Dependent Health Insurance

• Your spouse, as long as he or she is not also separately enrolled as an eligible state employee or retiree.
• Your unmarried children by birth, legal adoption, or legal guardianship who under 19 in your custody and dependent on you for support.

Coverage for your eligible dependents is the same as yours. You may be asked to provide tax returns as proof of dependency and school records as proof of school attendance.

In the case of legal adoption, a child is eligible for coverage as of the date of placement. Placement occurs when you become legally obligated for the total or partial support of the child in anticipation of adoption. A sworn statement with the date of placement or a court order verifying placement is required.

Continuing coverage after age 19

Coverage for your eligible children ceases the end of the month in which they turn 19. However, if your coverage is still active your dependent child can remain eligible through the month in which the child turns 25 if he or she is:

• Unmarried and between age 19 and 25; and
• Dependent on you for financial support; and
• A student who regularly attends school.

You may be asked to provide tax returns as proof of dependency and school records as proof of school attendance.

If your enrolled dependent is an incapacitated child, coverage will continue as long as he or she became incapacitated before age 19, continues to be incapacitated, and your coverage does not terminate for any other reason. Incapacitated children are those who are unable to earn a living because of a mental or physical impairment and must depend on their parents for support and maintenance. To ensure uninterrupted coverage for your incapacitated child, you must furnish proof of incapacitation and dependency before the end of the month in which the child turns 19.

Reporting changes for your dependents

It is your responsibility to notify ORS in writing of any change in your status or that of your family that would result in ineligibility, or of coverage under any other group insurance including Medicare. We will adjust your premium deductions if necessary, but we cannot refund premiums that were withheld before the month in which you report the change.

To report such changes, use miAccount or use the Insurance Enrollment/Change Request (R0452H) form, available from ORS and on the website.

You can use miAccount or the  Insurance Enrollment/Change Request (R0452H) form to add or change the name of someone on your health, dental, or vision insurance contract. If you're adding a spouse or dependent due to marriage, birth, or adoption, be sure to submit the form within 30 days of the event so that the six-month waiting period can be waived. Please include a copy of the marriage, birth, or adoption certificate.

COBRA protects your dependents after eligibility stops

If one of your dependents loses insurance eligibility, he or she may be able to pay for continued coverage for a limited time. A federal law known as the Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows your dependent spouse or child the option of paying for continued health insurance coverage for up to 36 months after a qualifying event.

The insurance carrier may also offer a conversion policy. Your dependents will be notified of these options.