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Department of Employee Trust Funds
September 19, 2012

2013 Dependent Eligibility Information

Dependent Information

Single coverage covers only you. Family coverage covers those described below. All eligible, listed dependents are covered under a family contract.

Dependent Eligibility

Who is eligible as a dependent if I select family coverage?

  • Your spouse.
  • Your domestic partner if elected.
  • Your children who include:
  1. Your natural children.
  2. Stepchildren or children of your domestic partner insured on the policy.
  3. Adopted children and preadoption placements. Coverage will be effective on the date that a court makes a final order granting adoption by the subscriber or on the date the child is placed in the custody of the subscriber, whichever occurs first. These dates are defined by Wis. Stat. § 632.896. If the adoption of a child is not finalized, the insurer may terminate coverage of the child when the adoptive placement ends.
  4. Legal wards that become your permanent ward before age 19. Coverage will be effective on the date that a court awards permanent guardianship to you (the subscriber or your spouse or domestic partner).

Note: Children may be covered until the end of the month in which they turn 26. His/her spouse and dependents are not eligible. Upon losing eligibility, they may be eligible for COBRA continuation.

Coverage may continue beyond that when children:

  1. Have a disability of long standing duration, are unmarried and dependent on you or the other parent for at least 50% of support and maintenance, and are incapable of self support;
  2. OR

  3. Are full-time students and were called to federal active duty when they were under the age of 27 years and while they were attending, on a full-time basis, an institution of higher education.
    The adult child must apply to an institution of higher education as a full-time student within 12 months from the date the adult child fulfilled his or her active duty obligation.

  • Your grandchildren born to your insured dependent children may be covered until the end of the month in which your insured dependent (your grandchild’s parent) turns age 18. Your child’s eligibility as a dependent is unaffected by the birth of the grandchild.

IMPORTANT NOTE: There are state and/or federal tax consequences to you when you provide coverage for dependents that do not meet the support test for federal income tax purposes. An example is a domestic partner who is not dependent on you for at least 50% of their support and maintenance.

Imputed Income Tables (Fair Market Value for Non-Tax Dependents)


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