Eligibility and Enrollment

You may enroll for health care coverage only at the following times:

  • Within 45 days after your date of hire (or date you are first eligible for benefits); coverage is effective the first of the month following your hire/first eligibility date 
  • During the annual Open Enrollment period held in October each year; coverage is effective on January 1
  • Within 45 days of an allowable change of status event, including marriage, birth adoption, or an increase to your regularly scheduled working hours from less than 32 to more than 32 hours per pay period.

You will receive enrollment materials when you are first eligible and at Open Enrollment each year. If you think you have experienced a qualified status change, contact Risk Management within 45 days of the event to make coverage changes.     

Dependent Eligibility

You may enroll your eligible dependents in medical, dental and vision coverage, as well as voluntary life insurance. Dependents are also eligible to receive Employee Assistance Program (EAP) services.

Dependents include the following:

  • Your spouse under a legally valid existing marriage or a Registered Domestic Partner     
       
  • Your natural children, stepchildren, domestic partner’s children, and/or adopted children of which the employee is the legal guardian. In addition, such children must be under the age of 26.       
     
  • Your disabled children age 26 or older. Such disabled children must meet the same conditions as listed above for natural children, stepchildren, or adopted children, and in addition is physically or mentally disabled on the date coverage but would otherwise end because of age and continue to be disabled.

  • A child for whom you are required to provide benefits by a court order, who satisfies the same conditions as listed above for natural children, stepchildren, or adopted children. Please note: grandchildren do not qualify.

This is a brief description of the eligibility requirements and is not intended to modify or supersede the requirements of the plan documents. The plan documents will govern in the event of any conflict between this description and the plan documents.

Adding and Removing Dependents

You are responsible for notifying the Risk Management Division of any changes in your dependent status during the plan year (marriage, birth, death, divorce, ineligibility of dependent child due to age). Such notification must be made within the month that the status change occurs. Failure to submit notification in a timely manner may impact dependent eligibility for health care continuation under COBRA, and may result in you incurring liability for medical expenses for non-eligible dependents. 

For assistance with your health benefits contact:  
Heather Evans, Risk Management Technician heather.evans@edcgov.us or RiskManagement@edcgov.us