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SPD > Benefits > 2008 Benefits > Eligibility Requirements to Enroll in the State of Indiana Benefit Plans Eligibility Requirements to Enroll in the State of Indiana Benefit Plans

There are no pre-existing condition limitations for any of the State's plans.  All active full-time employees and elected or appointed officials are eligible to participate.  For the purpose of benefits eligibility, full-time employees are defined as active employees whose regular work schedule is at least 37 ½ hours per week.   Part-time, intermittent and hourly (temporary) employees are not eligible for insurance or related benefits.

Dependents of eligible employees may be covered under the State's benefit plans.  Dependents are defined as:

Spouse: One's wife or husband. An ex-spouse is not eligible for coverage even if court ordered.

Children:  Unmarried dependent natural-, step-, foster-, or legally adopted- children, children who reside in the employee's home for whom the employee or spouse have been appointed legal guardian.

Age Limitation:  Dependent children are eligible for coverage through the end of the calendar year of their 19th birthday.

  • If the dependent child is a full-time student enrolled in an educational institution, the dependent child may be covered until the end of the calendar year of their 23rd birthday.
  • If the dependent child is both incapable of self-sustaining employment by reason of mental or physical disability and is chiefly dependent upon the employee for support and maintenance:
    • prior to age 19, the dependent child’s coverage shall continue if satisfactory evidence of such disability and dependency is received within 120 days after the end of the calendar year in which the maximum age is attained. Coverage for the dependent will continue until the employee discontinues his coverage or the disability no longer exists.
    • after age 19, a dependent child of the employee who attained age 19 while covered under another Health Care policy and met the disability criteria specified above, is an eligible dependent for enrollment so long as no break in coverage     longer than sixty-three (63) days has occurred immediately prior to enrollment. Proof of disability and prior coverage will be required. The plan requires annual documentation from a physician after the child’s attainment of the limiting age.

Adult Relatives: Even in situations where the employee possesses a court order or legal guardianship, adult relatives do no qualify as dependents and are not eligible for benefits through the State of Indiana except as dependents under the Dependent Care Spending Account.