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eligibility

Eligibility/Enrollment?
In order to establish participation in the MPI Active Health Plan for yourself, your spouse or your dependents, you will need to have completed and returned certain necessary forms. Please the consult the Enrollment Guide below to determine MPI requirements for each enrollment category.

Please note that Active Health Plan Participants must pay premiums for continuing coverage of their dependents and/or themselves, no matter which health plan they choose. If you are or become an Active Plan Participant and you choose to enroll your dependents, you will receive Health Premium Notices specifying the amount due to MPI for each ongoing eligibility period.

IF YOU WANT TO YOU MUST SUBMIT THE FOLLOWING DOCUMENTATION
Change addresses
Enroll yourself
 
Enroll your spouse

(For same sex domestic partners, see below.)
Enroll your same-sex domestic partner and, at least 3 of the following
  • Domestic Partnership Agreement
  • Joint mortgage or lease
  • Designation of partners as each other’s life insurance or retirement plan beneficiaries
  • Joint ownership of a motor vehicle, primary checking account or credit account
  • Other documentation confirming mutual financial support
  • Quarterly tax payment, if you do not claim your partner as a dependent on your taxes. (See enclosed Self-Pay Quarterly Tax Rates table.)
 
Enroll your new biological child
Enroll your stepchild, foster child, adopted child, or child for whom you are the legal guardian
Enroll your student(s) ages 19 - 23
Enroll your adult children ages 19 - 26 (Active Plan only)
 
* The Coordination of Benefits forms only apply to Participants and their dependents when enrolling in the Anthem Blue Cross Preferred Provider Option Plan (PPO) and the Oxford (POS) plan.

**If you are a Participant of the Retiree Health Plan, you are not required to pay a premium for your dependent(s)