Over Age Dependent Disability Coverage
Under federal law, group health plans that cover dependent children must extend coverage to those dependents until age 26. Beyond age 26, a dependent may remain eligible for group coverage if they have a qualifying disability — provided the plan otherwise would cover the dependent and the disability existed before the limiting age.
MonarkHQ now includes a disability review workflow for over-age dependents, allowing brokers to confirm which members qualify for continued coverage and ensure those members are handled correctly during quoting and carrier submission.
How It Works
When census data contains dependents who have exceeded the standard age limit, MonarkHQ flags them for review. A banner appears on the medical instant quote page identifying the over-age dependents in the group.
From the banner, brokers can:
- Review which dependents are flagged as over-age
- Confirm disability status for dependents who qualify for continued coverage
- Note that dependents confirmed as disabled are included in the carrier sync for quoting purposes
- Dependents not confirmed as disabled are excluded from the Ideon carrier sync to prevent quoting errors
Reviewing Over-Age Dependents
- Open the Group and navigate to the Quotes tab
- Select Medical and view the instant quote results
- If the census contains over-age dependents, a review banner appears at the top of the page
- Click Review to open the overage dependent list
- For each flagged dependent, confirm whether they have a qualifying disability
- Save your review — confirmed dependents remain in the quoting population; unconfirmed dependents are excluded
You can also view and update disability status directly from the Census tab, which displays an Overage Review column for flagged dependents.
Census Column
The census table includes an Overage Review column for dependents who exceed the plan's age limit. The column shows the review status for each flagged member:
| Status | Meaning | | ------------------ | ----------------------------------------- | | Pending | Not yet reviewed — broker action required | | Confirmed disabled | Included in carrier sync and quoting | | Not disabled | Excluded from carrier sync |
Editing a member's row in the Census tab allows you to update the overage review status at any time.
Important Notes
- Confirming disability status in MonarkHQ is a tracking action — it does not constitute a legal determination of eligibility or submit documentation to a carrier.
- Carriers typically require the employer to obtain documentation of disability directly from the dependent or their physician before extending coverage. That process happens outside MonarkHQ.
- Always confirm applicable state law and the specific plan's disability continuation provisions with the carrier before representing continued eligibility to the employer.
Questions?
Contact Monark via chat at monarkhq.com for platform assistance. For questions about a specific carrier's disability continuation rules, contact the carrier representative directly.