MMB's Updated Rules on Who is Eligible for Coverage through SEGIP and When

MMB updated its eligibility rules around who is eligible for insurance coverage through SEGIP.

​In addition to dependent eligibility, MMB also updated SEGIP policies around what happens when a dependent is found to be ineligible for the plan. Employees may now be liable for additional costs.

​Note that there may be financial implications to the employee from ineligible dependent enrollment.

​What Has Changed

• Former spouses cannot remain on SEGIP family coverage after a divorce.
• ​If an employee covers someone who is not eligible for coverage through SEGIP, the employee may have to pay extra costs in accordance with state and federal law.
• ​When MMB gets forms from the employee determines the date coverage is effective for a new spouse.
• ​Eligibility rules for adding grandchildren and foster children have been updated and clarified.

​Former spouses

A married employee with family coverage under a SEGIP plan must tell MMB if they get a divorce. Employees must submit a Qualifying Status Change form to SEGIP. The former spouse’s coverage on the family plan ends on the last day of the month that the divorce is final.

​When MMB receives notice within 60 days of the divorce, the former spouse can continue their coverage through COBRA. The former spouse will be removed from the employee's family coverage on the last day of the month in which the divorce occurred. The COBRA coverage begins the day after the family coverage ends, so there is no break in coverage. A former spouse who selects COBRA will be billed the COBRA premium each month for single coverage.

​If the employees fails to notify SEGIP of the divorce within 60 days, the former spouse is not eligible to continue coverage through COBRA. In addition, the employee may have to pay extra costs in accordance with state and federal law.

​New spouses

​The earliest a new spouse can go on an employee's coverage is the first of the month after SEGIP gets the forms from the employee. Employees have 30 days following their marriage to submit a Qualifying Status Change form​. The 30 days starts on the date of the marriage. Employees will find instructions on the form.

​The policy update is based on IRS rules and applies to medical, dental, vision, and life insurance coverage. ​For example:

• ​You get married Nov. 8, 2025. You send the form to SEGIP Nov. 20. Your spouse's coverage begins Dec. 1.

• ​If you wait until Dec. 1 to send in the form, your spouse's coverage isn't effective until Jan. 1, 2026.

​Grandchildren, foster children

​Employees can now add or keep their grandchildren on their coverage up to age 25 if the grandchild has received principal support and has continuously lived with the employee, or if the grandchild is a tax dependent of the employee.

​Rules for dependent children have been updated to clarify eligibility for foster children, children under legal guardianship, and children by placement to a relative (an employee). These children can now generally stay on coverage until age 26 as long as a court order or decree is in place.​​