MESSA Group Services Newsletter
November 12, 2013
Adult Children Age 26
With certain restrictions, MESSA health plans provide medical coverage for members’ adult children up to age 26. In some cases, coverage for dependent adult children is extended beyond the age of 26 provided they meet eligibility requirements and have no lapse in coverage. For complete details please refer to the attached MESSA fact sheet entitled “Eligibility Guidelines for Adult Children Age 19 and Older.”
This week we will be mailing letters to our members who currently cover an adult child age 26 notifying them that coverage will end effective Dec. 31, 2013.
In certain circumstances, some of these children may be eligible for continued medical-only coverage (primarily if they have become dependent on their parents again, are unmarried and are currently a full-time college student carrying either 12 undergraduate or 6 graduate credits).Please notify your members of the school district’s cancellation policies if they differ from MESSA’s.
MESSA does not change coverage for dependents or adult children without a signed application from the member. It is the member’s responsibility to notify MESSA of any changes to their child’s eligibility for coverage. Adult Children that are no longer eligible for MESSA coverage should be notified of their COBRA rights.
We will mail to each school business office a report listing the employees to whom we’ve mailed letters. If an employee did not receive a letter or requests another one, please contact our office at 888.888.4167. Please remember that you can check on a dependent’s status on the Dependent Listing Report available in the Business Office area of www.messa.org. This report is generated each month after the invoices are created.
MESSA Group Services
As always, please notify us of any e-mail address additions or changes!
1475 Kendale Blvd., East Lansing, MI 48823
Eligibility Guidelines for Adult Children Age 19 & Older
With certain restrictions, MESSA health plans provide medical coverage for members’ adult children upto age 26. In some cases, coverage for dependent adult children is extended beyond the age of 26provided they meet the eligibility requirements listed below and have no lapse in coverage.
In all cases, an enrollment application for continued coverage is required. Proof of eligibility may berequested before an application is approved. Members must notify their employer and MESSA of anychange in a dependent’s eligibility for coverage. Detailed information on eligibility can be found at www.messa.org.
Age 19 to 25 Dependent Coverage
Dependent adult children (including stepchildren, adopted children, and children for whom themember is legal guardian, however foster children are not eligible for coverage) are eligible formedical, dental and vision coverage until the end of the calendar year in which they turn 25.
Age 19 to 26 Adult Child (Not a Dependent) Coverage
Under the Affordable Care Act (ACA), adult children age 19 to 26 who are not dependent upon themember are eligible for medical-only coverage until the end of the calendar year in which they turn 26(or the end of the month in which they turn 26, at the discretion of the employer). Coverage for theseadult children is provided without regard to majority of support, dependent status, marital status or residency. (If a non-dependent adult child covered under this ACA provision becomes dependent on hisparents again, this medical-only coverage may be continued past age 26 as long as the adult child meets the Age 25 and Older dependent provisions below.)
Age 25 and Older Dependent Coverage
Dependent adult children are eligible for continued medical, dental and vision coverage beyond theend of the calendar year in which they turn 25 and continuously thereafter, provided they meet one ofthe following criteria. Annual verification of eligibility is required.
1. They are a full-time student (carrying 12 undergraduate or 6 graduate credit hours),unmarried, and dependent on the member for the majority of their support.
2. They have a mental or physical impairment, are dependent upon the member for the majorityof their support, and are not capable of self-sustaining employment by reason of their disability.Mental illness is not considered a cause of incapacity and is not a basis for continued coverage.
Ask your local MESSA Field Representative or call
MESSA’s Member Service Center at 800.336.0013.
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