Dependent Eligibility Requirements - Human Resources at Ohio State
Dependent Eligibility Requirements
The benefits available to you and your family reflect Ohio State’s commitment to offering high-quality, affordable options for your family’s health, financial and educational needs. Use the detailed information below to determine if your spouse and children are eligible for Ohio State’s medical, dental and vision benefits.
An individual whose marriage to a covered employee is recognized by the Internal Revenue Service for federal income tax purposes. A legally separated spouse is not eligible.
A dependent child of a covered employee who meets all of the following eligibility criteria:
- Has not reached the age limit of 26 (e.g., 26th birthday); and
- Fits into one of the following categories:
- Employee’s biological child; or
- Employee’s adopted child or child placed with the employee for adoption; or
- Employee’s step-child; or
- Child for whom the employee has legal guardianship, or legal custody, and such child is the employee’s tax dependent
A dependent child may be eligible for continued coverage as a dependent child after attaining age 26 if these four criteria are met:
- The child is and continues to be incapable of self-sustaining employment by reason of physical handicap or intellectual disability.
- The child is and continues to be primarily dependent upon the employee for support and maintenance.
- The child was:
- Covered by a university medical plan when he or she reached the limiting age and the employee makes application for continuation of coverage to the university within 31 days after the child’s loss of coverage due to reaching the limiting age, or
- Covered as a dependent under the medical plan of his or her parent’s employer immediately prior to a loss of coverage under such plan (documentation of prior coverage required) and the employee makes application for continuation of coverage to the university within 31 days after such loss of coverage occurs. In each case, the employee must provide satisfactory proof of the child’s incapacity and dependence upon the employee.
- The employee provides proof of the continuance of such incapacity and dependence upon request by the university.
- Dependents who do not meet the eligibility requirements outlined in this section.
- Dependents who are not successfully verified through the dependent eligibility verification process when requested.
This is intended to be an overview. Refer to the applicable Plan Document for complete information. In the event the information on these pages differs from the Plan Document, the Plan Document will govern.