Supplemental Dependent Enrollment Change Form - Aetna Supplemental Dependent Enrollment Change Form 2025

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  1. Click ‘Get Form’ to open the Supplemental Dependent Enrollment Change Form in the editor.
  2. Begin by entering your name in the 'Employee Name' field. Ensure it is printed clearly for accurate processing.
  3. Fill in the date of submission in the 'Date' field using the format Month/Day/Year.
  4. In the 'Additional Dependents' section, list each dependent you wish to add, change, or remove. For each dependent, provide their name, Social Security Number, birthdate, and select their coverage election (Medical, Dental, Life).
  5. Indicate if they are a current patient by checking 'Yes' under the respective coverage type if applicable.
  6. Sign and date at the bottom of the form where indicated to confirm your request.

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The Patient Protection and Affordable Care Act (PPACA) requires plans and issuers that offer coverage to children on their parents plan, to make the coverage available until the adult child docHubes the age of 26, even if the young adult child no longer lives with his or her parents, is not a dependent on a parents tax
Summary. The birthday rule is used to determine how coordination of benefits work when a child is covered by both parents health insurance policies. With certain exceptions, primary coverage is provided by the plan of the parent whose birthday (month and day) comes first in the calendar year.
Legally, child dependents can stay on their parents health insurance until age 26, even if they are eligible through their own employer. Even if you get married, even if you move out, even if you make a million dollars a year. If youre under 26, you can be carried as a child dependent by your parent.
You must apply for coverage within 60 days of aging out of your parents plan. Loss of coverage is the most typical life event, and thats whats happening to you you turned 26 and aged off your plan. You can get coverage outside open enrollment during the special enrollment period.
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