Covering a Spouse and Spousal Coordination of Benefits Policy

The Spousal Coordination of Benefits (SCOB) Policy is used to determine a spouse’s benefit eligibility status under the State of Delaware Group Health Insurance Plan (GHIP). Enrollment does not automatically guarantee primary coverage for the spouse under the Plan.

It is the member’s responsibility to review the SCOB Policy and Chart before enrolling a spouse under their State of Delaware health plan.

A spouse is likely required to enroll in their own coverage if:

• They are offered a health plan from a current or former employer, and

• They would be responsible for 50% or less of the premium for the lowest health plan available to them.

If you cover a spouse under your Highmark Delaware or Aetna health plan, you are required to complete the online SCOB Form within 30 days of enrolling a spouse in a State of Delaware health plan, within 30 days of a spouse losing or gaining employee coverage and every year during the Annual Benefits Open Enrollment.

You, your spouse, or your spouse’s employer may be required to provide additional information.

FAILURE TO COMPLETE A SCOB FORM OR PROVIDE DOCUMENTATION WHEN REQUIRED WILL RESULT IN A REDUCTION OF YOUR SPOUSE’S COVERAGE.