Who is eligible for NY DU30 continuation?
For an overage dependent to be eligible, the parent(s) of the dependent must be actively covered under a New York issued group health contract. Eligible dependents must be the insured's child (by blood or by law) and must meet all of the following criteria:
- Under the age of 30
- No dependents
- Not covered as a named subscriber, enrollee or covered person under any other health plan including Medicare
- Lives, works, or resides in the service area of the insurer's network-based policy or contract
Length of continuation
The continuation will cease on the earliest of the following events:
- The dependent's 30th birthday
- The dependent voluntarily terminates coverage
- The employee (insured) loses coverage
- The date the dependent becomes covered under another group plan
- The date the dependent marries
- The date the dependent moves out of state
- The date on which due premium is not paid
- The date on which the group plan terminates or the date the employee's employer terminates participation under the group plan.
If coverage is replaced by another group policy, the employee and the dependent have the right to become covered under the new policy for the balance of their continuation period.
How do I add my dependent?
A supplemental enrollment form needs to be signed and returned to Justworks. You can request a form by emailing our support team. Justworks will then confirm the dependent is eligible for the extended coverage and forward the form to Aetna. Aetna will need to receive the enrollment form within 31 days of the qualifying event (date dependent would otherwise age off plan). Aetna will then set up a specific CSA for the overage dependent. The dependent will retain the plan that the employee/dependent is currently enrolled in.
How much will this cost?
The premium charge for overage dependent coverage is 100% of the single rate of the plan in which the parent is enrolled. This is the rate that will be billed to the dependent.
How does billing work?
Aetna bills overage dependents directly, and he/she will remit the premium directly to Aetna. Aetna's Individual Billing Administration (IBA) department will do the billing. Enrollees will be required to enter an address in the "Direct bill dependent" section on the supplemental enrollment form even when it is the same as the employee's address.
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.