Eligible Employee and Eligible Dependent refer to individuals who are eligible for coverage under the health plan.
For Affordable Care Act (ACA) plans, the only individuals eligible to receive tax-favored coverage are the employee, the employee’s spouse, and the employee’s eligible qualifying dependents.
For employer-sponsored coverage, the employer may establish criteria for employee, spouse, and children eligibility. An employer can require employees to work a specified number of hours (for example, 30 or 40 hours per week) to be eligible for benefits.