Act now to preserve health benefits for student dependents

May and June are traditionally the months in which most full-time students complete their studies. If you have a child who is age 19 or older and enrolled in the NYS Health Insurance Program (NYSHIP), it is important to determine if he or she remains eligible for coverage.

Your unmarried dependent children who are age 19 or over but under age 25 are eligible if they are full-time students at an accredited educational institution, and are otherwise not eligible for employer group or military health care coverage (e.g., cadets at U.S. military academies). They continue to be eligible until the earlier of the following dates:

Students who want to continue health insurance coverage during the summer must have been enrolled in the previous spring semester and must be enrolled as full-time students for the fall semester. If a dependent child who was a full-time student in the spring semester does not enroll as a full-time student for the fall semester, coverage under the parent's policy will end on the last day of the month in which the student was a full-time student attending classes.

If you want your child to continue to be covered without interruption, you must act quickly in one of two ways:

Under provisions of COBRA (the federal Consolidated Omnibus Budget Reconciliation Act), the employee or a family member is responsible for informing the Employee Benefits Division (EBD) of the NYS Department of Civil Service of a child's losing NYSHIP eligibility within 60 days from the date coverage ends. To obtain a COBRA election form, send a written request to:

Please include your name, address, and social security number, your dependent's name and address (if different), the reason for the request, the date coverage ended, and a telephone number where you can be reached during the workday.

If you do not notify EBD within the required 60-day period, regardless of the reason, the dependent will not be entitled to COBRA continuation coverage.

The health care benefits your child may continue under COBRA are the same benefits you receive as an active employee enrolled in NYSHIP. COBRA requires that your child have the opportunity to continue coverage for up to 36 months. The cost of COBRA coverage is the full premium (both the employer and employee share) plus a two percent administrative fee.

If your child is seeking admission to a school over the summer, but has not yet been accepted, coverage should be continued through COBRA. Once your child's enrolled for the fall semester, his or her dependent student status will be reinstated back to the date he or she lost eligibility and the COBRA premium paid during the interim will be refunded.

In addition to continuation through COBRA, children losing eligibility are entitled to convert to direct-pay contracts after their NYSHIP coverage ends. Notification procedures and deadlines for applying for conversion coverage vary among the NYSHIP health care plans.

The benefit package for direct-pay conversion contracts may differ from what your child had under NYSHIP. To obtain premium information, contact the carrier or HMO directly.

Additional information concerning COBRA and Direct-Pay Conversion Contracts can be found in the January 1, 1996 NYSHIP General Information Book and the documents communicating changes made since then. You may also contact your agency health benefits administrator, who is usually located in your Personnel Office, for assistance.