Dependents in SEGIP

Your eligible dependents may also be enrolled in SEGIP health/vision and dental plans. Dependents must be enrolled in the same health insurance plan that you are enrolled in, and dependents must be enrolled in a health plan to be enrolled in the dental plan. Some dependents are also eligible for life insurance coverage.

You can add dependents to your SEGIP plans by accessing CMS 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:

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, May 1 through May 31.
  • 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. Dependents may only be enrolled in the SEGIP dental plan if they are also enrolled in a SEGIP health plan.

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. When you drop a dependent from your SEGIP health plan, you must also drop them from the dental plan. Dependents may not be enrolled only in the dental plan.

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.