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ELIGIBILITY LANGUAGE FOR IVY TECH HEALTH, DENTAL AND VISION PLANS
To enroll an individual as a Dependent in the Ivy Tech Community College Health and Dental Care Plan ("Health and Dental Plan")
and the Ivy Tech Community College Vision Plan ("Vision Plan"), the individual must be listed on the enrollment form completed
by the Covered Employee (including an LTD Participant) or Retiree, meet all dependent eligibility criteria established by Ivy Tech,
and fall within one of the following categories:
• The Covered Employee's or Retiree's spouse. For this purpose, "spouse" means a person who whom the Covered Employee's
or Retiree's is legally married to under federal tax law, unless:
o the Covered Employee or Retiree and his or her spouse are divorced or legally separated under a decree of
divorce or separate maintenance, or
o the spouse is not a citizen, resident or national of the United States, or
o the Covered Employee or Retiree and his or her spouse file separate returns, the Covered Employee or Retiree
maintains a household which is the principal place of abode for a child (with respect to whom the Covered
Employee or Retiree is entitled to a deduction) for more than ½ the calendar year, the Covered Employee or
Retiree furnishes more than ½ of the cost of maintaining that household, and the spouse was not a member of
that household during the last 6 months of the year.
• The Covered Employee's or Retiree's child until the end of the month in which the child attains age 26. For this purpose,
"child" means the natural child, stepchild, legally adopted child or child who has been placed for adoption, or eligible foster
child. An "eligible foster child" is a child who is placed with the Covered Employee or Retiree by an authorized placement
agency or by judgment, decree, or other order of a court of competent jurisdiction. For purposes of the Vision Plan only,
the child must be unmarried or a full-time student for coverage to extend until the end of the month the child attains age 26.
• The Covered Employee's or Retiree's child, as defined above, past the limiting age if the child:
o is enrolled as a Dependent prior to reaching the limiting age,
o is claimed as a tax dependent on the Covered Employee's or Retiree's federal tax return, and
o is "permanently and totally disabled," meaning that such child is unable to engage in any substantial gainful
activity by reason of a medically-determinable physical or mental impairment which can be expected to result in
death, or has lasted or can be expected to last for a continuous period of not less than 12 months.
The Covered Employee or Retiree must submit proof of incapacity to Ivy Tech within 120 days after the Dependent would
otherwise lose eligibility under the plan. Subsequent proof of continued incapacity may be required by Ivy Tech. You must
notify the Administrator and/or Ivy Tech if the Dependent’s status changes and he or she is no longer eligible for continued
The Plan may require the Covered Employee to submit proof of continued eligibility for any enrolled child. Your failure to provide
this information could result in termination of a child’s coverage.
Working Spouse Rule
The Working Spouse Rule requires employed spouses of Covered Employees or Retirees to enroll in their employer’s group health
plan and/or dental plan in order for them to be eligible to enroll in or remain on the Health and Dental Plan for secondary coverage.
The Working Spouse Rule will not apply with respect to any dental plan offered by Ivy Tech or any other employer that does not
coordinate benefits with other employer-sponsored dental coverage. Health and dental coverage are separately electable under
the Health and Dental Plan and this Working Spouse Rule will apply to each independently. The coordination of benefits provisions
under the Health and Dental Plan will continue to apply.
IMPORTANT: Your spouse may remain on the Health and Dental Plan for primary coverage as a Dependent if he or she meets
one of the following criteria:
1. He or she is currently unemployed and has no comprehensive group health and/or dental coverage (other than COBRA);
2. He or she is retired, is not currently employed, and is not eligible for coverage as a retiree under any employer-sponsored
comprehensive group health and/or dental plan, respectively;
3. He or she is employed or self-employed, but is not eligible for any employer-sponsored comprehensive group health
and/or dental plan, respectively;
4. He or she is employed or retired, but the employer or former employer does not provide comprehensive group health
and/or dental coverage, as applicable; or
5. He or she is employed or retired, but the employer or former employer does not pay at least 50% of the premium expense
for the spouse's employee/retiree only coverage under the employer-sponsored comprehensive group health and/or
dental plan, as applicable.
A Covered Employee's spouse is considered to be "eligible for" other coverage even if a pre-existing condition clause is applicable
or the spouse received a cash opt-out payment for not electing such coverage.
If you and your spouse are both benefits-eligible employees at Ivy Tech, you must each enroll as an employee under the Health
and Dental Plan and decide which parent will cover any Dependent children.