A brief overview of eligibility as a survivor is below. You can find a full description of survivor eligibility rules in the Plan of Benefits.
Spouses and children covered under the State Health Plan, Basic Dental or the State Vision Plan are classified as survivors when a covered employee or retiree dies.
If an active employee or a retiree of a participating optional employer dies, a family member should contact the deceased’s employer to report the death, to discontinue the employee’s coverage and to start survivor coverage for his covered spouse and children. If a retiree of a state agency, higher education institution or public school district dies, a family member should contact PEBA.
To continue coverage, a Survivor Notice of Election form must be completed within 31 days of the subscriber’s date of death. A new Benefits Identification Number (BIN) will be created, and identification cards will be issued by the vendors of the programs under which the survivors are covered.
More information about survivor coverage is available in the Insurance Benefits Guide.
Special eligibility situations
A special eligibility situation is an event that allows you, as a survivor, to enroll in or drop coverage for yourself or eligible family members outside of an open enrollment period.1
You can make changes using MyBenefitsexternal link, opens in a new tab if you have a special eligibility situation, such as adding a newborn, marriage, divorce or adoption. MyBenefits will display the documentation required for each change. The required documents can be uploaded through MyBenefits.
To make a change through your benefits administrator, you will need to:
- Contact your benefits administrator;
- Complete a Notice of Election form within 31 days2 of the event; and
- Upload documentation to MyBenefits or give documentation to your benefits administrator.
More details about special eligibility situations are available in the Insurance Benefits Guide.
1A salary increase or decrease, or transfer does not create a special eligibility situation.
2Changes related to Medicaid or the Children’s Health Insurance Program (CHIP) must be made within 60 days.