FEDweek

Anticipating When Children Will Lose Benefits

One consideration for older employees and retirees is that children’s eligibility for certain benefits changes as they age. Complicating the issue is that children’s benefits vary by type of benefit. Bear in mind that a major change that took effect in 2011, raising the eligibility age for continued health insurance coverage, did not affect the policies of other benefit programs.

Under the Federal Employees Health Benefits program, a child can be covered under self-and-family enrollment until he or she turns age 26. Children who lose coverage under your self-and-family enrollment may enroll for Temporary Continuation of Coverage for up to 36 months. Your children may also choose to convert to a private policy. To convert the child’s coverage to a nongroup plan, you or the child must apply directly to the health benefits plan within 31 days after the child’s eligibility ends.

A child has a 31-day temporary extension of coverage, at no cost, for the purpose of converting to a nongroup contract with his or her current health benefits plan. This is true even when the child also has the right to elect Temporary Continuation of Coverage. A child who elects temporary coverage instead of the conversion policy has another opportunity to convert to a nongroup contract when the temporary coverage ends (other than by cancellation).

In contrast, under the Federal Dental and Vision Insurance Program, eligible dependent children must be unmarried and under age 22, or if age 22 or over, incapable of self-support because of a mental or physical disability that existed before the child reached age 22. The same policy applies under Federal Employees Group Life Insurance Option C family coverage.

Under the Federal Employees Compensation Act, benefits paid to a child due to a parent’s receipt of FECA benefits end when the child marries or reaches age 18. Benefits can continue, however, after age 18 if the child is a full-time student, unmarried, under age 23, and has not completed four years of education beyond high school. They can also continue if the child is incapable of self-support because of physical or mental disability.

Eligibility for child survivor annuity benefits also generally end when a child reaches age 18 or marries; benefits can continue after age 18 if the person is incapable of self-support because of a disability incurred before age 18 or is a full-time student. Annuity benefits that were stopped because the child attained age 18 can be resumed if the person is unmarried and becomes a full-time student before reaching age 22. Annuity benefits that were stopped because the child married cannot be resumed if the marriage later ends due to divorce or death, although in some cases they can be continued if the marriage is annulled.