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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 37½ 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: A member of the opposite sex to whom you are legally married. IC 31-11-1-1(b) provides: A marriage between persons of the same gender is void in Indiana even if the marriage is lawful in the place where it is solemnized. Indiana does not recognize common law marriage entered into after Jan. 1, 1958. Employees are not allowed to claim dependents based on common law marriages.
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, under the age of 26.
Age limitation: Dependent children are eligible for coverage until their 26th 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 child’s 26th birthday. 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 26 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.
Adult relatives: Even in situations where the employee possesses a court order or legal guardianship, adult relatives (e.g. father, mother, aunt, uncle, niece, nephew) do not qualify as dependents and are not eligible for benefits through the state of Indiana except as dependents under the Dependent Care Spending Account.