You can extend your student’s/grad’s health insurance coverage

By LORRAINE SIMPKINS
If your child is age 19 or older and recently graduated or doesn‘t plan to return to school in the fall, you must act quickly to continue his or her coverage under your state health insurance policy.

Your 19-24-year-old unmarried dependent children are eligible for coverage under your NYS Health Insurance Program (NYSHIP) coverage if they are full-time students at an accredited school and are otherwise not eligible for employer group coverage. 

They’ll continue to be eligible until they turn 25, or until the end of the third month following the month in which they complete course requirements for graduation, whichever comes first.
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. 

You must act quickly
If your dependent child, who was a full-time student in the spring semester, does not enroll as a full-time student for the fall semester, he will lose coverage under the parent’s policy after the last day of the month he attended classes as a full-time student. 

If you want to continue his coverage without interruption, you must act quickly in one of two ways. Either:
• Continue coverage for up to 36 months in NYSHIP under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA); or
• Convert to a direct-pay contract.

60-day deadline for COBRA
Under provisions of COBRA, 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 — no excuses are accepted. 
To get a COBRA election form, write to:
NYS Department of Civil Service
Employee Benefits Division
Attn: COBRA Unit
State Office Building Campus
Albany, NY 12239

Include your Social Security number, the dependent’s name, the reason for the request, the date coverage ended and a telephone number where you can be reached during the workday.
COBRA guarantees you the opportunity to continue for up to 36 months the same health care benefits your child has been receiving. But you have to pay the full premium (both the employer’s and employee’s share), plus a 2 percent administrative fee.

If your child is still seeking admission to a school for the fall semester, 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 retroactively reinstated to the date he or she lost eligibility. You will be refunded the COBRA premium you paid during the interim.

Direct pay another option
Children who graduate or otherwise lose eligibility as student/dependents can 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.

Benefits for direct-pay conversion contracts may differ from what your child had under NYSHIP. 

Contact your carrier or HMO directly for premium and benefit information.

Additional information concerning COBRA and direct-pay conversion contracts can be found in the NYSHIP General Information Book for Empire Plan Enrollees dated June 1, 2002 and in the NYSHIP General Information Book for HMO Enrollees dated March 1, 2002, as well as in documents communicating changes made since then.