Your eligible dependents may also be enrolled in SEGIP health/vision and dental plans. You and your dependents must be enrolled in the same health insurance plan. Some dependents are also eligible for life insurance coverage.
You can add dependents to your SEGIP plans by accessing MyBenefits and providing the necessary documentation. Certain classifications of dependents will also require an annual certification.
Dependent Eligibility
See CMS Dependent Coverage for definitions and limitations of each of the following categories of dependents.
For the purposes of the SEGIP health/vision and dental plans, eligible dependents are defined by CMS as one of the following:
- Your spouse
- Your same-sex domestic partner, enrolled prior to June 1, 2011
- Your civil union partner, enrolled on or after June 1, 2011
- Your children, up to age 26
- Certain children age 26 and older – see CMS Dependent Coverage
Dependent eligibility for life insurance coverage is determined separately – see CMS Life Insurance.
Cost
Your employee contributions for dependent coverage are deducted from your pay. The actual deduction amount will vary depending on the plan you are enrolled in and your annual earnings. Dependent premiums are in addition to your employee-only premiums.
See the cost of dependent coverage for each plan:
Coverage for a non-IRS domestic partner, civil union partner, child of a civil union partner or adult veteran children will be assessed imputed income associated with those dependents.
Eligible part-time employees also pay a portion of the State contribution in addition to the employee cost. See Part-Time Employees.
Adding Dependents
Deadlines
Generally speaking, you may add dependents to your SEGIP plans at the following times:
- Within 30 calendar days of your date of hire into a position eligible for SEGIP benefits.
- During the annual Benefit Choice period, typically in May.
- Within 60 calendar days of certain qualifying events, including the birth or adoption of a child.
See Dependent Documentation Requirements for effective dates of coverage.
Providing Documentation
Per CMS policy, in addition to any other required documentation, you must provide the Social Security number within 90 calendar days for any dependent you add. See Dependent Documentation Requirements for more information.
You must provide documentation when you first add a dependent to your SEGIP plan(s). The deadline to submit documentation varies based on the event during which you added the dependent:
- If you add a dependent during your initial enrollment period (when you are hired into a position eligible for SEGIP benefits), you must submit documentation within 30 calendar days of your date of hire.
- If you add a dependent during the annual Benefit Choice period, you must submit documentation within 10 calendar days after the Benefit Choice period ends.
- If you add a dependent following a qualifying event, you must submit documentation within 60 calendar days of the event.
See Dependent Documentation Requirements for a list of acceptable documentation.
When adding spouse life insurance coverage after the initial 30 calendar day enrollment period an Evidence of Insurability (or Statement of Health) form is required – see CMS Life Insurance.
Health/Vision and Dental Plans
Your dependents may only be enrolled in the same health/vision and dental plans that you are enrolled in. Any dependent enrolled in a health plan will be automatically enrolled in the vision plan at no additional cost.
If both you and your spouse are eligible for SEGIP benefits, the same dependent may not be enrolled for the same type of coverage under both you and your spouse. However, you may each choose to add the same dependent for different types of coverage.
If you and your dependents enroll in an HMO health insurance plan, a primary care physician (PCP) must be selected for each dependent. See the HMO Provider Directories to find your PCP.
Dropping Dependents
You may drop dependent coverage during certain qualifying events.
You may re-add a dependent after they have been dropped, only during Benefit Choice or when you experience an eligible Qualifying Event. You will follow the same process as adding a new dependent, including providing documentation.