Must a dependent child already be enrolled to stay on as a dependent child
or if you switch plans, will the child be covered under the new plan?
In the past, we were able to enroll disabled dependents with proof of prior coverage and documentation of disability, but Blue Shield says that they will only cover disabled dependent children already enrolled on our group plan that happen to age out.
Our Blue Shield of CA medical EOC says:
Enrolled disabled Dependent children who would normally lose their eligibility under this Health Plan solely because of age, may be eligible for coverage if they continue to meet the definition of Dependent.
***Please when stating facts, provide a screen shot, URL – Internet Address or something. Here’s an actual EOC – Evidence of Coverage from Blue Shield for the PPO Platinum Plan. We don’t like hearsay (Federal Rules of Evidence)
Here is what we show the actual policy provisions to be:
If the employee or member changes carriers to another insurer or to a health care service plan, the new insurer or plan shall continue to provide coverage for the dependent child. CA Insurance Code 10277 (d)
This caused us to lose at least one new hire, because she decided to stay on her current medical plan (with her current employer) that provides coverage for her disabled adult child.
***I suggest you appoint us as your agent and we will fill out the disabled child form, along with the employee application and get a WRITTEN answer, not a “bozo” oral – hearsay (Federal Rules of Evidence) answer.
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