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Dependent Coverage

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Michigan Office of Retirement Services

Dependent Coverage

Dependent Coverage

For insurance purposes, a dependent refers to someone who is eligible to be added to your health insurance plans. Eligible dependents for the retirement system's health, prescription drug, dental, and vision insurance plans include:
  • Your spouse. If they're an eligible public school retiree, you'll be covered together on one contract.
  • Your child by birth, adoption, or legal guardianship until the end of the month in which they turn 26.
  • Your unmarried child by birth, adoption, or legal guardianship who is totally and permanently disabled, dependent on you for support, and incapable of self-sustaining employment. See coverage for disabled dependents below for more information.
    • 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.
    • In the case of legal guardianship, official guardianship paperwork must be in place for a dependent to be eligible for coverage. Once a guardianship terminates, dependent eligibility for coverage ends.
  • Either your parent(s) or parent(s)-in-law residing in your household — one set of parents or the other, but not both.
Coverage for your eligible dependents is the same as yours.

Note: Your stepchild is not eligible for coverage. 
 
You're responsible for immediately notifying the Michigan Office of Retirement Services (ORS) of any change in your status or that of your dependents that would affect insurance eligibility. If it's discovered that an ineligible person is covered by your insurance plan, that person will be disenrolled from your plan retroactively, and you may be responsible for repaying any claims paid on their behalf.

Required proof(s) for coverage

You'll be asked to provide photocopies of the following:

  • Government-issued marriage certificate or a copy of your and your spouse’s valid driver’s licenses showing matching addresses along with your most recent tax Form 1040 showing you filed as married. 
  • Government-issued birth certificates as proof of age and relationship.
  • Court orders to prove legal guardianship (if applicable).
  • To cover your parent(s) or parent(s)-in-law, you must provide proof of age, proof of residency, and proof of relationship. Proofs of age include a valid state driver's license, valid state-issued ID, or valid passport. Proofs of residency include a copy of one of the following in the parent or parent-in-law’s name showing your address: tax Form 1099 or Form 1098 for the previous year, a current voter registration card, a valid state driver’s license, or valid state-issued ID. Proof of relationship is a copy of your or your spouse’s government-issued birth certificate verifying parentage.

These documents are referred to as proofs, proving eligibility for coverage. Learn more here about the required proofs you may need to submit to enroll a spouse or dependent in the retirement system's insurance plans.

Note: The time frame to submit an enrollment request and proofs for your spouse and dependents is the same as enrolling yourself in insurances. 

Coverage for disabled dependents

To ensure coverage for your incapacitated child, you'll need to provide:

  • A current letter from the attending physician detailing the disability, stating the child is:
    • Totally and permanently disabled.
    • Incapable of self-sustaining employment.
  • IRS Form 1040 that identifies the child as your dependent.

Coverage for a disabled dependent can begin the first of the month after ORS approves their eligibility, so it's important to provide documentation as early as possible. In some cases, we may ask for additional information to determine medical eligibility. This may delay enrollment.

Note: The time frame to submit an enrollment request and proofs for your spouse and dependents is the same as enrolling yourself in insurances. 

Additional notes about insurance for your spouse, dependents

COBRA insurance

A federal law known as Consolidated Omnibus Budget Reconciliation Act (COBRA), allows your spouse or child the option of paying for continued health insurance coverage for up to 36 months after a qualifying event that results in the loss of eligibility for coverage. Your health insurance carrier may also offer a conversion policy for your dependents. Your dependents will be notified of these options by the health insurance carrier. Contact the insurance carrier for more information. 

Survivor coverage

If you choose a survivor option for your pension and you have the premium subsidy benefit, your designated pension beneficiary can enroll in or continue group insurances after your death. If you choose your spouse as your survivor pension beneficiary, your eligible dependents who were covered at the time of your death will also continue to receive insurance benefits as long as they remain eligible.

If you choose a survivor option for your pension and you have the Personal Healthcare Fund, any eligible beneficiaries and dependents who were already enrolled in the retirement system's insurance plans at the time of your death may continue to be enrolled in those insurance plans. They will continue to be responsible for the entire premium. If they are disenrolled from the plan at any time, they will not be able to reenroll.

Divorce

If you divorce, your former spouse's coverage stops as of the end of the month in which the divorce occurs. They may be eligible for COBRA continuation, however.

If you're covered under your spouse's plan at the time of divorce, and lose coverage, it's considered a qualifying event. Learn more about qualifying events and enrollment time frames.