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Indiana State Personnel Department

SPD > Benefits > Eligibility > Eligibility requirements to enroll Eligibility requirements to enroll

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 37½ hours per week. Part-time, intermittent and hourly (temporary) employees who worked an average of thirty (30) or more hours per week over a 12-month review period would also be eligible for benefits.  Part-time, intermittent and hourly (temporary) employees working less than thirty (30) or more hours per week over a 12-month review period are not eligible for insurance or related benefits.

Dependents of eligible employees may be covered under the State’s benefit plans. In order for dependents to be covered, the employee must be covered. Dependents are defined as:

Spouse:  An individual to whom you are legally married. IC 31-11-8-5 provides: a marriage is void if the marriage is a common law marriage that was entered into after Jan. 1, 1958. Employees are not allowed to claim dependents based on common law marriages. An ex-spouse is not eligible for coverage even if court ordered.  

Children: Natural-, step-, foster, or legally adopted children; children who reside in the employee's home for whom the employee or spouse has been appointed legal guardian or awarded legal custody by a court, until the end of the month in which they turn 26.

Age limitation: Dependent children are eligible for coverage until the end of the month in which they turn 26.

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 maximum age is attained.  Coverage for the dependent will continue until the employee discontinues his coverage or the disability no longer exists.

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 63 days has occurred immediately prior to enrollment. Proof of disability prior to age 19 and proof of prior coverage will be required. The plan requires annual documentation from a physician after the child’s attainment of the limiting age.

Examples of persons NOT eligible for coverage as a dependent:

  • Ex-spouse
  • Live-in boyfriends or girlfriends
  • Parents or parents-in-law
  • Grandchildren (unless employee is the court-appointed legal guardian or custody)
  • Adults under guardianship of employee
  • Dependents older than the end of the month in which they turned 26 that are not disabled
  • Any other members of your household who do not meet the definition of an eligible dependent