A spouse is eligible for enrollment in the State's health plan if they are a legal spouse or civil union partner. (Delaware law does not recognize common law marriage). Ex-spouses and ex-civil union partners are not eligible to be enrolled.

Please Note: A spouse's enrollment in the State of Delaware Group Health Insurance Plan does not automatically guarantee primary coverage under the State's health plan.

Spousal Coordination of Benefits Policy

The Spousal Coordination of Benefits (SCOB) Policy is a State of Delaware policy and applies to all spouses enrolled under the State's health plan. It is the member’s responsibility to review the SCOB Policy and Chart before enrolling a spouse under their health plan.

A spouse’s eligibility for primary coverage under the policy is determined on whether a spouse is offered healthcare benefits by their employer (or former employer) and the percentage amount they would be required to pay for the lowest individual plan available to them. It is not based on plan design, total plan cost or salary negotiations.

If you cover a spouse under your Highmark Delaware or Aetna health plan, you are required to complete an online SCOB Form immediately upon first enrolling your spouse, within 30 days of your spouse’s health care coverage or employment information changing, and every year during the Annual Benefits Open Enrollment.

Please Note: If you cover a Medicare eligible spouse under the Highmark Delaware Special Medicfill supplement plan, you are required to complete an online SCOB Form when you first enroll your spouse in the supplement plan and anytime your spouse’s health care coverage or employment information changes.

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.