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Eligibility Information

Part-time employees working at least 30 hours/week in a 35 hour position or 34 hours/week in a 40 hour position are also eligible to enroll in County benefits. Part-time employees working 26-29 hours are eligible for benefits at a reduced subsidy after three consecutive years of service.

Who is an Eligible Dependent?

  • A spouse (marriage must be legally recognized in the State of Maryland)
  • A dependent child who is unmarried, under the contract age limits, and for whom you must provide at least 50 percent support and who is:
    • The employee/retiree or their spouse's child by birth or legal adoption recognized under Maryland law or
    • A child under testamentary or court appointed guardianship recognized by Maryland law, who resides with the employee/retiree or their spouse or
    • A child who is the subject of a Qualified Medical Child Support Order (QMCSO) that creates the right of the child to receive health insurance benefits under employee or retiree coverage

Eligible dependents are required to have legal standing and/or legally sufficient documentation for residency in the United States while included on County health plans.

Age Limits for dependent children on Cigna plans, CareFirst BlueCross BlueShield Davis Vision and all Dental Plans:

  • Dependent children through the end of the calendar year they reach age 19
  • Dependent children who are full-time students through the month of graduation or other loss of student status, or the end of the calendar year they reach 25 - whichever comes first
  • Unmarried, dependent children enrolled in the Kaiser HMO plan and still residing in the employee or retiree's household, can continue coverage through the end of the month they reach age 25, regardless of student status

Non-Duplication of Coverage

You are not eligible to enroll in a County medical plan if you have similar coverage through another health plan (i.e. as a dependent on a spouse's employer plan.) If you should lose other medical coverage for any reason, you will be permitted to enroll in County plans by contacting the Insurance Division and providing proof of the loss of other coverage.

Family Status Changes

If you have a Family Status Change, you must notify the Insurance Division within 31 days of the event.

Baltimore County's Benefits Program allows you to choose the benefits you need while providing important tax advantages to County employees and to the County. Your share of the cost for your benefits is paid with before-tax payroll deductions. This means that employee payroll deductions for benefits are not subject to State, Federal and F.I.C.A. taxes.

In order to maintain this favorable tax treatment, the Internal Revenue Service (IRS) has established rules that govern our Benefit Program operation. Most importantly, the IRS requires that the choices you make remain in effect for 12 months unless you have a qualifying family status change.

If you experience a qualifying family status change, any change you make to your benefits must be "on account of and consistent with the lifestyle change". For example, if you get married or have a child, you can add your new dependent to your plan, but you cannot change the plan you chose during open enrollment.

When You Must Contact Baltimore County's Insurance Division

It is your responsibility to notify the Insurance Office each time you have a change in your Family Status. Including your dependent(s) on County benefit plans when they do not meet County eligibility requirements is fraudulent and subject to prosecution.

Contact the County Insurance Division at 410-887-2568 if any of the information on file with your benefits application changes. The Insurance Division is located at 400 Washington Ave, Room 111, Towson, MD, 21204. The Mail Stop number for this office is 2105.

Examples of Family Status Changes

  • Birth or adoption of a new child - children must be added to your coverage within 31 days of birth or adoption even if you already have family coverage
  • Divorce - the former spouse must be removed from your coverage within 31 days of the divorce decree
  • Loss of Student Status - if a dependent over age 19 is no longer a full-time student they must be removed from your coverage at the end of the month student status is lost (unless you are enrolled in Kaiser HMO plan) - CareFirst and Aetna health plans will deny claims if student status cannot be verified
  • Obtaining other health plan coverage - (including eligibility for Medicare) not identified on your health plan application
  • You or your spouse lose other benefit plan coverage - due to a change in employment status (i.e. changing from fulltime to part-time status)
  • You move to a new residence outside Maryland that is not included in your current health plan's coverage area

You may be asked to provide proof of the change requested (i.e. a copy of the divorce decree to remove a spouse from coverage.)

Continuation of Benefit Coverage While on an Approved Leave of Absence

If you are on an approved leave of absence from Baltimore County, your health plan contributions will continue to be deducted from your paycheck as long as you have paid leave (i.e., sick leave, vacation, holiday, etc.) available. When your accrued leave is exhausted or when you cease to be paid by Baltimore County, you must contact the County Insurance Division to make arrangements to continue your benefits.

COBRA Rights for Continuing Benefits When you or a Dependent no Longer Meet Eligibility Requirements

If your employment ends with Baltimore County, your coverage will end on the last day of the month following your final payroll deduction for benefits. (i.e. If you worked through the second pay in July and had a benefits deduction - your coverage stays in effect through August. If you did not have a payroll deduction in July, your benefits would end on the last day of July.)

If a dependent on your health plan no longer meets the County's eligibility requirements you must notify the County Insurance Division promptly. Benefit coverage for the dependent will end on the last day of the month in which your dependent was eligible. (Example - your 22 year old graduates from school on May 5 - their benefit coverage ends on May 31)

Spouses who lose benefit coverage due to the death of an employee or retiree must also contact the County Insurance Division promptly. In addition, employees who obtain a legal divorce must notify the County Insurance Division within 31 days of the final decree.

Through federal legislation known as COBRA, you may choose to continue County benefit coverage - if you do so, you will be required to pay the entire monthly premium plus and administrative fee of 2 percent of the premium for the plan(s) you choose to continue. Each individual covered by a County benefit plan has independent election rights to continue the benefit coverage that would have been lost. The right to continue coverage under COBRA provisions ends at the earliest of the following events:

  • You or your dependent(s) become covered under another group health plan; or
  • You or your dependent(s) become entitled to Medicare; or
  • You or your dependent(s) fail to pay the monthly premium cost; or
  • You or your dependents reach the maximum period of continuation

Revised June 18, 2012

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