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ELIGIBLE DEPENDENT

Only the following are eligible for dependent insurance:

1. Your lawful spouse;2. Your children by birth, legal adoption, or legal guardianship who are between the ages of 14 days and 23 years, unmarried and dependent on you for support as defined by IRS regulations; and3. Any other unmarried child between the ages of 14 days and 23 years who lives with you and is dependent on you for support as defined by IRS regulations.

When both parents of a child are insured under the policy as employees, the child can be insured only as a dependent of one parent.

No person will be considered a dependent while in the armed forces of any country (except for active duty of two weeks duration or less).

The following are not eligible for dependent insurance:

1. your divorced spouse or any married child; 2. a child who has been legally adopted by another person, (insurance ends on the date custody is assumed by the adoptive parents); 3. anyone eligible for insurance under the policy as an employee or retiree; or 4. a child less than 14 days, or who has attained the limiting age. The limiting age is the child’s 23rd birthday.

WHEN DEPENDENT INSURANCE BEGINS

(Active Employees)

If you want to insure your eligible dependent, you must make a written request for dependent insurance. You must also agree to pay any necessary dependent contribution. If your Human Resources Office receives the signed written request to enroll your dependent on, before or within 31 days from the day you become employed, your dependent insurance will begin the same day your insurance begins.

If you waive coverage for your dependent during the first enrollment period, you may enroll your dependent only during any subsequent annual open enrollment.

If you do not have a dependent until after you are insured, your Human Resources Office must receive your written request to enroll your dependent no later than 31 days from the date you acquire the dependent.

Dependent coverage is established at the time a person retires, i.e., if a person does not have dependent life insurance on the date of retirement, such coverage will not become available after retirement. If a pension recipient has dependent life insurance coverage on the date of retirement and a new dependent is subsequently acquired, the new dependent can be added within 31 days of the event, (marriage, birth). However, this provision does not apply to a new spouse or child of a widow or widower of a deceased State employee/retiree.

WHEN DEPENDENT INSURANCE ENDS

A dependent is insurance will end at midnight on the earliest of:

The insurance for a mentally or physically incapacitated child who attains the 19th birthday while insured under the policy may be continued if the child:

1. is chiefly dependent on you for support; and,
2. is not capable of self-sustaining employment.

The insurance will continue only if you provide proof of the child’s incapacity :

1. no later than 31 days prior to the child attainment of his/her 19^th birthday; and,
2. thereafter as may be required, but not more often than once every two years.

If your enrolled dependent is an incapacitated child, your coverage for this child will automatically continue at and beyond age 19 as long as he or she became incapacitated prior to age 19, continues to be incapacitated, and provided coverage does not terminate for any other reason. Your child will be considered incapacitated if he or she is unable to earn his or her own living because of a mental or physical impairment and he or she depends chiefly on you for support and maintenance. Contact your Human Resources Office or the Office of Retirement Services for additional information. You may be periodically asked for proof that your child remains incapacitated.

Next: Spouse Life Insurance Conversion Privilege