Dependent Eligibility

Many of the benefit plans allow you to add eligible family members to the same plan in which you are enrolled. Follow the links to learn more about Dependent Eligibility.

• Who is Considered a Dependent
• Dependent Verification
• Impact of Health Care Reform

Who is Considered a Dependent

Depending on the plan, eligible family members may include:

• Your spouse
• Your common-law spouse if you live in a state that recognizes such marriages
• Your same sex or opposite sex domestic partner and eligible dependent children (enrollment is limited to medical, pharmacy, dental, vision, life insurance and legal plan)
• Your children, step-children, adopted children or those for whom you have legal guardianship up to age 26
• Your children who are at least age 26 and are incapable of self-support because of a mental or physical disability and meet the IRS Definition of a tax qualified dependent.

NOTE:  You must immediately notify the Service Center at Banner Plan Administration when your dependent(s) no longer meet the eligibility requirements.

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Dependent Verification

When you add your dependents to your coverage in the enrollment system, you are verifying that they meet the eligibility criteria.  In addition, in order for Banner Health to comply with the Medicare as Secondary Payer Act, you must provide a valid Social Security number for each dependent, or indicate that the individual does not have a Social Security number.

If you are adding a newborn to your plan(s), you will have 45 days from the date of your child’s birth to provide this information.  If we do not receive this information, your child’s enrollment will be terminated at the end of the month in which he/she reaches 45 days of age. You may provide the Social Security number online by accessing the enrollment system, or you may call the Service Center at Banner Plan Administration at (480) 684-7070 in the Phoenix area or (800) 827-2464 in all other areas.

If you are enrolling any of the following dependents, additional verification steps are required.

• Domestic partner and/or children of domestic partner
• Newly adopted children 
• Children for whom you have legal guardianship
• Your children who are at least age 26 and are incapable of self-support because of a mental or physical disability and meet the IRS Definition of a tax qualified dependent.

View the Dependent Eligibility Matrix for verification details.

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Impact of Health Care Reform
The Health Care Reform Law does not change the definition of “dependent” that is used to determine the tax treatment of health coverage.  But, the Law does clarify that an individual will not be taxed on the cost of employer-provided adult child health coverage in tax years up to and including the year in which the child reaches age 26, provided that the covered adult child is:

1. a son, daughter, stepson or stepdaughter of the individual; or
2. a legally adopted (or placed for adoption) child of the individual; or
3. a child placed with the taxpayer by an authorized placement agency or by judgment, decree or court order.

NEW for 2013: The dependent can be eligible to enroll in another group health plan, other than provided by a parent.

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