Insurance Eligibility for Dependents
Effective January 1, 2011, the Patient Protection and Affordable Care Act allows your dependent children to continue eligibility for coverage up to age 26 regardless of their full-time student status.
Disabled Dependent Child(ren)
Dependent children who are disabled prior to age 26 and incapable of self-sustaining employment by reason of mental incapacity or physical disability are eligible for Flexible Benefits coverage if:
- The disabled child is already enrolled in the Flexible Benefits Program and turning age 26, you must provide proof (completed Disabled Dependent Certification Form) of the child’s disability within 31 days of the child turning 26 and when requested by the Flexible Benefits Program to continue coverage or recertify your dependent.
- To enroll a disabled child as a newly eligible dependent, the child must be disabled prior to age 26. You must provide proof of the child’s disability (completed Disabled Dependent Certification Form) within 31 days of enrollment in the Flexible Benefits Program.
Active employees and retirees whose dependents are currently enrolled for coverage, must complete and submit the Disabled Dependent Certification Form and any supporting documentation within 31 days of the disabled dependent turning 26 to Department of Administrative Services/ Human Resources Administration.
Note: Disabled dependents certifications approved by the State Health Benefit Plan (SHBP) do not transfer to the Flexible Benefits Program. Failure to certify or re-certify your disabled dependent, will result in the loss of the dependent’s coverage permanently.
The Flexible Benefits Disabled Dependent form is available on the DOAS website here.
End of Dependent Eligibility Status
If your child is 26 and no longer meets the definition of an eligible dependent under the Flexible Benefits Program, he or she may choose to continue their coverage under COBRA. A COBRA application will automatically be sent to you once your dependent’s coverage has been terminated. Dependent children who are canceled from their parents’ plan can continue coverage by paying the full cost, plus any administrative fee. Please contact the GaBreeze Benefits Call Center at 1-877-342-7339, if you have questions.
