SPOUSAL COVERAGE AFFIDAVIT 

Spouses with access to health insurance through their employer aren't eligible for HCDE health plans  unless they are only offered a high deductible health plan through their employer. Employees electing health insurance coverage on their spouse for the first time, after a life event, or during open enrollment, will need to complete a spousal coverage affidavit. 

The affidavit must be:

• Completed by the employee
• Signed by the employee and spouse
• Certified by the spouse’s employer if the spouse is employed
• Returned to the benefits department

Please contact the benefits department at 498-7060 if you need assistance.