Spouse Health Plan Enrollment Information
For Employees Hired Before August 1, 2003
To enroll for coverage in the PEBTF, if the spouse of an employee hired before August
1, 2003, is eligible for medical, prescription drug benefits or supplemental benefits
(vision, dental and hearing aid) through their own employer and does not have to pay
for coverage, your spouse must take their employer’s coverage as primary coverage.
In that event, your spouse’s coverage in the PEBTF is limited to secondary coverage.
If your spouse has to pay for coverage or is offered an incentive not to take their
employer’s coverage, your spouse does not have to enroll in their employer’s coverage
and the PEBTF will remain as primary.
Contact your HR office any time there is a change to a spouse’s medical, prescription
drug or supplemental benefits (vision, dental and hearing aid).
For Employee Hired or Re-hire on or After August 1, 2003
To enroll for coverage in the PEBTF, a spouse of an employee hired on or after August
1, 2003, who is eligible for medical, prescription drug benefits or supplemental benefits
(vision, dental and hearing aid) coverage through their own employer must take their
employer’s coverage as their primary coverage; regardless of any employee contribution
the spouse must pay and regardless of whether the spouse had been offered an incentive
to decline such coverage. Coverage for such spouse in the PEBTF is limited to secondary
coverage. This rule does not apply for those spouses who are self-employed. You will
have to complete an annual attestation to continue coverage for your spouse.
The PEBTF will notify you of the attestation deadlines.
Contact your HR office any time there is a change to a spouse’s medical, prescription drug benefits or supplemental benefits (vision, dental and hearing aid) coverage.
Common Law Marriages
The PEBTF will only recognize a Pennsylvania common law marriage entered into prior to September 17, 2003.
If you and your spouse are married by common law, the PEBTF will permit you to enroll
your common law spouse as a Dependent, provided you complete a Common Law Marriage
Affidavit and provide any additional information requested by the PEBTF to demonstrate
the validity of your common law marriage. There are no exceptions to this
rule.
Your common law marriage must be recognized as such by the state in which it was contracted.
Most states do not recognize common law marriage and while some states still recognize
common law marriage, there is no such thing as a common law divorce. If you list an
individual as your common law spouse and subsequently remove them from
coverage, you will not be permitted to subsequently add someone else as your spouse,
common law or otherwise, without first producing a valid divorce decree from a court
of competent jurisdiction certifying your divorce from your prior common law spouse.
If you entered into a common law marriage prior to September 17, 2003, and would like
to cover your common law spouse, you will be required to provide proof of such a common
law marriage by presenting documents dated prior to September 17, 2003, such as a
deed to a house indicating joint ownership, joint bank accounts, and/or a copy of
the cover page (indicating filing status) and signature page (if different) of your
federal income tax return indicating marital status as of 2002. Figures reflecting
income and deductions may be redacted, i.e. blacked out. Additional documentation
may be required by the PEBTF.
No Duplication of Coverage
If you and your spouse both work for the Commonwealth or a PEBTF-participating employer, you may not be enrolled as both an Employee Member and as a Dependent under your spouse’s coverage.
Also, you cannot participate in both the PEBTF’s Plan for Active Employees and the Retired Employees Health Program (REHP) of the Commonwealth of Pennsylvania. Finally, your Dependent child may be enrolled under your or your spouse’s coverage, but not both.
The only exception to this rule is that RPSPP members and REHP members may be covered on a spouse’s Active Member contract for supplemental benefits (vision, dental, hearing aid) only. The RPSPP member’s and REHP member’s coverage under their retiree plan will be primary for prescriptions and/or dental coverage, where applicable.