If the plan is a stand-alone dental and/or vision plan, then the definition of a dependent child does not have to adhere to “until age 26” requirement. These plans may use the old method of defining a dependent child, which is based on student status, financial need and other factors, which are defined by the plan. Although this alternative method can create more of an administrative burden, it is still allowed.
For all plans, dependent children with disabilities are usually allowed to be covered at any age, based on financial need and when the child became disabled under the plan. Additionally, children covered by a Qualified Medical Child Support Order are required to be covered under the employee’s core health benefits.
An entirely different definition of a dependent is used for Dependent Care Flexible Spending Accounts. The different definition is based on Code Section 152.
It is important to note that the plan and SPD should clearly establish who is eligible as a dependent for each benefit and any restrictions that may apply.
