Dependent Eligibility Criteria
SMU requires that all dependents enrolled in SMU Benefits Plans meet the eligibility criteria outlined below. It is extremely important that you understand the eligibility criteria and enroll only
those dependents that meet this criteria. Covering dependents that are not eligible is a violation of the Internal Revenue IRS Code, as well as University Policy. If your child is ineligible or becomes ineligible for coverage you must notify the Department of Human Resources by emailing email@example.com
What Are The Dependent Eligibility Rules?
Eligible dependents include your legal spouse or qualified domestic partner, and dependent children (including dependent children of a qualified domestic partner). "Children" are defined as your natural children, stepchildren, legally adopted children, and children under your legal guardianship.
- Medical Plans: Children until age 26 -- even if the child no longer attends college, doesn't live with his/her parents, is married, and/or is not a declared dependent.
- Coverage ends on the day prior to attainment of age 26.
- Dental Plan: Unmarried children until age 19 (or until age 25 if a full-time student).
- If the dependent is not a full-time student at age 19, coverage ends on the last day of the month in which the 19th birthday occurs.
- If the dependent ceases to be enrolled as a full-time student prior to the 25th birthday, coverage ends on the last day of the month in which he/she ceases to be a full-time student.
- If the dependent continues to be enrolled as a full-time student, coverage ends on the last day of the month in which the 25th birthday occurs.
- Vision Plan: Unmarried children until age 25 (regardless of student status).
- Coverage ends on the last day of the month in which the 25th birthday occurs.
- Dependent Life Insurance Plan: Unmarried children until age 25 (regardless of student status) and unmarried natural or adopted grandchildren, until age 25, who are financially dependent upon you for support.
- Accidental Death & Dismemberment (AD&D): Unmarried children until age 25 (regardless of student status) and unmarried natural or adopted grandchildren, until age 25, who are financially dependent upon you for support.
Physically or mentally disabled children of any age who are incapable of self-support are eligible for continued coverage. Proof of disability is required.
Loss of Dependent Eligibility
Please review the COBRA page for information regarding coverage options for dependents who no longer meet the eligibility requirements for SMU medical, dental, or vision coverage.
"Michelle's Law" became a federal law effective October 2009. This legislation enables students suffering from a serious illness or injury to take a medical leave during which they may reduce their course load to less than full-time or leave college for up to 12 months, to concentrate on their health needs - without jeopardizing the insurance they rely on to help pay for necessary medical services. Following are several key points. If you have a child in this situation please call the Department of Human Resources at 214-768-3311.
- This legislation allows full-time college students to take up to 12 months medical leave.
- It applies to students who are covered under their parent's health insurance plan.
- "Medical leave" can mean that the student is absent from school or reduces his/her course load to part-time.
- The date the medical leave begins is determined by the student's physician.
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