Benefit Reference Guide - The School District of Palm Beach County

Dependent Eligibility Requirements
Dependent verification is required to complete your request to add
eligible dependents to a plan. You will be required to provide written
documentation which supports your relationship and shows that
your dependent(s) satisfy the dependent eligibility criteria as outlined
below. The supporting documentation will need to be mailed or
brought to the Risk & Benefits Management Department within 30
calendar days of your initial eligibility date.
Subject to dependent verification, you may enroll eligible
dependents in most plans that you elect to enroll in. However, if
you and your eligible dependent are both employed and eligible
for benefits through the District, keep in mind that you may only be
enrolled in any given product as either an employee or a dependent
but not both. Domestic partner enrollment is limited to medical,
dental and vision plans*.
* You may only enroll your registered domestic partner in medical, dental and
vision plans - not term life insurance.
Dependent Eligibility
Subject to dependent verification documentation, an eligible
dependent includes your legal spouse, domestic partner (subject
to additional eligibility criteria) or an dependent child. The term
“child” is defined as:
• a child born to or legally adopted by you.
• a stepchild.
• a child of a covered domestic partner.
• a child placed in your home pending adoption.
• a child for whom legal guardianship/custody has been awarded
to you or your spouse.
• a grandchild added as a newborn up to a maximum of 18
months of age. Coverage continuation beyond 18 months of age
is not available to grandchildren.
NOTE: If the grandchild’s parent (your child) becomes ineligible,
coverage for the grandchild and the grandchild’s parent will
terminate at the end of the month in which the eligibility criteria is
not met.
The definition of eligible “child” is subject to the following
conditions and limitations:
• Dependent child under the age of 26
• Supporting documentation such as a birth certificate will be
required as dependent verification
Benefit Coverage for Over Aged Adult Children
(Unmarried 26 - 30 years of age)
A separate enrollment and premium are required to enroll an
unmarried over aged adult child in the same medical plan you are
enrolled in. The eligiblity criteria is that the over aged adult child is:
• unmarried and has no dependents of his/her own;
• does not otherwise have other major medical health insurance
available (can not have another option of coverage available);
lives in Florida or is a student in another state (proof required of
residency or student status)
• has continuously been insured (Certificate of Creditable coverage
required)
The application for this type of of coverage is available at:
http://www.palmbeachschools.org/riskmgmt/Benefits/BenefitForms.asp
Extended Coverage for Unmarried Handicapped Children
Coverage for an unmarried enrolled dependent child who is
incapable of self-sustaining employment because of mental
retardation or physical handicap will be continued beyond
the specified limiting age, provided that the child becomes
so incapacitated prior to attainment of the limiting age (while
covered as a dependent under this plan) and the child is primarily
dependent upon you for support and maintenance. We require that
you provide documentation from the Social Security Administration
which indicates your child has been deemed disabled. Proof must
be provided 30 days prior to when your child would no longer meet
the eligibility age definition.
Did you read about...
• Who is eligible to enroll?
• Documentation requirements?
• Dependent eligibility?
www.myFBMC.com
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