Coverage for Your Dependents

Eligible dependents for health, dental, and vision insurance plans include the following:

• Your spouse. If he or she is an eligible public school retiree, you will be covered together on one contract.
• Your unmarried child by birth, legal adoption, or legal guardianship through December 31 of the year in which he or she turns age 19.
• Your unmarried child by birth, legal adoption, or legal guardianship from age 19 through December 31 of the year in which he or she reaches age 25 if a full-time student and dependent on you for support. 
• Your unmarried child by birth, legal adoption, or legal guardianship age 19 or older who is physically or mentally disabled, dependent on you for support, and unable to self-sustain employment. 
• Your parent or parent-in-law residing in your household.

Coverage for your eligible dependents will be the same as yours. 

In the case of legal adoption, a child is eligible for coverage as of the date of placement. Placement occurs when you become legally obligated for the total or partial support of the child in anticipation of adoption. A sworn statement with the date of placement or a court order verifying placement is required.

Required evidence.

You will be asked to provide birth certificates as proof of age and relationship, tax returns as proof of dependency, school records as proof of full-time attendance, and court orders to prove legal guardianship.

To ensure coverage for your incapacitated child, you will need to provide a letter from a physician stating the child is incapable of self-sustaining employment, along with a copy of the IRS form 1040 that identifies the child as your dependent. In addition, every year you may be asked to furnish proof of incapacitation and dependency.

Additional notes about insurance for your dependents.

• Upon your death, insurance benefits continue for your survivor pension beneficiary. (See Public Act 617 exception below.) Your eligible dependents who were covered at the time of your death may continue to receive insurance benefits if you have chosen the survivor option and designated your spouse as your survivor pension beneficiary.
• A federal law known as COBRA (Consolidated Omnibus Budget Reconciliation Act), allows your dependent the option of paying for continued health insurance coverage for up to 36 months after a qualifying event. The insurance carrier may also offer a conversion policy. Your dependents will be notified of these options.
• If you divorce, your former spouse's coverage ceases as of the divorce date. He or she may be eligible for COBRA continuation, however. Be sure to send ORS your divorce papers as soon as they are available.
• P.A. 617, which takes effect January 1, 2009, permits naming a new spouse as a survivor pension beneficiary under certain conditions. Upon your death, your surviving spouse named under this provision would be eligible to continue insurance coverage, but would be responsible for paying the full premium cost.