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Over Age (Age 26-30) Dependent Affidavit
Content
Over Age 26-30 Dependent Affidavit
Florida Statute §627.6562 allows medical coverage for dependents from the age of 26 through the end of the year in which they turn 30 years old (“Over-Age Dependent”) when certain eligibility requirements are met. The Internal Revenue Service (IRS) rules permit tax-favored treatment for dependents up to age 27. Special rules apply with respect to the taxation of health benefits of dependents age 27 and above.
To be eligible, the parent(s) of the Over-Age Dependent
mus
t be actively covered under a Florida Group Health Plan. Eligible dependents must be the insured’s child (by blood or by law). For your Over-Age Dependent(s) to enroll or continue their medical coverage from the age of 26 through the end of the calendar year in which they turn 30 years old, your Over-Age Dependent must meet
all
the following eligibility criteria:
is unmarried; and
has no dependents of his/her own (i.e., children); and
is not provided coverage or covered under any other group or individual benefit plan; and
is not entitled to benefits under Title XVIII of the Social Security Act; and
is a resident of Florida or is a full or part-time student
To continue medical coverage for your Over-Age Dependent, you must complete the Over-Age Dependent Affidavit and provide the Student or Florida Resident required documents. This Affidavit must be updated each year until the Over-Age Dependent is no longer eligible.
If your dependent is not a Federal Tax Dependent (age 27 & above), you will be taxed on applicable imputed income.
This information is your notification that Benefits Office MUST receive the Affidavit and required documents fourteen (14) days PRIOR to the dependent’s birthday, IF NOT, Group Health Plan coverage for the Age 26-30 Dependent(s) will be terminated.
PLEASE NOTE:
Dependent children will be removed from
Dental & Vision
benefits at the
end of the year
they turn 25 years old.
Dependent children will be removed from
Dependent Life Insurance
at the
end of the month
they turn 26 years old. If this is your only dependent, your dependent life will be cancelled.
DEPENDENT AGE 26-30 AFFIDAVIT FORM