Over Age (Age 26-30) Dependent Affidavit

Overage 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 the child reaches 30 years old (“Overage 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 Overage Dependent must be actively covered under a Florida Group Health Plan. Eligible dependents must be the insured’s child (by blood or by law). For your Overage Dependent(s) age 26-30 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 Overage Dependent must meet all the following eligibility criteria listed below:

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 Overage Dependent Age 26 - 30, you must complete the enclosed Overage Dependent Affidavit and provide the Student or Florida Resident required documents.

An overage dependent will be considered an out-of-state resident and ineligible for continued coverage as an Overage Dependent if they do not permanently move back to the State of Florida within 60 days of their graduation date from college.

If your dependent is not a Federal Tax Dependent (age 27 & above), you will be taxed on applicable imputed income.

This informaiton is your reminder that Employee 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

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