Who Is Eligible?
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).
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Individual coverage
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- 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
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Family coverage
and you continue to cover other eligible
pre-tax dependents
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- 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.
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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.
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