Changes in Dependent Status

If a covered dependent loses his/her eligibility, you must immediately notify MCHCP and terminate his/her coverage. MCHCP must be provided with the date of loss of eligibility (i.e. date of marriage of child, date of divorce from spouse, date of emancipation of child, etc.) The dependent’s coverage will terminate at the end of the month in which such loss of eligibility occurs. Should MCHCP later discover a non-eligible dependent covered by the Plan, MCHCP will take all necessary actions, including legal actions against the subscriber, to recover costs incurred for such ineligible dependents. Further, should MCHCP determine that you knowingly engaged in fraudulent activity by providing someone with coverage who was not eligible, MCHCP may immediately terminate your coverage and refuse to provide you with coverage in the future. If your emancipated child regains dependent status, the child may be added to your coverage if application is made within 31 days of the status change.

Submit the following:

• Change/Cancellation (M-2) form
• Proof of eligibility

  AND, either

• Letter from previous insurance carrier or former employer (if dependent had group insurance while emancipated) stating that the coverage has been terminated, the reason for coverage termination (i.e. reduction in hours), individual covered, and the date coverage was terminated

  OR

• Documentation that proves the child meets the requirements to qualify as an eligible dependent (i.e. proof of student status, divorce documentation, proof of address change)

Example #1: Your 20 year old child is covered under group health insurance through his/her employer. He/she decides to quit work and attend college. He/she has regained dependent status and can be added to your coverage with proof of:

• Class schedule.
• Loss of coverage.
• Eligibility.