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Medical

PPO

HMO

Dental

Life Insurance

Vision

   

Who Is Eligible?

 

Children include:

  • natural children
  • legally adopted children
  • children placed in your home for adoption
  • stepchildren you can claim on your federal income tax return
  • foster children or other children for whom you have court-ordered custody
  • children for whom you are legal guardian
 

You

If you are a full-time or part-time state officer or state employee in a salaried position.

Dependents

If you enroll, you may also cover your eligible dependents for medical, dental, prescription drug and vision coverage by selecting family coverage under those options when you enroll. Eligible dependents include your:

  • Spouse.
  • Unmarried children through the end of the month in which they reach age 19.
  • Unmarried children age 19 through the end of the calendar year they reach age 25 if they depend on you for more than 50% of their financial support and live with you or are enrolled in any school, college or university certified or licensed by a state or foreign country.
  • Mentally or physically disabled children who have reached the age limits but are incapable of self-sustained employment and dependent on you for more than 50% of their financial support.
  • An eligible child's newborn child for 18 months after the child's birth, or until your eligible child who is the infant's parent no longer qualifies as your dependent.

Over-age Children

Covered in Family Tier: Children, from age 19 through the end of the calendar year when the child turns 25, are covered within in the existing family if they:

  • Are dependent on you for financial support, and
  • Either live with you or are a full-time or part-time student

Optional Over-age Coverage: For health insurance only, coverage for children age 19 through the end of the calendar year when the child turns 30 may be purchased at an additional premium for dependent children that:

  • Are not married,
  • Have no dependents (i.e. children, domestic partner),
  • Are not provided or otherwise have available other major medical health insurance, and
  • Either live in Florida or are a student in another state.

Coverage for optional over-age children is not automatic. You must enroll these children in an individual policy through People First. By enrolling these children you agree to pay premiums, for the entire plan year, through payroll deductions.

  • Your premium payments may qualify for pre-tax treatment (if, for example, you provide more than half of their support). This means your premium payments are deducted from your wages before taxes. You must certify that your optional over-age child qualifies as a tax dependent for health coverage purposes at the time of enrollment.
  • If your optional over-age child does not qualify for pre-tax treatment, your premiums must be paid with post-tax dollars (the premium is deducted from your paycheck after taxes).
If you currently have … Then …

Individual coverage

  • You keep your individual pre-tax policy (your premium deducted before taxes)
  • Your dependent will have an individual policy and premiums will be deducted from your paycheck either pre-tax or post-tax

Family coverage … and you continue to cover other eligible pre-tax dependents

  • You keep your pre-tax family policy (your premium deducted before taxes)
  • Your dependent will have an individual policy depending on the tax status of your child.

Coverage may continue for your over-age dependent as long as you are a state employee or retiree, or until the end of the calendar year in which they reach age 30. When your dependent loses eligibility, he/she will be eligible to purchase a COBRA policy.

The premium for Over-Age Dependent coverage is $449.26(Standard Plans) or $372.60(Health Investor Health Plans).

Health Savings Accounts (HSAs) - Special Eligibility Rules

Employees' who enroll in a Health Investor PPO or HMO may open an HSA through the state plan as long as the people they cover under the Health Investor medical plan do not have:

  • Medical coverage through a spouse's employer, Medicare or any other medical plan, other than the hospital, cancer or intensive care coverage available through the state's supplemental plans.
  • A healthcare flexible spending account that covers medical expenses.

You may participate in an HSA if you have a Limited Purpose Medical Reimbursement Account or enroll in the supplemental cancer, hospital or intensive care policies available to you as a state employee.

See How to Enroll for additional information.