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Change in Dependent Eligibility

Applies to:
All benefit eligible employees whose dependent gains or loses benefits eligibility due to Age, Student Status, or Medicaid eligibility.

Answer:
Dependent children are eligible for coverage under UNC Health Care’s various benefit offerings until the age of 19. Coverage may be extended up to age 26 as long as the dependents are full-time students at a college or university. If a covered dependent exceeds the maximum age or ceases to be a full-time college student it is the employee’s responsibility to inform the Employee Benefits office and remove the dependent from his or her benefit elections. Coverage for ineligible dependent will terminate on the last day of the month in which the child turns age 19, age 26 (if a full-time student) or ceases to be a full-time student. The child will be eligible to continue coverage under COBRA; employees may contact the benefit provider for information.

A change in a dependent’s eligibility for Medicaid coverage allows an employee to make appropriate changes to his or her benefits. An employee may remove the dependents from Health, Dental and Vision coverage if they are now eligible for Medicaid, or add the dependents to his or her benefits if they are losing Medicaid coverage.

Change Instructions:
Changes must be initiated within 30 days of the dependent’s change in eligibility, but preferably as soon as possible. If the change increases your insurance premiums, catch-up deductions may apply. All forms may be found online at:

www.unchealthcare.org/benefits

Changes to the Health Insurance:

  • Employees may submit the Online State Health Plan Change to add or remove their child(ren) from their policy. The Date the child exceeded the age limit, became a full-time student or stopped being a full-time student must be noted.
  • If the change is due to gaining or losing Medicaid coverage, select “Medicaid Eligibility Change” and the Date the change in eligibility occurred must be noted.
  • If the employee is not currently enrolled in the State Health Plan, he or she may submit enrollment on the State Health Plan Enrollment Application Online.
  • Please visit the Employee Benefits Web site for current rate information and bear in mind that Health Insurance premiums are collected one month in advance. Catch-up deductions may apply.

Employees should keep a copy of the changes for their records.

Changes to NCFlex Benefit Elections (Vision, Dental, etc):
All changes must be made online; UNC Health Care does not process paper change forms for NCFlex benefits. Employees may log into their NCFlex account online at https://shp-login.hrintouch.com/.

To initiate changes online, employees should:
1) log into their NCFlex account,
2) click on My Account (top right corner),
3) select Add Life Status Change Event (on the left),
4) select the appropriate event from the drop down menu
5) follow the instructions displayed to complete the transaction
6) make the appropriate changes to your benefit elections

This transaction will open the Web site for benefit changes for 30 days from the date of the life event. Employees may call 1-888-860-6118 for assistance with the Web site.

Changes to MetLife Life Insurance:
Employees must go online to http://www.metlife.com/mybenefits to add or remove dependents from their MetLife Life Insurance policy.

Once completed, employees should keep a copy for their records and forward all originals to:
UNC Health Care Employee Benefits, 211 Friday Center Drive, Suite 2057, Chapel Hill, NC, 27517
Example
Ben’s son is turning 19 on March 12, but has decided to travel for a year before going to college. Ben will need to inform the Employee Benefits office and remove his son from his Health, Dental and Vision Insurance effective April 1.

Ben will complete and submit the State Health Plan Change form to remove him from the Health Insurance, making sure to write “3/12/08” on the Maximum Child Age section of the form.

Ben will then log into his online NCFlex account to remove him from his Dental and Vision coverage. When his son returns and begins college, Ben will be able to add him back onto his benefits.

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