Coverage Changes Due to Death

1. Survivor(s) of Active Subscribers
2. Survivor(s) of Terminated Vested Subscribers or Retired Subscribers
3. Death of a Dependent

Survivor(s) of Active Subscribers
Your eligible dependents may participate in one of the MCHCP plans if one of the following conditions is met, they:

• Have had coverage through MCHCP since the effective date of the last Open Enrollment period.
• Have had other health insurance for the six months immediately prior to your death - proof of insurance including effective dates of coverage and termination date is required.
• Have had coverage since first eligible.
  
  AND
  
  You, the subscriber, die:
  
  • As an active vested employee.
  • While vested and are receiving a long-term disability benefit from MOSERS or PSRS based on State employment.

To enroll as a survivor, your dependent(s) must notify MCHCP within 31 days of your death. They must also submit an Application for Survivor to Retain Medical Coverage (M-7) form, a copy of the death certificate and pay the required premium. If survivors do not elect coverage within 31 days, they cannot enroll at a later date. If the survivor marries, has a child, or adopts a child, the dependent must be added when first eligible. If dependents are not enrolled when first eligible, they cannot be enrolled at a later date.

Under certain circumstances, your dependents may qualify for continued medical coverage under provisions of COBRA. Your dependents are responsible for the full cost of the premium from the date of their loss of coverage.

Survivor(s) of Terminated Vested Subscribers or Retired Subscribers
If you, the subscriber, die as a:

• Missouri State Employees' Retirement System (MOSERS) retiree or as a terminated vested subscriber, OR
• Public School Retirement System (PSRS) retiree based on State employment,

dependents covered under your MCHCP plan at the time of your death may continue in one of the MCHCP plans.

Coverage must be elected within 31 days of your death. To continue coverage, your dependent(s) must submit an Application for Survivor to Retain Medical Coverage (M-7) form, a copy of the death certificate and pay the required premium. If coverage is not elected within 31 days, dependents cannot enroll at a later date.

If the survivor marries, has a child, or adopts a child, the dependent must be added when first eligible. If dependents are not enrolled when first eligible, they cannot be enrolled at a later date.

Death of a Dependent
When a covered dependent dies, the dependent’s coverage ends on the date of death. If there is a change in your level of coverage, your premium is pro-rated the month of the death. Submit a Change/Cancellation (M-2) form and copy of the death certificate within 31 days of the death.