Qualifying Life Events

Legislation allows for the continuation of HCTC benefits for Qualifying Family Members for up to 24 months after the eligible primary individual achieves the following certain life events: Medicare eligibility, divorce, or death.

Medicare Eligibility

In most cases, an individual becomes eligible for Medicare the first day of their birth month the year they turn 65. An individual will remain HCTC eligible their entire birth month in which they turn 65.

Divorce

In the case a divorce between an eligible participant and spouse, the spouse is treated as an eligible individual beginning in the month of divorce if the spouse was a qualifying family member immediately before the divorce and had a separate coverage. If the spouse was a QFM immediately before the divorce and did not have separate coverage, the spouse is treated as an eligible individual beginning with the month after the date of divorce.

  • The enrollment form must be completed and signed by the QFMP and will be enrolled in their name
  • A divorce certificate, or similar legal documentation, is required for the PBGC payee or TAA recipient and must include the date of divorce

Death

In the case of the death of an eligible participant, beginning with the month of the date of the death for individuals on separate coverage or with the month after the date of the death for individuals not on separate coverage:

  • Any spouse of the participant (determined at the time of death) is treated as an eligible individual
  • Any individual who was a QFM immediately before such death is treated as an eligible individual
  • The enrollment form must be completed and signed by the QFMP and will be enrolled in their name

A death certificate, or similar documentation, is required for the PBGC payee or TAA

 

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