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Employee Benefits

Enrollment and Eligibility FAQs

Who is eligible for the Plan?

For State Employees:

  • A full-time employee in a budgeted position.
  • A Member of the General Assembly.
  • An elected Constitutional Officer.
  • An appointed or elected member of a Board or Commission serving on a full-time, salaried basis.

For Public-School Employees:

  • A full-time employee that performs their duty for at least 30 hours per week during the annual school year.
  • A school bus driver 
    • Who is contracted with a school district to operate a school bus for at least 720 hours during the school year; or
    • Where driving a school bus is their primary source of income; or
    • Who is designated by the district superintendent as a “full-time school bus driver.”
Are Extra Help positions eligible to enroll on the Plan?

Extra Help employees are not eligible to enroll on the Plan unless they have been assured coverage by their agency and the agency has agreed to pay the state match for their coverage.  The extra help employee must also be a non-eligible employee as defined under state law.  The employee will be responsible for their portion of the premium.

Are my dependents eligible to be on the Plan?

A legal spouse is eligible to be on the Plan unless the spouse is eligible for employer-sponsored group insurance from their employer.  Former spouses are not eligible to be dependents on the Plan.

Children are eligible if they:

  • Are Under the age of 26.
  • Are your biological children, adopted children, stepchildren, or you have permanent legal guardianship of them.
  • Have a Qualified Medical Child Support Order (QMCSO) dependent under 26 and you have the full issued order.
  • Are a qualified disabled dependent and have been medically certified as Totally Disabled due to mental or physical incapacity.
How long can my children stay on the Plan?

Children may stay on the plan until they are 26 years old.  Once a child turns 26, you will be notified of their automatic removal from your plan, which will occur on the last day of their birth month.  For example, if a child turns 26 on June 10th, they will be termed from your plan on June 30th.

How do I enroll on the Plan?

You must submit an ARBenefits Election Form or enroll through the online member portal within 60 days of your start date or a qualifying event allowing you to enroll.  If you are adding dependents, you must submit supporting documentation as needed within the 60-day window to enroll.

What is a qualifying event?

A qualifying event (QE) is an event that allows you to enroll or cancel coverage for you or your dependents.  Examples include marriage, birth, adoption, divorce, gain or loss of Medicaid, gain of Medicare Part A, and gain or loss of other employer sponsored group coverage. 

To makes changes to your coverage outside of Open Enrollment you must submit an ARBenefits Change Form indicating the type of QE as well as any required supporting documentation.

What supporting documentation is needed to complete my enrollment?

Marriage: Copy of your marriage license and a completed Spousal Affidavit Form

Birth: Birth Certificate(s)

Adoption/Permanent Legal Guardianship: Birth certificate(s) and court order of adoption or permanent legal guardianship

Divorce: Copy of your final divorce decree

Gain or Loss of Coverage:  Certificate of Credible Coverage (COCC) from the new or previous provider

Gain or Loss of Medicaid:  Letter from DHS stating eligibility.  If you are trying to enroll because of the loss of Medicaid, the letter must state you are ineligible and that you have completed the full eligibility process with Medicaid.

Gain of Medicare Part A: Copy of Red, White, and Blue card

How can I make changes during Open Enrollment?

You may submit the ARBenefits Election Form via the ARBenefits online portal, to the Employee Benefits Division, or to your local Health Insurance Representative (HIR).  The Open Enrollment period allows you to change your coverage type or adjust your existing plan.  All changes made during the Open Enrollment period will begin January 1 of the following year.

When is Open Enrollment?

The Open Enrollment period for 2024 will be October 1-31.

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