WHO CAN BE COVERED?
Your status as a full-time or part-time employee is based on your classification in the HR/payroll system and not on the number of hours you work. You are eligible for benefits if you are in the HR/Payroll system as a:
- Full-time employee classified to work 30 or more hours per week
- Part-time employee classified to work 24 – 29.9 hours per week
Eligible Family Members
You must enroll yourself in benefits in order to enroll your eligible family members. Eligible family members include:
Examples of who you CAN’T cover on Texas Health’s benefits: your parents, your aunt, your uncle, your neighbor’s kids.
- Your legal spouse (same- or opposite-sex)
- Your Common Law spouse (same- or opposite-sex)
- Your children and stepchildren
To be eligible for medical coverage, a child must:
- Be under 26 (or any age if physically or mentally incapable of self-support and unmarried) AND
- Live in the United States
To be eligible for dental, vision, or life insurance coverage, a child must:
- Be under 25 (or any age if physically or mentally incapable of self-support)¹
You may also cover a child that meets the criteria above if you are able to provide documentation that shows: you have adopted the child, the child has been placed in your home for foster care, or you have been appointed by the court as the child’s legal guardian or non-parent managing conservator. The documentation you provide must be copies of the court order signed by the judge. If you receive a QMCSO, special rules apply.
REQUIRED DOCUMENTATION FOR FAMILY MEMBERS
Did you know? Texas Health previously allowed same-sex domestic partners to be added to benefits, but when same-sex marriages became legal in all 50 states in 2015, our plan rules were updated to include same- or opposite-sex legal spouses. If you need legal resources to formalize a same- or opposite-sex domestic partnership, check out the EAP or Legal Insurance.
Whenever you add a family member to medical, dental or vision coverage, to make sure only eligible family members are enrolled, Texas Health requires you to provide documentation showing meet the eligibility requirements as stated in your Employee Benefits Handbook.
- Documents to Submit: a list of documentation can be found here or your Employee Benefits Handbook
- Deadline to Submit Documents: if you are enrolling as a new hire or making changes due to a work/life event, you must submit documentation within 31 days of your hire date, life event, or work event
- How to Submit Documents: You can submit documentation via email to THRBenefitsSupport@texashealth.org. Please attach this cover sheet when you send your documentation.
If you do not provide all required documentation within 31 days of the date your event occurs, your family members will not be added to coverage.
IF YOUR SPOUSE OR CHILD WORKS FOR TEXAS HEALTH
If you and your spouse both work for Texas Health, you cannot be covered both as an employee and a family member on the same benefit. And, only one of you may cover your eligible family members. If you and your benefits-eligible child work for Texas Health, you may cover your child as long as they meet the eligibility requirements. However, your child cannot be covered as an employee and a family member on the same benefit.
¹For Life Insurance, the term “child” means a child born or legally adopted by you. It includes a child during any waiting period prior to the finalization of the child’s adoption. It also means stepchild living with you and financially dependent upon you. Coverage is from live birth to age 25.