Eligibility
Employee Eligibility
Regular full-time employees are eligible for all City of Plano benefits. Benefits begin on the first of the month following 30 days of service.
Who Can You Add to Your Plan?
Eligible Dependents
- Spouse
- Common law spouse
- Natural child
- Stepchild
- Domestic partner’s child
- Legally adopted child
- Child under your legal guardianship or custodianship (for example, grandchildren or foster children)
Dependent children are eligible until the end of the month in which they turn age 26, unless they are physically or mentally disabled and incapable of self-support. Please refer to Family Status Changes and Dependent Eligibility Requirements found at plano.gov/benefits.
Your dependent’s required documentation must be received within 30 days of the new hire date or qualifying event. If the documentation is not received, their enrollment will be removed from the plan.
Ineligible Dependents
- Divorced or legally separated spouse
- Foster children
- Sisters, brothers, parents, in-laws, and other relatives
Important note: Newborns are not automatically covered by the medical plan. You must contact Human Resources to enroll your child within 30 days of birth to elect coverage for the infant.
Change in Status
Generally, you may enroll in the plan, or make changes to your benefits, when you are first eligible. However, you can make changes or enroll during the plan year if you experience a qualifying change in status. As with a new enrollee, you must submit your paperwork within 30 days of the change or you will be considered a late enrollee.
Examples of a Change in Status
- You get married, divorced, or legally separated
- You have a baby or adopt a child
- You or your spouse/domestic partner takes an unpaid leave of absence
- You or your spouse/domestic partner has a change in employment status
- Your spouse/domestic partner dies
- You become eligible for or lose Medicaid coverage
- There is a significant increase or decrease in plan benefits or cost
| Eligibility and Enrollment | ||||||
|---|---|---|---|---|---|---|
| Deadline to Make Benefits Change | Effective Date of Change | Required Documentation | ||||
| Marriage / Divorce | 30 days from event date | Date of event | Marriage License, Divorce Decree, Registration of Informal Marriage (Common Law), Social Security Number | |||
| Birth / Adoption | 30 days from event date | Date of event | Birth Certificate, Adoption Agreement, Social Security Number | |||
Spouse Gain or Loss of Coverage | 30 days from gain/loss of coverage | Date coverage was gained / lost | Proof of gain – offer letter indicating hire date and when benefits begin, copy of completed enrollment form Proof of loss – letter from spouse’s HR office, termination notice, copy of completed enrollment form, Marriage License, Social Security Number | |||
| Death | 30 days from event date | Date of event | Death Certificate | |||
After you have enrolled in insurance coverage, you will receive additional information in the mail from the insurance carriers. This information will include your personal identification cards.
Visit plano.gov/benefits to download the Benefits Change Form.
Important note: Employees and spouses who turn age 65 and become Medicare-eligible will need to apply for Medicare Part A only. The City of Plano will provide your primary insurance coverage and Medicare will be secondary.