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Who is eligible?

Your eligible dependents are defined as:

  • Legal spouse
  • Natural or adopted children to age 26
  • Children to age 26, over whom you have legal guardianship or legal foster care
  • Grandchildren and stepchildren to age 26 if they qualify as your dependents for federal income-tax purposes and live with you
  • Disabled dependents over age 26 who are incapable of self-sustaining employment because of mental retardation or physical handicap. The dependent must be primarily dependent on you for more than 50 percent of financial support and approved for coverage after age 26
  • Dependents (children and grandchildren) for whom a court order has been received requiring the employee to provide healthcare coverage, provided HR benefits receives the court order within 31 days after issuance. After a divorce, an ex-spouse is not eligible, except by court order issued at the time of a divorce. A divorce decree may not be amended to require a retiree to cover an ex-spouse under a city medical plan.
  • Changes to your benefits are limited to open-enrollment periods, unless you have a qualified change in family status. The change in benefits must be consistent with the status change.