The following information is a brief overview of eligibility as a survivor. You can find a full description of survivor eligibility rules in the Plan of Benefits.

Spouses and children covered under the State Health Plan, Basic Dental or State Vision Plan are classified as survivors when a covered employee or retiree dies.

If an active employee or a retiree of a participating optional employer or charter school that participates in insurance only dies, a family member should contact the deceased’s employer to report the death, to discontinue the employee’s coverage and to start survivor coverage for their covered spouse and children. If a retiree of a state agency, higher education institution, public school district or charter school that participates in both insurance and retirement dies, a family member should contact PEBA.

To continue coverage, complete a Survivor Notice of Election within 31 days of the subscriber’s date of death. PEBA will generate a new Benefits Identification Number, and vendors will issue new ID cards for the programs under which the survivors are covered.

More information about survivor coverage is available in the Insurance Benefits Guide.

Special eligibility situations

A special eligibility situation is an event that allows you, as a survivor, to enroll in or drop coverage for yourself or eligible family members outside of an open enrollment period.¹

You can make changes using MyBenefits if you have a special eligibility situation, such as adding a newborn, marriage, divorce or adoption. MyBenefits will display the documentation required for each change, and you can upload the required documents through MyBenefits.

To make a change through your benefits administrator, you will need to:

• Contact your benefits administrator;
• Complete a Notice of Election within 31 days² of the event; and
• Upload documentation to MyBenefits or give documentation to your benefits administrator.

More details about special eligibility situations are available in the Insurance Benefits Guide.

¹A salary increase or decrease, or transfer does not create a special eligibility situation.
²Changes related to Medicaid or the Children’s Health Insurance Program must be made within 60 days.