Overview of PPO Plans
Who is eligible to enroll in a benefit plan with the State Health Plan?
- State employees with permanent employment working at least 30 hours per week for nine or more months per calendar year. For these employees, the state pays 100% of the cost of the coverage for the 70/30 Basic plan.
- Permanent state employees working 20 or more hours but less than 30 per week. These employees may enroll, but they must pay the full cost of coverage.
- Retired state employees and teachers.
- Dependents, the employee pays the full cost. Dependents that are eligible for coverage include the following:
- Legal spouse;
- Children under age 26, including natural, legally adopted, or foster children of the employee or employee's spouse;
- A child for whom the employee is a court-appointed guardian;
- Stepchildren of the employee when the employee is married to the stepchildren's natural parent; and
- Children who are physically or mentally incapacitated, to the extent that they are incapable of earning a living, and such handicap developed or began to develop before the dependent's 26th birthday.
New employees who enroll themselves and dependents age 19 and over within 30 days of employment are not subject to a waiting period for pre-existing conditions.
How to Enroll