Dependent Health Insurance

As long as you are enrolled in one of the retirement system's insurance plans, your eligible dependents can be enrolled in the same insurance plans. Eligible dependents include:

  • Your spouse, as long as he or she is not also enrolled separately as an eligible state employee or retiree.
  • Your unmarried children by birth, legal adoption, or full legal guardianship who are in your custody and dependent on you for support.

In the case of legal adoption, a child is eligible for coverage as of the date of placement. Placement occurs when you become legally obligated for the total or partial support of the child in anticipation of adoption.

In the case of full legal guardianship, eligibility for coverage ceases when the child reaches age 18 or upon your death, whichever occurs first.

 

Continuing coverage after age 19.

Normally, coverage for your eligible children ceases the end of the month in which they turn age 19. However, your dependent(s) by birth or legal adoption remain eligible through the end of the month in which the child turns age 26 or graduates, whichever comes first, if he or she is an unmarried student who is enrolled at least half time in an accredited educational institution and is dependent on you for financial support.

 

If your enrolled dependent is a disabled child, coverage will continue as long as he or she was totally and permanently disabled before age 19, continues to be disabled, and your coverage does not terminate for any other reason. Disabled children are those who are unable to earn a living because of a mental or physical impairment and must depend on their parents for support and maintenance. You must furnish proof of disability and proof of dependency.

Go to How to Apply for the list of proofs you'll need to provide when enrolling dependents in your insurances.

Note: Federal law changes in 2010 extend coverage to all adult children to age 26 for active employee plans, but this does not apply to retiree health plans.

 

Reporting changes for your dependents.

It is your responsibility to notify ORS of any change in your status, or that of your family, that would result in ineligibility, or of coverage under any other group insurance including Medicare. We will adjust your premium deductions if necessary, but we cannot refund premiums that were withheld before the month in which you report the change.

To report changes, log in to miAccount, navigate to the Insurance Coverage section, make your changes, and mail us required proofs if necessary. You can also use the Insurance Enrollment/Change Request (R0452G) .

You can also use miAccount to add or change the name of someone on your health, dental, or vision insurance contract. If you're adding a spouse or dependent due to marriage, birth, or adoption, be sure to send a copy of the marriage, birth, or adoption certificate within 30 days of the event so that the 6-month waiting period can be waived. If we do not receive the proofs on time, your request will be canceled.

Do not mail in original documents, as they will not be returned.

COBRA protects your dependents after eligibility stops.

If one of your dependents loses insurance eligibility, he or she may be able to pay for continued coverage for a limited time. A federal law known as the Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows your dependent spouse or child the option of paying for continued health, dental, and vision coverage for up to 36 months after a qualifying event. The retiree or affected family member must notify our office within 30 days of the date of a qualifying event and request an Application for Continuation of Insurances (CS-1767).

Your health insurance carrier may also offer a non group conversion policy for your dependents. Contact the insurance carrier for more information.

Additional notes about insurance for your dependents.

Upon your death, insurance benefits continue for your survivor pension beneficiary. Your eligible spouse and unmarried children by birth or legal adoption who were covered at the time of your death will continue to receive insurance benefits only if you have chosen the survivor option and there is no break in eligibility since your death.