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Who is Eligible

You

Retiree

You are eligible for the health insurance plan if you were a State officer or State employee and:

  • retired under a State of Florida retirement system, or a State optional annuity or retirement program or go on disability retirement under the State of Florida retirement system, as long as you:
    • were covered by the health insurance plan at the time of your retirement and you begin receiving retirement benefits immediately after you retired, or
    • maintained continuous coverage under the State plan from termination until receiving retirement benefits
  • retired before January 1, 1976, under any State retirement system, and you are not eligible to receive any Social Security benefits.

Surviving Spouse

You are eligible for the health insurance plan if you are the surviving spouse of:

  • an employee or retiree and you were enrolled in the health insurance plan as a dependent when the employee or retiree died
  • an employee or retiree who died before July 1, 1979
  • a retiree who retired before January 1, 1976, under any State retirement system, and you are not eligible to receive any Social Security benefits… and you have not remarried. Coverage ends on the first of the month following your remarriage.

COBRA Participant

You are eligible for the health insurance plan for a specified period of time if you qualify to continue coverage after leaving the State under the terms of the Consolidated Omnibus Budget Reconciliation Act (COBRA).

Dependents

If you enroll, you may also cover your eligible dependents by selecting family coverage. Eligible dependents include your:

  • Spouse.
  • Unmarried children through the end of the month in which they reach age 19.
  • Unmarried children age 19 through the end of the calendar year they reach age 25 if they depend on you for more than 50% of their financial support and live with you or are enrolled in any school, college or university certified or licensed by a state or foreign country.
  • Mentally or physically disabled children who have reached the age limits but are incapable of self-sustained employment and dependent on you for more than 50% of their financial support.
  • Child's newborn child for 18 months after the child's birth, or until your child who is the infant's parent no longer qualifies as your dependent.

Health Savings Accounts (HSAs) - Special Eligibility Rules

Retirees, surviving spouses and COBRA participants who are not Medicare-eligible and enroll in a Health Investor PPO or HMO may open an HSA through the State plan as long as the people they cover under the Health Investor medical plan do not have:

  • Medical coverage through a spouse's employer, Medicare, Medicaid or any other medical plan, other than the hospital, cancer or intensive care coverage available through the State's supplemental plans.
  • A healthcare flexible spending account that covers medical expenses.