517 Insurance - State Employee Health Plan

Revised 04/09/2020

Policy

A child does not qualify for KidsCare if a parent, the child, or the child’s spouse is a state employee and can get state employee health insurance.

This requirement applies even when the child, child’s spouse, or parent chooses not to enroll.

NOTE     Some state employees do not qualify for state employee health insurance. When the person cannot get state employee health insurance, the child can qualify for KidsCare.

Even though they participate in the Arizona State Retirement System (ASRS), employees of school districts and charter schools are not state employees. Employees of school districts and charter schools cannot get state employee health insurance.

Exception:

Employees of the Arizona State Schools for the Deaf and the Blind are state employees, and can get state employee health insurance.

Definitions

Term	Definition
State employees who do not qualify for State Employee health insurance.	Employees who work less than 20 hours per week; Seasonal, temporary, emergency, and clerical pool employees; Patients or inmates employed in state institutions; Employees in positions created for rehabilitation only; and Employees of a state college or university who are hired to work for less than six months, or are not part of a state retirement plan.

 

Proof

When the person lists coverage through state employee health insurance on the application or verbally, accept the statement as proof.

When the person is a state employee but does not list coverage on the application, proof of coverage includes:

• Pay stubs showing any deduction for health coverage. Dental and vision plans are deductions for health coverage.

• Work Number records showing the person has medical, dental or vision insurance.

• Phone call to the personnel office at the agency, department or university where the person works to confirm whether the employee qualifies for state employee health coverage.

Legal Authority

This requirement applies to the following program:

Program	Legal Authorities
KidsCare	42 USC 1397jj(b)(2)(B) 42 CFR 457.310(c)(1) ARS 36-2983(G)(3) AAC R9-31-303(12)