Extended Eligibility for Student Certification

If any of your employees have children in college as full-time students, just one form will ensure their Highmark Blue Shield medical, dental and vision insurance coverages are not interrupted. 

Unmarried children between 19 and 25 years old are considered eligible dependents as long as they are enrolled as full-time students in an accredited college or university.

As dependents near age 19, we will send you a roster of employees with dependent names.  At the same time, those employees will receive an Extended Eligibility Form to complete and return to you.  If your employee’s dependent is not a student, but is deemed disabled and you wish to continue their coverage, you can also utilize this Extended Eligibility form.

After you review and sign the form, just mail or fax them back to us and you’re done.  No other carrier forms are required.