MMC Benefits Handbook
Children
To cover an eligible child(ren), you will be required to certify in the Mercer Marketplace Benefits Enrollment Website that your child(ren) meets the eligibility criteria as defined below.
  • your biological child
  • the child of a domestic partner
  • your stepchild
  • a child for whom you or your spouse are the legally appointed guardian with full financial responsibility
  • your legally adopted child or child placed with you for adoption.
The phrase "placed for adoption" generally means that the employee has assumed the legal obligation to totally or partially support the child in anticipation of adoption of such child.
Note: Any child that meets one of these eligibility requirements and who is incapable of self support by reason of a total physical or mental disability as determined by the Claims Administrator, may be covered beyond the end of the calendar year in which the child attains age 26.
Eligibility for Children
Dependent children are eligible for healthcare coverage until the end of the calendar year in which they attain age 26. This eligibility provision applies even if your child is married, has access to coverage through his or her employer, doesn't attend school full-time or live with you, and is not your tax dependent.
Note: While married children are eligible for healthcare coverage under your plan until the end of the calendar year in which they attain age 26, this provision does not apply to your child's spouse and/or child(ren), unless you or your spouse is the child's legally appointed guardian with full financial responsibility.
The Company has the right to require documentation to verify the relationship (such as a copy of the court order appointing legal guardianship). Company healthcare plan coverage does not cover foster children or other children living with you, including your grandchildren, unless you are their legal guardian with full financial responsibility—that is, you or your spouse claims them as a dependent on your annual tax return.
How long can I cover my child?
Generally, you can cover your child through the end of the calendar year in which the child attains age 26. You may be able to extend coverage for your child beyond the end of the calendar year in which the child attains age 26, if your child is disabled.
Your child's coverage will stop upon the earlier of:
  • reaching the maximum age for coverage (the end of the calendar year in which the child attains age 26), or
  • no longer meeting the plan's eligibility requirements.
If your child continues to be disabled over the age limit for coverage, your child may still be eligible to continue coverage. Otherwise, if your child reaches the age limit for coverage (the end of the calendar year in which the child attains age 26) or no longer meets the eligibility requirements, you must remove your child from coverage. Go to Colleague Connect (https://mmcglobal.sharepoint.com/sites/home), click Pay & Benefits and select Mercer Marketplace Benefits Enrollment Website under Benefits. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the plan for these claims. Failure to timely remove your child may also result in missing the child's opportunity for COBRA continuation coverage.
My spouse or domestic partner also works for the Company; can we both cover our child?
Your child can be covered under either your coverage or your spouse's or domestic partner's coverage, but not both. To be covered, your child has to meet the dependent child eligibility requirements.
I am divorced and do not have sole custody of my child; can I still cover my child under the healthcare plans?
You can still cover your child until the end of the calendar year in which the child attains age 26.
Can I continue covering my disabled child once my child reaches the age limit for coverage?
You can cover your disabled child over the limiting age. To be eligible for coverage, your child has to be incapable of self support by reason of a total mental or physical disability, as determined by the Claims Administrator.
In order to register a child as disabled, you must fill out the applicable medical plan provider form (contact your medical plan provider for the appropriate form) for continuing coverage beyond the limiting age and return the form to the Claims Administrator no later than 30 calendar days after the disabled child's coverage would otherwise end. The Claims Administrator will review the request for disabled status and will notify the Company and the employee whether the child is determined as disabled. If approved, eligibility records will be adjusted to allow for coverage beyond the end of the calendar year in which your child attains age 26, as long as the child meets the remaining eligibility requirements.
Your child's disability has to begin before the date eligibility would otherwise end. In addition, to be covered beyond the limiting age, your child must already be covered or have current continuous coverage under one of the Company healthcare plans prior to reaching the limiting age.
If approved, eligibility records will be adjusted to allow for coverage beyond the limiting age as long as the child meets the remaining eligibility requirements.
Can I cover my grandchild?
You cannot cover your grandchild unless you are the legally appointed guardian or you have legally adopted the child, and the child resides with you.
My dependent child is having a baby; what will be covered?
If your daughter is covered under a Company medical plan, she is covered for maternity benefits, which include delivery of the baby. Unless the newborn meets the definition of an eligible child and is covered under the Company healthcare plan, medical care for the newborn, whether in or out of the hospital is not covered.
Can I cover my child who is not attending school, is temporarily out of school (as a student on leave or for medical reasons) or changes to a part-time status?
As long as your child meets the eligibility requirements, coverage will continue through the end of the calendar year in which your child attains age 26, whether or not a full- or part-time student. This provision also applies if your child is married, has access to coverage through his or her employer, doesn't live with you and is not your tax dependent.
When your child reaches the age limit for coverage (the end of the calendar year in which your child attains age 26) or no longer meets the eligibility requirements, you must remove your child from coverage. Go to Colleague Connect (https://mmcglobal.sharepoint.com/sites/home), click Pay & Benefits and select Mercer Marketplace Benefits Enrollment Website under Benefits. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the Plan for these claims.
Can I cover my married child who is still dependent on me?
Yes, you can cover a married child up to the end of the calendar year in which your child attains age 26.
Note: While married children are eligible for healthcare coverage under your plan until the end of the calendar year in which they attain age 26, this provision does not apply to your child's spouse and/or child(ren), unless you or your spouse is the child's legally appointed guardian with full financial responsibility.
Once your child reaches the age limit for coverage (the end of the calendar year in which your child attains age 26), you must remove your child from coverage. Go to Colleague Connect (https://mmcglobal.sharepoint.com/sites/home), click Pay & Benefits and select Mercer Marketplace Benefits Enrollment Website under Benefits. No refund of contributions will be paid beyond the date eligibility ceases. If you fail to remove your child from coverage and any claims are paid for expenses incurred after the date eligibility ceases, you and your family must reimburse the Plan for these claims. Failure to timely remove your child may also result in missing the child's opportunity for COBRA continuation coverage.
Can I cover my child when a Qualified Medical Child Support Order (QMCSO) is in effect?
In order to add a child as required by a Qualified Medical Child Support Order, submit the QMCSO to the Global Benefits Department for validation. If the QMCSO is determined to be complete and valid, you will be notified and your child will be added to your coverage.