Eligibility

The term "employee" includes only:
  • Full-time state employees and employees of county health departments who are paid by the State Comptroller, the State Department of Mental Health, Historic Blakeley, Ft. Payne Improvement Authority, Historic Ironworks Commission, Bear Creek Development Authority, International Motor Sports Hall of Fame, Space and Rocket Center, the Alabama Sports Hall of Fame, the State Docks, St. Stephens Historical Commission, USS ALABAMA Battleship Commission, Red Mountain Greenway Commission, County Soil & Water Conservation Districts, or the Alabama Community College System.
  • Part-time employees working at least ten hours per week if they agree to have the required premium paid through payroll deduction.
  • Members of the Legislature and the Lieutenant Governor during their term of office.
Exclusion: You are not eligible for coverage if the SEIB determines that you are employed on a seasonal, temporary, intermittent, emergency, or contract basis unless you receive a W-2 and work an average of 30 hours per week, or 130 hours per month, during a designated measurement period as stipulated under the Affordable Care Act.
  • Your spouse (excludes divorced or common-law spouse);
  • A child under age 26, only if the child is:
    • your son or daughter,
    • legally adopted by you or your spouse,
    • your stepchild, or
    • a dependent for whom you, or your spouse, has legal and physical custody granted by a court of competent jurisdiction.
  • An incapacitated dependent child* over age 25 will be considered for coverage provided the dependent is:
    • unmarried,
    • permanently mentally or physically disabled or incapacitated,
    • had the condition prior to the dependent’s 26th birthday,
    • incapable of self-sustaining employment,
    • dependent on you for 50% or more financial support,
    • otherwise eligible for coverage as a dependent except for age,
    • covered as a dependent on your Plan immediately prior to the child’s 26th birthday,
    • and not eligible for any other group health insurance benefits.
    *The above requirements must be met to be eligible for coverage as an incapacitated child. The SEIB shall decide whether an application for incapacitated status will be accepted and final approval of incapacitation will be determined by Medical Review conducted by BCBS. The SEIB reserves the right to periodically recertify incapacitation. Neither a reduction in work capacity nor the inability to find employment is, of itself, evidence of eligibility. If a mentally or physically incapacitated child is employed, the extent of their earning capacity will be evaluated.

In the event of the death of a retired employee who carried family coverage, the eligible dependents may continue coverage by making appropriate premium payments to the SEIB. The SEIB must be notified within 90 days of the date of death.

Dependents may not be added to coverage after the death of the retired employee. To be eligible to continue coverage under this section, a dependent must be covered under the SEHIP immediately prior to the death of the retired employee.

If a dependent covered under this section cancels coverage for any reason, the dependent is ineligible for survivor coverage at a later date.

  • Your spouse or other dependents if they are independently covered as a state employee unless they are employed as a professional civil engineer trainee with ALDOT and their employment is part of their educational training
  • An ex-spouse or ex-stepchildren, regardless of what the divorce decree may state
  • Your biological child if the child has been adopted by someone other than your spouse and you have been relieved of your parental rights and responsibilities
  • Children age 26 and older
  • Incapacitated children age 26 and older who do not meet the Incapacitated Child eligibility requirements listed above under Eligible Dependent
  • A child of a dependent child
  • A daughter-in-law or son-in-law
  • Grandchildren or other children related to the member by blood or marriage for which the member does not have legal and physical custody
  • Grandparents
  • Parents
  • A fiancé(e) or live-in girlfriend or boyfriend
If your child meets the other Incapacitated Child eligibility requirements listed above under Eligible Dependent, a completed Incapacitated Child Certification Form and proof of incapacity must be provided to the SEIB no more than 60 days after the child’s 26th birthday. If you fail to submit the form and proof of incapacity within the required time period, or, if you do not maintain continuous coverage on the incapacitated child thereafter, your child is not eligible for future enrollment except in the following two situations:
  1. When a new employee requests coverage for an incapacitated child within 60 days of employment; or
  2. When an employee’s incapacitated child is covered under a spouse’s employer group health insurance for at least 18 consecutive months and:
    • the employee’s spouse loses the other coverage because:
      • the employer ceases operations, or
      • termination of employment or reduction of hours of employment, or
      • employer stopped contributing to coverage,
    • a change form is submitted to the SEIB within 30 days of the incapacitated child’s loss of other coverage, and
    • Medical Review approved incapacitation status.
In these two situations, your child must meet all Incapacitated Child eligibility requirements.