Dependent Eligibility Guidelines

See Also: Required Documentation
See Also: Employee Eligibility Guidelines

Note: Because of the ongoing declared national emergency for the COVID-19 pandemic, the deadline to contact the MI HR Service Center to add or change enrollment due to a qualifying life event occurring on or after January 30, 2020, has been extended. The extended due date is now 60 days after the end of the national emergency (once determined), plus the remainder of the original 31-day deadline period occurring after February 29.

Select a dependent type from the list below to review specific eligibility requirements. Review the Required Documentation page to find the specific documentation you are required to submit to the MI HR Service Center to add a dependent to your benefits, or, maintain their eligibility.

Benefit Effective Dates

Newly Hired Employees: Benefits will be effective the first day of the new pay-period starting after you call the MI HR Service Center (877-766-6447) to enroll. Newly hired employees must call MI HR within 31 days of their hire date to enroll in benefits. Benefits are not effective immediately upon hire or immediately after contacting MI HR to enroll.

2019 Insurance Open Enrollment (IOE): Any newly-elected benefits or changes made during IOE will go into effect on the first day of the full pay-period in October (the new fiscal year).

Student Eligibility Guidelines: Effective October 6, 2019, student eligibility guidelines will change. Please review the 2019 IOE Plan Changes page for a description of the new guidelines.

Eligibility Exclusions

If you and your retiree or active spouse are both covered by state group insurance plans, you may maintain separate coverage through your individual plans or enroll in one plan with one of you listed as a dependent. If you choose to maintain separate coverage, your children can only be listed as a dependent on one plan. This applies even if you are divorced.

An employee’s spouse, OEAI, and dependents are not eligible for coverage if he or she is in the armed forces on active duty. Those individuals are eligible for coverage under TRICARE, effective the date of active duty orders.

Life Events

To add or change eligible dependents due to a qualifying life event (e.g.: marriage, birth, divorce), call the MI HR Service Center (877-766-6447)  as soon as possible, no later than 31 days following the life event. Do not wait until you have the official documentation. All supporting documentation must also be provided within 31 days of the qualifying life event.

Legal Spouses - Legally recognized under Michigan law

An employee's legal spouse may be covered as a dependent under the health care, dental care, vision care, and dependent life insurance options as long as he or she is not also separately enrolled (at the same time) as a State employee or retiree in the same category of insurance (for example, State Health Plan or HMO).

Ex-spouses are not eligible to be listed as dependents. Contact the MI HR Service Center immediately to cancel an ex-spouse's enrollment(s). You must provide, within 31 days of the divorce, a copy of your divorce decree to the MI HR Service Center.

Your ex-spouse will be provided with an application to continue State group health, dental and vision insurance in his or her own name for up to 36 months by making direct premium payments pursuant to federal COBRA regulations. Conversion health care and life insurance policies are also available directly from the insurance plan administrators. COBRA and conversion options are explained in each benefit booklet.

Children

Eligible dependents may be enrolled in your health, dental, vision, and dependent life insurance plans (OEAI and their dependents may only be enrolled in health insurance plans). Children by birth, legal adoption, or step-children are eligible for dependent life insurance until the day before their 23rd birthday, and eligible for health, dental, and vision insurance through the last day of the month in which they turn age 26.

Children the employee has legal guardianship of or foster care (placed in your home by a state agency or court) are eligible for health, dental, vision, and dependent life insurance until the day before their 18th birthday, unless the placement expires prior to that date.

Note: State-employed married or divorced employees carrying independent enrollments may cover their children in either parent's insurance plan, as long as each child is only covered once. If employees cannot agree which parent will cover the children, the parent who has covered the children first during their employment with the State of Michigan will cover the dependent children.

Continuing Coverage for Incapacitated Children

Your child who is unmarried and unable to sustain employment because of a developmental or physical disability can continue enrollment in health, dental, vision, and dependent life insurance beyond normal age limits if all the following conditions establishing incapacitated status are met:

  • Your child became incapacitated before reaching the age limit for the coverage (age 23 for dependent life insurance and the end of the month in which they turn age 26 for health, dental and vision).
  • You have submitted documentation verifying your child’s incapacity within 31 days after the child reaches the age limit for termination of the coverage.
  • Your child is unmarried and continues to be incapacitated and chiefly dependent on you for support and maintenance.
  • Your coverage does not terminate for any other reason.

Other Eligible Adult Individuals (OEAI)

NEREs and employees currently represented by AFSCME, MCO, MSEA, UAW Local 6000, and SEIU Local 517 M may enroll one OEAI and their dependent(s) into a State of Michigan health plan only. Coverage does not extend to dental or vision plans for OEAIs or their dependents. To be considered eligible, the following criteria must be met:

  1. The employee does not have a spouse eligible for enrollment in the State of Michigan health plans.
  2. The OEAI is at least 18 years of age.
  3. The OEAI is not the employee’s spouse, child, parent, grandparent, foster parent, grandchild, parent-in-law, sibling, aunt, uncle, or cousin.
  4. The employee and OEAI have jointly shared the same regular and permanent residence for at least 12 continuous months, and continue to share a common residence other than as a tenant, boarder, renter, or employee.
  5. Dependent children of an OEAI may enroll in health insurance only under the same conditions that apply to dependent children of employees.

OEAI and dependent enrollment is only available upon initial hire or during the annual Insurance Open Enrollment (IOE) period. If the criteria for enrollment of an OEAI or the OEAI’s dependent child(ren) are no longer met, the employee must notify the MI HR Service Center within 14 calendar days. The employee will be responsible for paying taxes associated with enrolling an OEAI and the OEAIs dependents. Review the OEAI tax implications document for additional tax information.

Dependent Life Insurance

Eligible dependents can include your spouse and unmarried children from the age of 14 days up to their 23rd birthday for whom you provide at least 50% of their support. Your spouse is also eligible if they are not a state employee or state retiree.

As a state employee, you are automatically enrolled in life insurance. If this coverage is maintained, you are not eligible to be covered as a spouse or dependent on another employee or retiree dependent life insurance plan.

Canceling Coverage

Immediately notify the MI HR Service Center to cancel your dependent coverage when he or she no longer meets the definition of an eligible individual. Ex-spouses are not eligible and must be removed from coverage effective the date of the divorce.

Ineligible dependents will be provided an application to continue coverages in his or her own name for up to 36 months by making direct premium payments pursuant to federal COBRA regulations. A conversion health insurance policy may also be available directly from the insurance carrier. Additional information about COBRA and conversion options are available by visiting www.mi.gov/COBRA.