FY2011 Health Benefits Booklet

6 s u m m a r y o f g e n e r a l b e n e f i t s j u l y 2 0 1 0 – j u n e 2 0 1 1
• If you do not provide the required documentation
by the deadline, any dependent(s) added during
Open Enrollment will be removed from your
coverage back to July 1, 2010.
a• Disabled Eligible Dependent Child: You are not
required to provide Disability Certification until the
child reaches age 25. You will then be required to
provide continued certification of his/her disability
status every two years in order to keep him/her on
your coverage.
Who Can BE CoverED
For plans in which you are enrolled, your dependents
must be in one of the three categories listed in the table
on page 7.
• Beneficiaries of deceased State Retirees can only
cover dependents who would be eligible dependents
of the State Retiree if he/she were still living.
Refer to the Required Documentation For Dependents
section for a list of documentation you must submit for
all newly enrolled dependents.
Please note: It is your responsibility to remove a
dependent child, spouse, domestic partner or domestic
partner’s child immediately when he/she no longer
meets dependent eligibility criteria provided on page 7.
Important – Duplicate Coverage Prohibited
A husband and wife who are both Active State
Employees and/or Retirees may not be enrolled as
both an Employee/Retiree and as a dependent spouse
in the same plans. This is duplicate coverage and is
not permitted under the benefit program. This also
applies to Satellite agency dependents [including
domestic partners and their child(ren)]. Two State
Employees and/or Retirees may not be covered twice
under the coverage of two Employees/Retirees. It is the
Employee’s/Retiree’s responsibility to make sure that
they and their dependents do not have duplicate State
coverage. Duplicate benefits will not be paid.
Your Cost
The amount you pay for benefits coverage depends on
several factors, including:
• The benefit plans you choose;
• Whom you choose to cover;
• Your age (for Life Insurance and Long Term Care
Insurance only);
• Your Medicare eligibility (for Retiree medical
benefits only);
• Your status (full-time Active, part-time Active,
Retiree, ORP Retiree, etc.); and
• Your amount of service with the State (for Retirees
and ORP Retirees only).
If you are eligible for the maximum State subsidy, you
pay the amount shown on the premium rate charts
in the back of this Guide. However, some individuals
will receive no State subsidy or only a percentage
of the State subsidy and will be responsible for the
amount shown on the premium rate chart plus the
difference between the maximum State subsidy and the
percentage for which he or she is eligible to receive, if
any.
The premiums do not apply to Contractual, Part-time
Active (below 50%) Employees, Satellite Employees,
and some State Retirees and ORP Retirees. Contractual
and Part-time Employees do not receive any State
subsidy of their coverage. Satellite Employees
receive only the subsidy provided by their Satellite
Organization employer.