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					                    Eligibility for University of Michigan Benefits by Career/Group
        Group                                 Eligibility Criteria1                                     Eligible                                              Not Eligible

       Faculty                               • You are a regular faculty or staff member,               • Medical Insurance2
       Staff                                   including primary and instructional staff                • Dental Plan (Option 1, 2, or 3)
                                             • You have at least a 50% appointment                      • Vision Plan
       LEO Lecturers                           lasting four continuous months or longer                 • Basic Long-Term Disability
          II/III/IV                            (exception: for Long-Term Disability, your                 (AFSCME members only)
       AFSCME                                  appointment must last eight months or                    • Expanded Long-Term Disability
                                                                                                            (Supplemental Faculty appointments and
       POAM                                    more)
                                                                                                            AFSCME members are not eligible)
       MNA                                   • Basic Retirement Plan and SRA eligibility
                                                                                                        • University Life, Optional Life, and
                                               only requires a 1% or greater appoint-                     Dependent Life Insurance
       IUOE                                    ment and funding for four consecutive                    • Long-Term Care
       Trades                                  months or longer                                         • Legal Plan
                                                                                                        • Flexible Spending Accounts
                                                                                                        • Travel Accident Insurance and Secure
                                                                                                          Travel Plan
                                                                                                        • Basic Retirement Plan, SRA, and 457(b)
                                                                                                        • MHealthy Rewards3
                                                                                                        • MHealthy Programs4

       Supplemental                          • You have a 50% or greater appointment                    •   Medical Insurance2                                • Basic Retirement Plan if less than
       LEO Lecturers I                          and funding for four continuous months                  •   Dental Plan (Option 1, 2, or 3)                      a 50% appointment
                                                or longer                                               •   Vision Plan                                       • Long-Term Disability
                                                                                                        •   University Life, Optional Life, and
                                                                                                            Dependent Life Insurance
                                                                                                        •   Long-Term Care
                                                                                                        •   Legal Plan
                                                                                                        •   Flexible Spending Accounts
                                                                                                        •   Travel Accident Insurance and Secure
                                                                                                            Travel Plan
                                                                                                        •   Retirement Plan (Basic)
                                                                                                        •   SRA and 457(b) with a 1% or greater
                                                                                                            appointment for four consecutive
                                                                                                            months or longer
                                                                                                        •   MHealthy Rewards3
                                                                                                        •   MHealthy Programs4

       GSI                                   You have less than a 25% appointment                       • GradCare2                                          •   Dental Plan (Option 2 or 3)
       GSSA                                  and funding for one full term. You must pay                • Dental Option 1                                    •   Vision Plan
                                             50% of the premium for Dental Option 1.                    • Long-Term Care (50% appointment)                   •   Long-Term Disability
                                                                                                        • Travel Accident Insurance and Secure               •   University, Optional, and
                                                                                                          Travel Plan                                            Dependent Life Insurance
                                                                                                        • SRA and 457(b) with a 1% or greater                •   Flexible Spending Accounts
                                                                                                          appointment for four consecutive
                                                                                                          months or longer                                   •   Legal Plan
                                                                                                        • MHealthy Programs4                                 •   Retirement Plan (Basic)
                                                                                                                                                             •   MHealthy Rewards

                                             You have a 25% or greater appointment                      •   Medical Insurance (including GradCare)2          • Long-Term Disability
                                             and funding for a minimum of four continu-                 •   Dental Plan (Option 1, 2, and 3)                 • Basic Retirement Plan
                                             ous months for fall and winter term or 25%                 •   Legal Plan                                       • MHealthy Rewards
                                             appointment and two months continuous                      •   Long-Term Care (50% appointment)
                                             appointment in the spring/summer term.                     •   Flexible Spending Accounts
                                                                                                        •   Travel Accident Insurance and Secure
                                                                                                            Travel Plan
                                                                                                        •   University, Optional, and Dependent
                                                                                                            Life Insurance
                                                                                                        •   Vision Plan
                                                                                                        •   SRA and 457(b)
                                                                                                        •   MHealthy Programs4

       GSRA                                  You have a 25% or greater appointment                      •   Medical Insurance (GradCare only)2               • Long-Term Disability
                                             and funding for a minimum of four                          •   Dental Plan (Option 1, 2, and 3)                 • Basic Retirement Plan
                                             continuous months at all times                             •   Legal Plan                                       • MHealthy Rewards
                                                                                                        •   Long-Term Care
                                                                                                        •   Flexible Spending Accounts
                                                                                                        •   Travel Accident Insurance and Secure
                                                                                                            Travel Plan
                                                                                                        •   University, Optional, and Dependent
                                                                                                            Life Insurance
                                                                                                        •   Vision Plan
                                                                                                        •   SRA and 457(b) with a 1% or greater
                                                                                                            appointment for four consecutive
                                                                                                            months or longer
                                                                                                        •   MHealthy Programs4

    1 Employees with dual career/job families are eligible for the Basic Retirement Plan if effort and funding are present in the appropriate combination. For example, if you are a Research Fellow
      who is also appointed as a Lecturer, you are eligible for the Basic Retirement Plan if the Lecturer job has at least a 1% appointment, regardless of which position has funding.
    2 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
    3 For more information on MHealthy Rewards, please visit: mhealthy.umich.edu/rewards
1   4 For more information on MHealthy Programs, please visit: mhealthy.umich.edu
                Eligibility for University of Michigan Benefits by Career/Group
    Group                               Eligibility Criteria1                                  Eligible                                              Not Eligible


    HOA                                  You receive U-M funding and have a 0%                •   Medical Insurance2                                  • Expanded/Basic Long-Term Disability
                                         or greater appointment lasting four con-             •   Dental Plan (Option 1, 2, or 3)                     • Basic Retirement Plan
                                         tinuous months or longer                             •   Vision Plan
                                                                                              •   Long-Term Disability (provided through
                                                                                                  the House Officers Association)
                                                                                              •   University, Optional, and Dependent
                                                                                                  Life Insurance
                                                                                              •   Long-Term Care
                                                                                              •   Legal Plan
                                                                                              •   Flexible Spending Accounts (stipends
                                                                                                  are not eligible)
                                                                                              •   Travel Accident Insurance and Secure
                                                                                                  Travel Plan
                                                                                              •   SRA and 457(b) with a 1% or greater
                                                                                                  appointment for four consecutive
                                                                                                  months or longer
                                                                                              •   MHealthy Rewards3
                                                                                              •   MHealthy Programs4

   Research Fellows                     For medical insurance, you must have a                 • Medical Insurance2                                   • Long-Term Disability
                                        0% or greater appointment and funding                  • Dental Plan (Option 1, 2, and 3 after one            • Retirement Plan (Basic)
                                        (stipend, Special Purpose Funds) or salary               year of continuous eligibility)
                                        for a minimum of four continuous months                • University, Optional, and Dependent Life
                                                                                                 Insurance (0% or greater appointment.
                                        For life insurance and supplemental                      Stipend funds not eligible)
                                        retirement plans, must have more than a                • Legal Plan
                                        0% appointment and university funding.                 • Long-Term Care
                                        Stipend money is not eligible.                         • Flexible Spending Accounts (0% or
                                                                                                 greater appointment. Stipend funds or
                                                                                                 temporary hourly wages are not eligible)
                                        For dental, must have 0% or greater                    • SRA and 457(b); 1% or greater appoint-
                                        appointment and one year of service                      ment. Stipend funds or temporary hourly
                                                                                                 wages are not eligible)
                                        Research Fellows must provide proof of                 • Travel Accident Insurance and Secure
                                        comparable coverage to waive medical                     Travel Plan
                                        insurance and prescription drug plan                   • Vision Plan
                                        coverage (SPG 201.19)                                  • MHealthy Rewards3
                                                                                               • MHealthy Programs4

   Professional                         You have a 0% or greater appointment and               • Medical Insurance2                                   • Dental Plan
   Specialists                          U-M funding (stipend, Special Purpose                  • Long-Term Care                                       • Vision Plan
                                        Funds) or salary for a minimum of four                 • Flexible Spending Accounts (50% or                   • Long-Term Disability
                                        continuous months                                        greater appointment. Stipend funds                   • University, Optional, and
                                                                                                 or temporary hourly wages are not                      Dependent Life Insurance
                                                                                                 eligible)                                            • Legal Plan
                                                                                               • SRA and 457(b); 1% or greater appoint-
                                                                                                 ment. Stipend funds or temporary hourly              • Retirement Plan (Basic)
                                                                                                 wages are not eligible)
                                                                                               • Travel Accident Insurance and Secure
                                                                                                 Travel Plan
                                                                                               • MHealthy Rewards3
                                                                                               • MHealthy Programs4

   Benefit-Eligible                     Holders of designated fellowship                       • Medical Insurance2 (GradCare only)                   • University, Optional, and
                                                                                                                                                          Dependent Life Insurance
   Fellowship Holders                   Michigan Science Training Program fellows
                                                                                               • Dental Plan (Option 1, 2, and 3)
                                                                                                                                                      • Long-Term Care
                                                                                               • Legal Plan
                                                                                                                                                      • Flexible Spending Accounts
                                                                                               • Vision Plan
                                        Check with your department if you do not                                                                      • Retirement Plan (Basic and
                                                                                               • MHealthy Programs4                                       SRA)
                                        know if you are sponsored for GradCare
                                        under this provision                                                                                          • Travel Accident Insurance
                                                                                                                                                      • Long-Term Disability
                                                                                                                                                      • MHealthy Rewards

   Medical School                       Medical insurance coverage is mandatory                • Medical Insurance2 (GradCare only)                   • University, Optional, and
                                        for all University of Michigan medical school                                                                     Dependent Life Insurance
   Students                             students. Medical school students are
                                                                                               • Dental Plan (Option 1, 2, and 3)
                                                                                                                                                      • Long-Term Care
                                                                                               • Legal Plan
                                        required to either enroll in GradCare or pro-                                                                 • Flexible Spending Accounts
                                                                                               • Vision Plan
                                        vide verification that they have comparable                                                                   • Retirement Plan (Basic and
                                        medical insurance coverage elsewhere                                                                              SRA)
                                                                                                                                                      • Travel Accident Insurance
                                                                                                                                                      • Long-Term Disability
                                                                                                                                                      • MHealthy Rewards

1 To be eligible for the Retirement Plan, all career/job families, except Supplemental, must have at least a 1% appointment for four continuous months or longer. Supplemental must have a 50% or
  greater appointment and funding for one full term.
2 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
3 For more information on MHealthy Rewards, please visit: mhealthy.umich.edu/rewards
4 For more information on MHealthy Programs, please visit: mhealthy.umich.edu


                                                                                                                                                                                                    2
                      Eligibility for University of Michigan Benefits for Dependents
                                               Group
        Dependents                                                         Eligible                                                          Not Eligible

        Spouse                                  Faculty                    • Medical Insurance3                                              •   Long-Term Disability
        A person who:                           Staff                      • Dental Plan (Option 1, 2, or 3)                                 •   Group Term Life Insurance
        • Is of the opposite sex as you;                                   • Vision Plan                                                     •   Flexible Spending Accounts
        • Is legally married to you; and        Lecturers                  • Dependent Life Insurance2 (Dependent spouse                     •   Retirement Plan
        • Is not already covered                Supplemental                 or OQA can work for the university)                             •   Travel Accident Insurance and Secure Travel Plan
          through the university as             LEO                        • Long-Term Care                                                  •   MHealthy Rewards
          an employee1                          AFSCME                     • Legal Plan
                                                HOA                        • MHealthy Tobacco Independence Program4
        OR                                                                   (if enrolled in medical insurance)
        Other Qualified Adult (OQA)             POAM
        See page 15 for OQA eligibility         MNA
                                                IUOE
                                                Trades
                                                GSI
                                                GSSA
                                                GSRA
                                                Research
                                                   Fellows

                                                Professional               • Medical Insurance3                                              •   Vision Plan
                                                   Specialists             • Long-Term Care                                                  •   Long-Term Disability
                                                                           • MHealthy Tobacco Independence Program4                          •   Group Term Life Insurance
                                                                               (if enrolled in medical insurance)                            •   Dependent Life Insurance
                                                                                                                                             •   Legal Plan
                                                                                                                                             •   Flexible Spending Accounts
                                                                                                                                             •   Retirement Plan
                                                                                                                                             •   Dental Plan (Option 1, 2, or 3)
                                                                                                                                             •   Travel Accident Insurance and Secure Travel Plan
                                                                                                                                             •   MHealthy Rewards


                                               Benefit-Eligible            • Medical Insurance3 (GradCare only)                              •   University, Optional, and Dependent Life Insurance
                                               Fellowship                  • Dental Plan (Option 1, 2, and 3)                                •   Long-Term Care
                                                                           • Legal Plan                                                      •   Flexible Spending Accounts
                                               Holders                                                                                       •   Retirement Plan (Basic and SRA)
                                                                           • Vision Plan
                                                                                                                                             •   Travel Accident Insurance
                                                                                                                                             •   Long-Term Disability
                                                                                                                                             •   MHealthy Rewards


                                               Medical                     • Medical Insurance3 (GradCare only)                              •   University, Optional, and Dependent Life Insurance
                                               School                      • Dental Plan (Option 1, 2, and 3)                                •   Long-Term Care
                                                                           • Legal Plan                                                      •   Flexible Spending Accounts
                                               Students                                                                                      •   Retirement Plan (Basic and SRA)
                                                                           • Vision Plan
                                                                                                                                             •   Travel Accident Insurance
                                                                                                                                             •   Long-Term Disability
                                                                                                                                             •   MHealthy Rewards

    1   If you and your spouse or OQA are both employees of the university, you cannot be covered as both an employee and as a dependent on U-M Medical, Prescription Drug, Dental, or Vision Plans.
    2   If you and your spouse or OQA are both employees of the university, you may both carry Dependent Life on each other and on your dependent children.
    3   Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
    4   For more information on the MHealthy Tobacco Independence Program (MTIP), please call 734-998-2193 or visit mhealthy.umich.edu/mtip




3
                  Eligibility for University of Michigan Benefits for Dependents
                                            Group
  Dependents                                                          Eligible                                                         Not Eligible


  Never Married Children by                 Faculty                   • Medical Insurance1                                             •   Long-Term Disability
  Birth, Adoption, or Legal                                           • Dental Plan (Option 1, 2, or 3)                                •   Group Term Life Insurance
  Guardianship*, Birth to
                                            Staff
                                                                      • Vision Plan                                                    •   Long-Term Care
  Age 25                                    Lecturers                 • Dependent Life Insurance (eligible from                        •   Flexible Spending Accounts
                                            Supplemental                15 days to age 25)2                                            •   Retirement Plan
  Eligible from birth through end           LEO                       • Legal Plan                                                     •   Travel Accident Insurance and Secure Travel Plan
  of the year your children turn
  age 19 and are not eligible for           AFSCME                                                                                     •   MHealthy Rewards
  coverage through the univer-              HOA
  sity as an employee or are not            POAM
  already covered through the               MNA
  university as a dependent on
  another university employee’s             IUOE
  coverage.                                 Trades
                                            GSI
  From age 20 through the end
  of the month they reach age
                                            GSSA
  253, your children who:                   GSRA
  • Live primarily with you but             Research
     may be temporarily away from              Fellows
     home attending school; and
  • You provide over 50% of the
     dependent’s total support;             Professional              • Medical Insurance1                                             •   Vision Plan
     and                                       Specialists                                                                             •   Long-Term Disability
  • Are not eligible for coverage                                                                                                      •   Group Term Life Insurance
     through the university as an                                                                                                      •   Dependent Life Insurance
     employee or are not already                                                                                                       •   Long-Term Care
     covered through the university                                                                                                    •   Legal Plan
     as a dependent on another                                                                                                         •   Flexible Spending Accounts
     university employee’s coverage.                                                                                                   •   Retirement Plan
                                                                                                                                       •   Dental Plan (Option 1, 2, or 3)
  * For legal guardianship, in addition                                                                                                •   Travel Accident Insurance and Secure Travel Plan
    to the above, a dependent ward                                                                                                     •   MHealthy Rewards
    remains eligible only until the expi-
    ration date stipulated by the court
    within the Letters of Guardianship.     Benefit-Eligible          • Medical Insurance1 (GradCare only)                             •   University, Optional, and Dependent Life Insurance
                                            Fellowship                • Dental Plan (Option 1, 2, and 3)                               •   Long-Term Care
                                                                      • Legal Plan                                                     •   Flexible Spending Accounts
                                            Holders                                                                                    •   Retirement Plan (Basic and SRA)
                                                                      • Vision Plan
                                                                                                                                       •   Travel Accident Insurance
                                                                                                                                       •   Long-Term Disability
                                                                                                                                       •   MHealthy Rewards


                                            Medical                   • Medical Insurance1 (GradCare only)                             •   University, Optional, and Dependent Life Insurance
                                            School                    • Dental Plan (Option 1, 2, and 3)                               •   Long-Term Care
                                                                      • Legal Plan                                                     •   Flexible Spending Accounts
                                            Students                                                                                   •   Retirement Plan (Basic and SRA)
                                                                      • Vision Plan
                                                                                                                                       •   Travel Accident Insurance
                                                                                                                                       •   Long-Term Disability
                                                                                                                                       •   MHealthy Rewards


1 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
2 If you and your spouse or OQA are both employees of the university, you may both carry Dependent Life on each other and on your dependent children.
3 Your eligible children meeting the listed requirements may continue eligibility through the end of the month in which the child reaches age 25.




                                                                                                                                                                                                4
                     Eligibility for University of Michigan Benefits for Dependents
                                            Group
      Dependents                                                           Eligible                                                    Not Eligible
      Never Married Children                Faculty                        • Medical Insurance1                                        •   Long-Term Disability
      of Your Spouse or Other               Staff                          • Dental Plan (Option 1, 2, or 3)                           •   Group Term Life Insurance
      Qualified Adult, Birth to                                            • Vision Plan                                               •   Long-Term Care
      Age 25 3 who:                         Lecturers                      • Dependent Life Insurance                                  •   Flexible Spending Accounts
                                            Supplemental                     (eligible from 15 days to age 25)2                        •   Retirement Plan
      • Live primarily with you             LEO                            • Legal Plan                                                •   Travel Accident Insurance and Secure Travel Plan
        but may be temporarily              AFSCME                                                                                     •   MHealthy Rewards
        away from home attend-
        ing school; and
                                            HOA
      • You and your spouse or OQA          POAM
        provide over 50% of your            MNA
        dependent’s total support;          IUOE
        and                                 Trades
      • Are not eligible for cover-
        age through the university          GSI
        as an employee or are not           GSSA
        already covered through             GSRA
        the university as a depen-          Research Fellows
        dent on another university
        employee’s coverage.
                                            Professional                   • Medical Insurance1                                        •   Vision Plan
                                               Specialists                                                                             •   Long-Term Disability
                                                                                                                                       •   Group Term Life Insurance
                                                                                                                                       •   Dependent Life Insurance
                                                                                                                                       •   Long-Term Care
                                                                                                                                       •   Legal Plan
                                                                                                                                       •   Flexible Spending Accounts
                                                                                                                                       •   Retirement Plan
                                                                                                                                       •   Dental Plan (Option 1, 2, or 3)
                                                                                                                                       •   Travel Accident Insurance and Secure Travel Plan
                                                                                                                                       •   MHealthy Rewards


                                            Benefit-Eligible               • Medical Insurance1 (GradCare only)                        •   University, Optional, and Dependent Life Insurance
                                            Fellowship                     • Dental Plan (Option 1, 2, and 3)                          •   Long-Term Care
                                                                           • Legal Plan                                                •   Flexible Spending Accounts
                                            Holders                                                                                    •   Retirement Plan (Basic and SRA)
                                                                           • Vision Plan
                                                                                                                                       •   Travel Accident Insurance
                                                                                                                                       •   Long-Term Disability
                                                                                                                                       •   MHealthy Rewards


                                            Medical                        • Medical Insurance1 (GradCare only)                        •   University, Optional, and Dependent Life Insurance
                                            School                         • Dental Plan (Option 1, 2, and 3)                          •   Long-Term Care
                                                                           • Legal Plan                                                •   Flexible Spending Accounts
                                            Students                                                                                   •   Retirement Plan (Basic and SRA)
                                                                           • Vision Plan
                                                                                                                                       •   Travel Accident Insurance
                                                                                                                                       •   Long-Term Disability
                                                                                                                                       •   MHealthy Rewards


    1 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
    2 If you and your spouse or OQA are both employees of the university, you may both carry Dependent Life on each other and on your dependent children.
    3 Your eligible children meeting the listed requirements may continue eligibility through the end of the month in which the child reaches age 25.




5
                 Eligibility for University of Michigan Benefits for Dependents
                                       Group
  Dependents                                                           Eligible                                                    Not Eligible

  Never Married Principally            Faculty                         • Medical Insurance1                                        •   Long-Term Disability
  Supported Children, to               Staff                           • Dental Plan (Option 1, 2, or 3)                           •   Group Term Life Insurance
  Age 19 3                                                             • Vision Plan
                                       Lecturers                       • Dependent Life Insurance
                                                                                                                                   •   Long-Term Care
                                                                                                                                   •   Flexible Spending Accounts
  Children through the end of          Supplemental                      (eligible from age 15 days to age 25)2                    •   Retirement Plan
  the year in which they reach         LEO                             • Legal Plan                                                •   Travel Accident Insurance and Secure Travel Plan
  age 19 who:                          AFSCME
  • Are not your own children
                                                                                                                                   •   MHealthy Rewards
    by birth or marriage; and          HOA
  • Are related to you by blood        POAM
    or marriage; and                   MNA
  • Live with you on a perma-
    nent basis; and                    IUOE
  • Are not eligible for coverage      Trades
    through the university as an       GSI
    employee; and                      GSSA
  • Are not already covered
    through the university as          GSRA
    a dependent on another             Research Fellows
    university employee’s
    coverage; and
  • Will be claimed as depen-          Professional                    • Medical Insurance1                                        •   Vision Plan
    dents on your income tax              Specialists                                                                              •   Long-Term Disability
    return for the current year;                                                                                                   •   Group Term Life Insurance
    and                                                                                                                            •   Dependent Life Insurance
  • Have been principally sup-                                                                                                     •   Long-Term Care
    ported by you for at least                                                                                                     •   Legal Plan
    six consecutive months                                                                                                         •   Flexible Spending Accounts
    before you apply for cover-                                                                                                    •   Retirement Plan
    age.                                                                                                                           •   Dental Plan (Option 1, 2, or 3)
                                                                                                                                   •   Travel Accident Insurance and Secure Travel Plan
  Coverage will go into effect the                                                                                                 •   MHealthy Rewards
  first of the month following 90
  days after the application is
  received in the Benefits Office.
                                       Benefit-Eligible                • Medical Insurance1 (GradCare only)                        •   University, Optional, and Dependent Life Insurance
                                       Fellowship                      • Dental Plan (Option 1, 2, and 3)                          •   Long-Term Care
                                                                       • Legal Plan                                                •   Flexible Spending Accounts
                                       Holders                                                                                     •   Retirement Plan (Basic and SRA)
                                                                       • Vision Plan
                                                                                                                                   •   Travel Accident Insurance
                                                                                                                                   •   Long-Term Disability
                                                                                                                                   •   MHealthy Rewards


                                       Medical                         • Medical Insurance1 (GradCare only)                        •   University, Optional, and Dependent Life Insurance
                                       School                          • Dental Plan (Option 1, 2, and 3)                          •   Long-Term Care
                                                                       • Legal Plan                                                •   Flexible Spending Accounts
                                       Students                                                                                    •   Retirement Plan (Basic and SRA)
                                                                       • Vision Plan
                                                                                                                                   •   Travel Accident Insurance
                                                                                                                                   •   Long-Term Disability
                                                                                                                                   •   MHealthy Rewards


1 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
2 If you and your spouse or OQA are both employees of the university, you may both carry Dependent Life on each other and on your dependent children.
3 Your eligible children meeting the listed requirements may continue eligibility through the end of the year in which the child reaches age 19.




                                                                                                                                                                                            6
                     Eligibility for University of Michigan Benefits for Dependents
        Dependents                                     Group                                 Eligible                                         Not Eligible

       Never Married Disabled                          Faculty                              • Medical Insurance1                             •   Long-Term Disability
       Children,                                       Staff                                • Dental Plan (Option 1, 2, or 3)                •   Group Term Life Insurance
       Age 19 or Older                                 Lecturers
                                                                                            • Vision Plan                                    •   Long-Term Care
                                                                                            • Dependent Life Insurance (eligible             •   Flexible Spending Accounts
       Your children by birth, adoption,               Supplemental                           from age 15 days to age 25)2                   •   Retirement Plan
       or legal guardianship or your                   LEO                                  • Legal Plan                                     •   Travel Accident Insurance and Secure Travel Plan
       spouse or OQA’s children who:                   AFSCME                                                                                •   MHealthy Rewards
                                                       HOA
       • Are not classified as
         principally supported                         POAM
         children; and                                 MNA
       • Have reached the end of the                   IUOE
         calendar year in which they                   Trades
         turn age 19; and                              GSI
       • Are dependent on you                          GSSA
         for support and                               GSRA
         maintenance; and
       • Became disabled and were
                                                       Research Fellows
         covered by university medical
         insurance plan before reach-                  Professional                         • Medical Insurance1                             •   Vision Plan
         ing age 19; and                                  Specialists                                                                        •   Long-Term Disability
       • Are not eligible for coverage                                                                                                       •   Group Term Life Insurance
         through the university as an                                                                                                        •   Dependent Life Insurance
         employee or are not already                                                                                                         •   Long-Term Care
         covered through the Univer-                                                                                                         •   Legal Plan
         sity as the dependent on                                                                                                            •   Flexible Spending Accounts
         another university employee’s                                                                                                       •   Retirement Plan
         coverage; and                                                                                                                       •   Dental Plan (Option 1, 2, or 3)
       • Are incapable of self-                                                                                                              •   Travel Accident Insurance and Secure Travel Plan
         sustaining employment                                                                                                               •   MHealthy Rewards
         by reason of mental or
         physical disability.                          Benefit-Eligible                     • Medical Insurance1 (GradCare only)             • University, Optional, and Dependent Life
                                                       Fellowship                           • Dental Plan (Option 1, 2, and 3)                   Insurance
                                                                                            • Legal Plan                                     •   Long-Term Care
                                                       Holders                                                                               •   Flexible Spending Accounts
                                                                                            • Vision Plan
                                                                                                                                             •   Retirement Plan (Basic and SRA)
                                                                                                                                             •   Travel Accident Insurance
                                                                                                                                             •   Long-Term Disability
                                                                                                                                             •   MHealthy Rewards


                                                       Medical                              • Medical Insurance1 (GradCare only)             • University, Optional, and Dependent Life
                                                       School                               • Dental Plan (Option 1, 2, and 3)                   Insurance
                                                                                            • Legal Plan                                     •   Long-Term Care
                                                       Students                                                                              •   Flexible Spending Accounts
                                                                                            • Vision Plan
                                                                                                                                             •   Retirement Plan (Basic and SRA)
                                                                                                                                             •   Travel Accident Insurance
                                                                                                                                             •   Long-Term Disability
                                                                                                                                             •   MHealthy Rewards




    1 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
    2 If you and your spouse or OQA are both employees of the university, you may both carry Dependent Life on each other and on your dependent children.




7
                 Eligibility for University of Michigan Benefits for Dependents
     Dependents                             Group                          Eligible                                                Not Eligible

     Survivors of                           Faculty                        • Medical Insurance1 (eligible if you meet criteria;    •    Dental Plan
     Deceased                               Staff                            contact the HR/Payroll Service Center for             •    Vision Plan
                                                                             information)                                          •    Long-Term Disability
     Active Eligible                        Lecturers                      • Individual Long-Term Care (eligible if you are        •    Group Term Life Insurance
     Faculty and Staff                      Supplemental                     currently enrolled or were previously enrolled.       •    Dependent Life Insurance
     Members                                LEO                              Call the plan to continue coverage)                   •    Legal Plan
                                            HOA                            • MHealthy Tobacco Independence Program2                •    Flexible Spending Accounts
                                            IUOE                             (if enrolled in medical insurance)                    •    Retirement Plan
                                                                                                                                   •    Travel Accident Insurance and Secure Travel Plan
                                            POAM                                                                                   •    MHealthy Rewards
                                            MNA
                                            Trades
                                            AFSCME
                                            GSI
                                            GSSA
                                            GSRA
                                            Research Fellows


     Survivors of                          Faculty                         • Medical Insurance1 (eligible if you meet criteria;   •     Vision Plan
     Deceased                              Staff                             contact the HR/Payroll Service Center for            •     Long-Term Disability
                                                                             information)                                         •     Group Term Life Insurance
     Retired Faculty                       Lecturers                       • Dental Plan (eligible if you meet criteria;          •     Dependent Life Insurance
     and Staff                             LEO                               contact the HR/Payroll Service Center for            •     Legal Plan
     Members                               POAM                              information)                                         •     Flexible Spending Accounts
                                           MNA                             • Long-Term Care (eligible if you are                  •     Retirement Plan
                                           AFSCME                            currently enrolled or were previously enrolled.      •     Travel Accident Insurance and Secure Travel Plan
                                                                             Call the plan to continue coverage)                  •     MHealthy Rewards
                                           IUOE
                                           Trades

1 Enrollment in any U-M medical plan automatically includes enrollment in the U-M Prescription Drug Plan.
2 For more information on the MHealthy Tobacco Independence Program (MTIP), please call 734-998-2193 or visit mhealthy.umich.edu/mtip




“Other Qualified Adult”
 Eligibility Criteria
Under the Other Qualified Adult (OQA) program, a U-M employee                                    The following individuals are not eligible for participation in
who does not enroll a spouse in the health or other benefit                                      the OQA program if they are the employee’s or the spouse of
plans may enroll one adult individual for benefit coverage if all                                the employee’s:
of the following eligibility criteria are met:                                                  •	      Parents
•	     The employee is eligible for U-M benefits; and                                           •	      Parents’ other descendents (siblings, nieces, nephews)
•	     The Other Qualified Adult, at the time of proposed enroll-                               •	      Grandparents and their descendents (aunts, uncles, cous-
       ment, shares a primary residence with the employee and                                           ins)
       has done so for the previous 6 continuous months, other
       than as an employee or tenant .                                                          •	      Renters, boarders, tenants, employees
                                                                                                •	      Children* or their descendents (children, grandchildren)
(Eligible children of an Other Qualified Adult may also be
                                                                                                *Eligibility for children is defined by the eligibility
enrolled .)
                                                                                                 criteria for dependent children . For details, visit:
                                                                                                 benefits .umich .edu/eligibility




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