Effective July 1, 2011, to qualify for dependent coverage under the Plan, a child must: (1) meet the definition of “Child” below, and (2) be under age 26. Under these new rules, a Child under age 26 can qualify for coverage even if he/she is married or has his or her own employment-based health coverage. In addition, a Child under age 26 does not have to be a student to qualify for health coverage.

You or your spouse’s unmarried disabled child aged 26 or older is also eligible for coverage if: the child is incapable of sustaining employment by reason of physical or mental handicap as certified by a physician [1]; the disability occurred prior to the child reaching age 26; you (or your spouse) are chiefly responsible for the child’s support and maintenance.

“Child” Defined: Your natural or adopted child (including a child placed for adoption); your stepchild (your spouse’s natural or adopted child, or child placed with your spouse for adoption); a child for whom you have been appointed a legal guardian [2]; and a child for whom you have been designated as the responsible party under a Qualified Medical Child Support Order (QMCSO).

The newborn child of an enrolled dependent Child is eligible for coverage only from birth up to 31 days immediately following the birth. Coverage for the child of a dependent Child will not be extended beyond 31 days following the birth unless the participant is appointed legal guardian.

West Haven Public Schools

SRBI for English Language Learners

Open Enrollment for Health Insurance - 2011

Changes in Eligibility July 1, 2011