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• If the court decree does not specify the parent responsible for the child's health care expenses,
the policy of the parent with custody pays first. The policy of the parent without custody pays
second.
• If the parent with custody has remarried, the order is as follows:
1. The policy of the parent with custody;
2. The policy of the step-parent
3. The policy of the parent without custody
Young Adult Dependent Coverage
Effective January 1, 2011, the new Health Care Reform Act allows young adults ages 19 through 26 to be
covered through a parent’s group health insurance policy regardless of their student status. Under the
new Young Adult Dependent Option, eligible young adults may continue coverage once they reach the
maximum age of dependency (age 26).
Please note, that the Young Adult Option premiums are included in the cost of family coverage.
However, in order to continue dental/vision benefits with your union you will need to provide proof of
full-time student status for eligible dependents 19 – 25. The Health Care Reform act only covers Health
Insurance not Dental/Vision.
Once a dependent reaches the maximum age of 26 the Young Adult Option Coverage will be available.
Please see criteria below.
Young Adult Option Coverage
At the end of the month in which your child reaches age 26, they will no longer be dependents under
your active employee health plan. Information will automatically be mailed to the address on file from
the Department of Civil Service Employee Benefits Division regarding continuing coverage under the
plan.
Please note, that the Young Adult Option premiums are paid by the young adult or parent, not the
employer. The cost is the full cost of individual coverage for the NYSHIP option selected.
Birthday Rule
The coordination of benefits establishes the order of payment when more than one policy is involved. IF
the child is covered by both parent’s plans, the order of payment for dependent children’s claims will be
determined by which parent’s birthday falls earlier in the calendar year.
In the case of divorce or separation of the parents, the order of payment works as follows:
• If a court decree states that one of the parents is responsible for the child’s health care expenses,
the policy of that parent will pay first;
• If a court decree does not specify the parent responsible for the child’s health care expenses,
the policy of the parent with custody pays first. The policy for the parent without custody pays
second.
• If the parent with custody has remarried, the order is as follows:
1. The policy of the parent with custody