will be sent to offer a continuation of coverage for the
ex-domestic partner.
Children
General Overview
Unmarried biological children, stepchildren and adopted children
who are solely dependent upon you for support are eligible to be covered on
your insurance policy up until the age of 25 (if he or she is a full-time student).
Newborns
Newborn children are automatically covered under your policy from
the moment of birth to a maximum of 31 days from the date of birth. You
will need to complete status change paperwork with the
Office of Human Resources within those 31 days to add the newborn to your
policy so that they may continue coverage beyond that time period. If paperwork
is not completed within those 31 days, UPMC Health Plan will terminate the
childs coverage.
Dependent Children between the Ages of 19-25
Dependent children who are between the ages of 19 and 25 must be
full-time students in order to remain on your policy. Proof of full-time
student status is required once your child reaches 19 years of age and from
then on annually for your child to remain on your policy. If your child is not
in school on a full-time basis, graduates, or reaches the age of 25, you will
need to complete status change paperwork with the
Office of Human Resources to remove him or her from your policy. This is
very important in the event that you are audited. Once your child is removed
from your policy, COBRA notification will be sent to
offer a continuation of coverage. For additional information on coverage
for your college student,
click here.
Disabled Dependents
Eligibility will be continued past the age of 19 for unmarried
dependent children who, as medically certified by a physician, are incapable of
self-support due to mental retardation, physical disability, mental illness or
a developmental disability that started before age 19. UPMC Health Plan will
require medical documentation.
Documentation Requirements for Dependents
If you are making an election to cover for the FIRST time a spouse, domestic
partner, or child(ren) with medical, vision, and/or dental coverage,
documentation of the relationship is required.
For a spouse, present a marriage certificate with the enrollment form to the
Human Resources Benefits Department; otherwise, your election will not be put
into effect. For dependent child(ren), a birth certificate(s) must be
presented; otherwise your election will not be put into effect. Paperwork
for adopted or stepchildren is also applicable.
For a domestic partner, contact the Human Resources Benefits Department to
schedule an appointment for review of a completed Affidavit of Domestic
Partnership, along with an enrollment form. For dependent child(ren), a
birth certificate(s) must be presented; otherwise, your election will not be
put into effect. Paperwork for adopted children is also applicable.
If you are making an election to delete a spouse or domestic partner due to the
end of a relationship, a copy of a divorce decree or dissolution form is
required.
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