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Employer Bulletin

State Agencies & Local Health Employers
Vol. 18, State 19
November 28, 2001

Annual Student/Dependent Status Letters

The Department of Employee Trust Funds (ETF) annually sends participating health insurance plans an instructional memo providing a template student/dependent status letter and questionnaire. You will find copies of each of these items attached.

As noted in the instructions, each plan forwards each employer a list of employees whose coverage has automatically been changed from family to single because the subscriber no longer has a covered dependent. In this case, the employer must request a Health Insurance Application (ET-2301) from the employee changing from family to single coverage. In addition, the employer must issue a Continuation/Conversion Notice (ET-2311) to the dependent.

When family coverage remains in force but a dependent is removed from coverage, the employer must have the subscriber complete an Information Change Form (ET-2329) deleting the dependent from the existing family contract. The employer must also issue a Continuation/Conversion Notice (ET-2311) to the dependent.

If evidence of the dependent's eligibility is later provided, the plan will reinstate coverage.

Please call the Employer Communication Center at (608) 264-7900 with questions


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