May a spouse, who is also a state or higher education employee, enroll as an employee and as a dependent of the other spouse?

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• If two employees in the same plan (state, local education or local government) are married, are they required to choose the employee + spouse premium level, or can each sign up for employee only coverage? What if there are children?
• If a current state, higher education, local government or local education employee changes jobs and becomes an employee of another entity (state employee to local government employee, etc.), how does that affect their insurance coverage?
• Can I decrease the amount of coverage I have?
• I tried to get a prescription filled but my claim was denied because the medication is now available over the counter. Does this mean my pharmacy benefits are becoming more limited?
• What if both the head of contract and spouse work for state/higher education. Will each receive the cash incentive because we each receive a paycheck?