Coverage for Dependents

• Spouse
• Domestic Partner
• Children
• Your College Student

If you are making an election to cover for the FIRST time a spouse, domestic partner, or child(ren) with medical, vision, and/or dental coverage, documentation of the relationship is required. 

For a spouse, present a marriage certificate with the enrollment form to the Human Resources Benefits Department; otherwise, your election will not be put into effect.  For dependent child(ren), a birth certificate(s) must be presented; otherwise your election will not be put into effect.  Paperwork for adopted or stepchildren is also applicable.

For a domestic partner, contact the Human Resources Benefits Department to schedule an appointment for review of a completed Affidavit of Domestic Partnership, along with an enrollment form.  For dependent child(ren), a birth certificate(s) must be presented; otherwise, your election will not be put into effect.  Paperwork for adopted children is also applicable.

If you are making an election to delete a spouse or domestic partner due to the end of a relationship, a copy of a divorce decree or dissolution form is required.

Spouse

A faculty or staff member’s spouse, under a legally valid existing marriage between two persons of the opposite sex, is eligible to be covered on the insurance policy.

In the event of a divorce, the ex-spouse must be removed from your policy within 60 days of the divorce being finalized as stated by the date on the official divorce decree. A copy of the divorce decree must be submitted with the appropriate status change paperwork to remove the ex-spouse from your policy. Once the paperwork has been received and processed, COBRA notification will be sent to offer a continuation of coverage for the ex-spouse.

Domestic Partner

To enroll a domestic partner, an approved Affidavit of Domestic Partnership with supporting documentation of a consecutive 12-month relationship is required. Approved affidavits allow enrollment in medical, dental, vision coverage.

In the event of a dissolution of the domestic partnership, the ex-domestic partner must be removed from your policy within 60 days of the event being finalized as stated by the date on the statement of termination of domestic partnership. A copy of the statement must be submitted with the appropriate status change paperwork to remove the ex-domestic partner from your policy. Once the paperwork has been received and processed, COBRA notification will be sent to offer a continuation of coverage for the ex-domestic partner.  

Children

General Overview

Unmarried biological children, stepchildren and adopted children who are solely dependent upon you for support are eligible to be covered on your insurance policy up until the age of 25 (if he or she is a full-time student).

Newborns

Newborn children are automatically covered under your policy from the moment of birth to a maximum of 31 days from the date of birth. You will need to complete status change paperwork with the Office of Human Resources within those 31 days to add the newborn to your policy so that they may continue coverage beyond that time period. If paperwork is not completed within those 31 days, UPMC Health Plan will terminate the child’s coverage.

Dependent Children between the Ages of 19-25

Dependent children who are between the ages of 19 and 25 must be full-time students in order to remain on your policy. Proof of full-time student status is required once your child reaches 19 years of age and from then on annually for your child to remain on your policy. If your child is not in school on a full-time basis, graduates, or reaches the age of 25, you will need to complete status change paperwork with the Office of Human Resources to remove him or her from your policy.  This is very important in the event that you are audited. Once your child is removed from your policy, COBRA notification will be sent to offer a continuation of coverage.

Disabled Dependents

Eligibility will be continued past the age of 19 for unmarried dependent children who, as medically certified by a physician, are incapable of self-support due to mental retardation, physical disability, mental illness or a developmental disability that started before age 19. UPMC Health Plan will require medical documentation.