HERE IT IS! The Student Certification Form needs to be provided to the Fund Office twice/per year, before the Spring and Fall semester.
In the past the Fund has been lenient in accepting late Student Certification Forms. Unfortunately, we can no longer continue this practice. If we have not received a form for your student by September 1st, benefits will be terminated retro to July 1st and you will be responsible for reimbursing the Fund for any benefits received after that date. In the Spring, the deadline is January 1st with a retro term date of January 1st. Please be sure to get your student's form to the H&W office before the deadline. Some college websites have a verification form which can be printed directly from their site. This form is acceptable. Please do not print the class schedule, only the college's official verification form is acceptable.
The benefits for your child will continue if you have filled out the Student Certification Form and had it stamped with the school seal (or have the school attach their own version of verification) and mail the form to our office. Note: Please do not send grades, acceptance letters, class schedules or bills. These documents are not acceptable as proof of attendance. We will then notify the benefit providers that your student is eligible for benefits. Please note that your child's name will not appear on your Express Scripts or NVA card. He/she IS eligible for benefits, but the name will not be printed on the card!
Some parents have utilized the services of this website to provide a verification of full time student status: http://studentclearinghouse.org/
Click the image on the left to download a Student Certification Form.
You will need Adobe Reader to view and print the PDF file.
NEW Effective 1/1/10:
The Pennsylvania Social Services Union Local Unit Health and Welfare Fund Employee/Dependent Eligibility Information shall be amended to add the following language to the definition of “Dependent”:
Effective January 1, 2010, a Dependent shall also include a “dependent child on a medically necessary leave of absence” for a period of up to one year after the first day of a “medically necessary leave of absence,” provided that participation in the Plan would not otherwise terminate during that time (e.g., on the death of the Retired Employee). (1)A “dependent child on a medically necessary leave of absence” shall include a dependent child:
A “dependent child on a medically necessary leave of absence” shall include a dependent child:(a)who is covered under the Plan on account of being a full-time student at a postsecondary educational institution; and
who is covered under the Plan on account of being a full-time student at a postsecondary educational institution; and(b)who was covered under the Plan on the basis of being a student at a postsecondary educational institution immediately before the first day of the “medically necessary leave of absence.”
who was covered under the Plan on the basis of being a student at a postsecondary educational institution immediately before the first day of the “medically necessary leave of absence.”A “post secondary educational institution” includes an institution of higher education as defined in Section 102 of the Higher Education Act of 1965.
(2)A “medically necessary leave of absence” shall include a leave that meets the following three criteria:
A “medically necessary leave of absence” shall include a leave that meets the following three criteria:(a)the leave commences while such child is suffering from a serious illness or injury;
the leave commences while such child is suffering from a serious illness or injury; (b)the leave is “medically necessary” as certified in writing by the child’s treating physician, documenting that the child is suffering from a serious illness or injury; and
the leave is “medically necessary” as certified in writing by the child’s treating physician, documenting that the child is suffering from a serious illness or injury; and(c)the leave is necessitated by a serious illness or injury that causes the child to lose full-time student status.
the leave is necessitated by a serious illness or injury that causes the child to lose full-time student status.(3)A “dependent child on a medically necessary leave of absence” shall be entitled to the same coverage to which he would have been entitled as a Dependent. If coverage changes for all similarly situated individuals, the coverage for the “dependent child on a medically necessary leave of absence” shall also change.
A “dependent child on a medically necessary leave of absence” shall be entitled to the same coverage to which he would have been entitled as a Dependent. If coverage changes for all similarly situated individuals, the coverage for the “dependent child on a medically necessary leave of absence” shall also change.
