Insurance Benefits
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Coverage & Eligibility Adjust font size Decrease Font SizeIncrease Font Size

If an active employee or a retiree of a local subdivision dies, a family member should contact the deceased's employer to report the death, to discontinue the employee's coverage and start survivor coverage for any covered dependents. If a state agency, higher education or school district retiree dies, a family member should contact PEBA Insurance Benefits for details.

If one of your dependents dies, please contact your benefits administrator. PEBA Insurance Benefits is the benefits administrator for retirees of state agencies, higher education institutions and school districts. Retiree subscribers of local subdivisions keep the same benefits administrator.

Survivors
Spouses and children who are covered as dependents under the State Health Plan or an HMO are eligible as survivors for a one-year waiver of health insurance premiums when a covered employee dies.

Premiums are also waived for qualified survivors of funded retirees of state agencies, higher education institutions and school districts. Participating local subdivisions may elect to, but are not required to, waive the premiums of survivors of retirees. Retirees of a participating local subdivision should check with their benefits administrator to see whether the waiver applies.

After the premium has been waived for a year, a survivor must pay the subscriber and employer share of the premium to continue coverage. If the deceased and his spouse are both covered employees or retirees at the time of death, the surviving spouse is not eligible for the premium waiver.

State Dental Plan, Dental Plus and vision premiums are not waived. However, survivors may continue State Dental Plan, Dental Plus and vision coverage by paying the full premium.

The health and dental premiums of a covered spouse or dependent child of a covered employee who was killed in the line of duty while working for a participating group will be waived for the first year after the employee’s death. The survivor must submit verification of death in the line of duty. After the one-year waiver, a covered surviving spouse of a state agency, higher education institution or a school district employee may continue coverage, at the employer-funded rate, until he remarries or otherwise become ineligible. A covered surviving dependent child may continue coverage at the employer-funded rate until he is no longer eligible for coverage as a dependent. Participating local subdivisions may elect to, but are not required to, contribute to a survivor’s insurance premium, but the survivor may continue coverage, at the full rate, for as long as he is eligible.

A surviving spouse may continue coverage until he remarries. A dependent child can continue coverage until he is no longer eligible as a dependent. Please notify PEBA Insurance Benefits within 31 days of loss of eligibility for coverage. A person who is no longer eligible for coverage as a survivor, may be eligible to continue coverage under COBRA. Contact PEBA Insurance Benefits for details.

As long as a survivor remains covered by health, vision or dental insurance, he can add the others during open enrollment or within 31 days of a special eligibility situation. If he drops health, vision and dental insurance, he is no longer eligible as a survivor and cannot re-enroll in coverage, even at open enrollment.

If a surviving spouse becomes an active employee of a participating employer, he can switch to active coverage. When he leaves active employment, he can go back to survivor coverage within 31 days, if he has not remarried. 

Additional information:
COBRA
Insurance Benefits Guide