Where the employee does not have a spouse eligible for enrollment in the State Health Plan the plan shall be amended to allow a participating employee to enroll one other eligible adult individual, as set forth below:

To be eligible, the individual must meet the following criteria:

1. Be at least 18 years of age.
2. Not be a member of the employee’s immediate family as defined as employee’s spouse, children, parents, grandparents or foster parents, grandchildren, parents-in-law, brothers, sisters, aunts, uncles, or cousins.
3. Have jointly shared the same regular and permanent residence for at least 12 continuous months, and continues to share a common residence with the employee other than as a tenant, boarder, renter, or employee.

Dependents and children of another eligible adult individual may enroll under the same conditions that apply to dependents and children of employees.

In order to establish that the criteria have been met, the Employer will require the employee  to sign an affidavit setting forth the facts that constitute compliance with those requirements.