Eligibility

You are eligible for Trust-sponsored benefits if you are an active full or part-time permanent employee, including established term employees, and a member of:

OCSEA/AFSCME - Units 3-9, 13, 14, 45, 50, 55

District 1199/SEIU - Units 11, 12

OSTA - 1, 15

FOP/OLC - Units 2, 46, 48

SCOPE/OEA - Unit 10

CWA - Unit 40.

Eligibility for Dental and Vision Coverage

Exempt and union-represented employees are eligible to enroll in dental and vision coverage after completing one full year of continuous state service.

Dependent Coverage

The following are eligible to enroll as dependents:

• An employee’s current legal spouse.
• An employee’s and the legal spouse’s unmarried children (including legally adopted
  children, children for whom either the employee or spouse has been appointed
  legal guardian and dependent stepchildren and foster children who normally
  reside with you until the end of the month in which they reach age 19).
• Unmarried children noted above who are age 19 or older, who are attending an
  accredited school and are primarily dependent on the employee or their current
  legal spouse for maintenance and support, are eligible until the end of the month
  in which they either reach age 23 or cease being a student - whichever occurs
  first.
• Children of divorced or separated parents who are not residing with the employee
  but whom the employee is required by law to support.
• Unmarried children of any age who are incapable of self-support due to mental
  retardation, severe mental illness or physical handicap, whose disability began
  before age 23 and who are primarily dependent upon the employee.
• Adopted children have the same coverage as children born to you or your spouse
  whether or not the adoption has been fi nalized. Coverage begins upon placement/
  custody.
• Stepchildren who currently are living in the employee’s home more than 50 percent
  of the time.
• When two state employees are married and have legally separate dependents, the
  employee who has coverage as a spouse may be included as a covered dependent
  as well as children not residing with the employee, but for whom the spouse is
  required by law to provide insurance.
• Dependents of divorced employees may be enrolled on both parents’ family plans
  pursuant to a court order or joint-custody agreement. Check your plan for details.

Supplemental life insurance, the legal service plan and Working Solutions are available to you upon hire. (You have 90 days from your date of hire to purchase supplemental life insurance and/or the legal service plan, and will have the opportunity to enroll in or change your coverage under these plans at each Trust-sponsored open enrollment.)

While the Trust mails enrollment materials to your homes, we strongly encourage you to review the information online and make your selection. You may use the forms and books to enroll in coverage if you do not receive or misplace your enrollment packet.

Voluntary options may have more liberal eligibility definitions. Please see the plan details for more information.

When dependents' dental and/or vision coverage ends, you may extend it through COBRA.

Limits & Exclusions

• No person is considered a dependent while in the armed forces.



• A child who is eligible as an employee of the State is not eligible as the dependent of either parent who also may be a State employee.



• A divorced spouse is not eligible as a dependent.



• When you and your spouse are both State employees, one may carry family coverage and the other single coverage, provided that the spouse is not listed as a dependent under family coverage.

See your Payroll/Personnel officer for more information.

Eligibility/Enrollment Chart
	Who's Eligible			When Eligible	To Enroll	Premium Paid By
	Member		Family
Dental				First of the month following one year continuous State service	Complete an enrollment form within 31 days of hire anniv. date	Trust
Vision
Basic Life				First of the month following one year continuous State service	Automatic	Trust
Supplemental Life				On hire date	Complete Prudential supplemental life enrollment form within 90 days of hire or at open enrollment	Member
Working Solutions				On hire date	Automatic	Trust
Legal Service Plan				On hire date	Complete Hyatt enrollment form within 90 days of hire or at open enrollment	Member

This chart applies to full- and part-time employees. Established term employees should discuss eligibility/enrollment information with their Payroll/Personnel officers.

Changes During the Year

You may change your coverage level (single or family) during the year if you have a family status or employment-related coverage change. You must complete and return an Enrollment and Change form and, if necessary, an Affidavit of Dependent Status, within 31 days of the change or you will have to wait until the next open enrollment to adjust your coverage level. If you have enrolled in the Hyatt legal service plan, you may change from single to family or family to single coverage level following a family status change, but you must complete Hyatt's form separately (within 31 days of the change) to make the change effective, and you must remain in the plan until the end of the plan year.

Review the chart below to see if you may change your coverage level.

Change		Type of Coverage Change Allowed		Date Change Effective
Marriage		Add dependent spouse (and spouse's children)		First of the month following your marriage*
Birth or adoption		Add dependent child		Date of birth or placement in home*
Legal guardianship		Add dependent child		Date of receipt of final papers*
Divorce (you provided coverage)		Drop spouse		Last day of the month in which divorce occurred
Death of dependent (you provided coverage)		Drop dependent		Last day of the month in which death occurred
Loss of coverage through spouse's employer if spouse laid off, terminated, dies or divorces you		Enroll in coverage Add dependent		Date varies by type of change; see your Payroll/Personnel officer
Return to work through arbitration order or grievance settlement or administrative order		Re-enroll		Date varies by settlement agreement; see your settlement notice

* For supplemental life insurance coverage, dependents must be at least 14 days old.

Plan Changes for Dental and Vision Coverage