Learning How to Join the Lumenos Georgia Health Insurance Plan
For specific information on joining the Lumenos plan, see:
- Eligibility
- Enrolling in the Lumenos plan
- When Coverage Begins
- Cost of Coverage
Eligibility
You and your dependent(s) may be covered under the Lumenos plan depending on your eligibility for benefits. For more information, see:
- Your Eligibility
- Dependent Eligibility
Your Eligibility
You are eligible to enroll yourself and your eligible dependents in the Lumenos Program on the first day of the month following one full calendar month of employment if you meet the following criteria:
- A full-time employee of the State of Georgia.
- You work at least 30 hours a week consistently and your employment is expected to last at least nine months.
Dependent Eligibility
You can also choose to cover your eligible dependents under the Lumenos plan. Eligible dependents include:
- Your legally married spouse (as defined by the State of Georgia)
- Your unmarried child who is under 19 years of age unless they are eligible for coverage as employees. Children that are legally adopted through the judicial courts become eligible only after they are placed in your physical custody.
- Stepchildren under age 19 who live with you at least 180 days per year and for whom you can provide documentation satisfactory to the plan that they are your dependents.
- Other children under age 19 if they live with you permanently and legally depend on you for financial support-as long as you have a court order, judgment or other satisfactory proof from a court of competent jurisdiction.
- Your natural children, legally adopted children or stepchildren 19 or older from categories 1 and 2 above who are physically or mentally disabled prior to reaching age 19 and who depend on you for primary support may continue their existing Plan coverage past age 19.
- Your natural children, legally adopted children, stepchildren or other children ages 19 through 25 from categories 1, 2, and 3 above who are registered Full- time Students at fully accredited schools, colleges, universities or nurse training institutions and, if employed, who are not eligible for a medical benefit plan from their employer. The number of credit hours required for Full-time Student status is defined by the school in which the child is enrolled
If an unmarried child reaches age 19 and is not a full-time student, you may continue coverage for that child if he or she meets the criteria listed below prior to age 19:
- incapable of self-support due to mental retardation or a physical handicap
- dependent on you for support and maintenance or dependent on other care providers for lifetime care and supervision
You must provide proof of your child's incapacity to the State Health Benefit Plan within 90 days after coverage would otherwise terminate. The Plan administrator may ask for proof of incapacity and dependency at any reasonable time. While the Plan requires that coverage requests be made within a specific time period, the documentation required to support your request may be filed, if necessary, within 60 days following the deadline to file the coverage request.
If your spouse also works for the State of Georgia, he or she may be covered as an employee rather than a dependent. If both parents are employees of the State of Georgia only one parent can cover the children.
Resources:
- » The Language of Health Insurance Companies & Claims
- » The Language of Hospitals, Health Insurance Claims & More
- » The Sample Explanation of Benefits Statements Table
- » Sample Explanation of Benefits Statement for Providers
- » The Language of Health Insurance Claims & Reimbursement
Articles:
- » A Smattering of Health Insurance News from Around the Nation
- » Massachusetts' Health Care Mandate a Success? Also, Online Health Records and Other News
- » Online Health Records in the News Again, Aetna Supports Health Insurance Reform and Health Care's Failures
Gerogia Consumers Guide to Health Insurance:
- » Introduction to the Georgia Health Insurance Consumer Guide
- » A Summary of Georgia Health Insurance Benefits
- » Verification of Georgia Health Insurance Benefits
- » Georgia Health Insurance Summary Notice
- » Important Georgia Health Insurance Phone Numbers
- » When Georgia Health Insurance Coverage Begins
- » When to Enroll in Georgia Health Insurance
- » Georgia Health Insurance Coverage Changes
- » Ending Georgia Health Insurance Coverage
- » Georgia Health Insurance Retirees & Employees Near Retirement
- » What Happens to Your Georgia Health Insurance if You Return to Active Service
- » How Georgia Health Insurance Benefits Work
- » Georgia Health Insurance Benefits Guide
- » More Information on Georgia Health Insurance Benefits
- » Georgia Health Insurance Benefits Information
- » Further Information Regarding Georgia Health Insurance Benefits
- » Georgia Health Insurance Network Mental Health Care and Substance Abuse Treatment Information
- » Georgia Health Insurance Prescription Drug Information
- » Georgia Health Insurance Exlusions from Coverage
- » Exlusions from Georgia Health Insurance Coverage
- » More Exclusions from Georgia Health Insurance Benefits
- » Coordination of Georgia Health Insurance Benefits
- » Georgia Health Insurance Information on Subrogation
- » General Information Regarding Georgia Health Insurance
- » More General Information on Georgia Health Insurance
- » Georgia Health Insurance General Coverage Information
- » When Georgia Health Insurance Coverage Terminates
- » Georgia Health Insurance Definitions
- » More Definitions Regarding Georgia Health Insurance
- » More Relevant Definitions Discussing Georgia Health Insurance
- » Even More Useful Georgia Health Insurance Definitions
- » A Final Page of Georgia Health Insurance-Related Definitions
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