Covered services can be received in a nursing home, an assisted living center, through community care or at home. Participants can continue their plan when they retire or leave state service. Employees, retirees, and spouses, parents and in-laws of active employees or retirees, as well as dependent children under the age of 18 may participate in the program. Active employees are guaranteed acceptance into the plan.
Spouses have limited underwriting criteria to meet to participate.
All others are subject to full underwriting for participation. The employee or retiree does not need to participate for their spouses, parents, in-laws and dependent children to participate. Activities of daily living include bathing, dressing, toileting, transferring, eating and continence. The deductible period must be 90 consecutive calendar days. Once an applicant has been accepted, there are no limits or exclusions on coverage based on a participant's health prior to acceptance.