Eligibility Guidelines

Guidelines for employees

Before an employee can be added to a group plan, they must meet the following requirements:

• Have satisfied the group’s chosen New Hire Waiting Period (NHWP)
• Be a full-time employee, meaning they work 30 hours or more a week,* owner, partner, independent contractor, public officer, or public employee

*For Idaho only, there is an option for employers to lower the minimum hours to be eligible for coverage to 20 hours per week.

Guidelines for dependents

Enrolled employees can add their eligible dependents to the group plan. To qualify, dependents must meet one of the following requirements:

• Be a lawful spouse of an employee
• Be a domestic partner of an employee       
  • Optional on a group-by-group basis at employer’s discretion 
  • Employees will need to meet the domestic partner eligibility requirements as outlined in the contract documents
• Be the child of an employee (younger than age 26)
  • Natural or adopted child of the employee 
  • Child for whom the employee or employee’s legal spouse has been appointed legal guardian by a court 
  • Disabled children may stay on plan after age 26 if they meet certain requirements (See the group contract for details)