Capital Blue Cross (CBC):

Dependent Eligibility Audit

Who are Eligible Dependents?

Dependents eligible for Health, Dental, and/or Vision Plans include your:

  • Legally married spouse (opposite or same gender);
  • Employee children under age 26; including natural children, stepchildren, and legally adopted children, regardless of marital status; and children for whom you are required to provide health coverage, under a Qualified Medical Child Support Order;
  • Unmarried or married employee children of any age, who are incapable of self-support and who became mentally or physically handicapped before the limiting age of 26, and are dependent on you for over half of their maintenance and support.

Note: All Dependents must be enrolled using the name listed on their Social Security Card.

Eligible Spouse Rule*

Spouses are eligible to elect LG Consumer or LG Select Plan as primary if:

  • Self-employed (Note: Work related injuries or illnesses are not covered)
  • Unemployed
  • Employed but employer does not offer health insurance
  • Employed, but paying 50% or more of their employer’s cost of single health insurance coverage

If spouse pays less than 50% of their employer’s cost of single health insurance coverage, LG Health Insurance Plans will be available as secondary coverage, if desired.

*Eligible Spouse Rule only applies to Health Insurance Plans. Dental and Vision Plans are not governed by the Eligible Spouse Rule.

Dependent Eligibility Verification

After enrolling dependent(s), you will receive a “Review Documents” task in a Workday Inbox To-Do. This task will include a due date for enrollment and the uploading of documents. The below link provides you with a documentation matrix and lists of acceptable documentation and verification forms. Note: The Spouse Eligibility Form must be completed if adding a spouse to your health insurance. If adding a spouse to your dental or vision insurances only, this form will not be required. The audit is used to verify Dependent identity, eligibility and the correct spelling of their name(s). All enrolled Dependents must be covered using the name listed on their Social Security Card.

Newly enrolled dependent(s) will not be eligible for coverage until their eligibility has been verified and documents accepted/approved in Workday. If verification is not received by audit deadline, your dependent(s) will not be covered by health, dental, and/or vision benefit plans.

LG Health reserves the right to verify the eligibility qualifications of any dependent(s) submitted during an enrollment offering.

Quick Links:
LGH Documentation Matrix
Spouse Eligibility Form
Add Dependent/Enroll in Benefits

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