To terminate a dependent’s coverage, the plan sponsor must submit a written request within 31 days of any change listed below:
- An employee voluntarily requests coverage to be terminated.
- A divorce decree has been finalized.
- The spouse or domestic partner no longer resides or works in our service area.
- The dependent child no longer resides in our service area, unless there is a standing health coverage court order.
- The dependent child reaches the maximum dependent age as defined by the group agreement or ceases to meet other dependent eligibility requirements.
Be sure to include the following:
- Company name
- Employee name
- Dependent(s) to be removed from coverage
- Termination date
Please send your written request via:
You must specify that this request is only for an employee's dependents.
Omitting a member from an application or simply not paying for the member will not terminate the member’s coverage.
The termination date of benefits is always the last day of the last month the employee was eligible. For example, if the employee terminates employment on June 3, then their health coverage ends June 30.