Benefits Overview
Rules of the Game
1
Who is eligible for coverage?
1.
2.
3.
4.
Active employees
Full time (FT) Employees scheduled 32+
hours/week
Regular Part time (RPT) Employees
scheduled between 20 and 31
hours/week
FT and RPT employees on approved
Leaves of Absence (LOAs)
2
When can coverage begin?
Upon hire
At open enrollment (in October/November to be
effective the following January 1st)
Through a Qualifying Event (within 30 days)
and with proper documentation
1.
2.
3.
a)
b)
c)
d)
e)
Gain or loss of a dependent (birth, adoption, 26th
birthday of a child, marriage, divorce, death)
Spouse/partner’s gain or loss of employment
Spouse/partner’s open enrollment
Medicare/Medicaid eligibility
Change in Daycare charges
3
When will coverage
become effective?
1.
2.
3.
New hires: Coverage is effective the first of the month
after one month of FT/RPT employment
Open enrollment: Paperwork in October/November
with coverage effective January 1st.
Qualifying event: Changes in coverage effective the
first of the month following the event. Changes made
must be related to the event. For example, birth of a
child would allow you to add the newborn to medical
and begin a dependent care spending account but
would not allow you to begin vision insurance.
4
When does coverage end?
Coverage ends the last day of the month of:
1. At termination of employment (either
voluntary or involuntary)
2. December (if dropping coverage through
Open Enrollment)
3. At retirement
4. At a change to per diem status (less than
20 hours/week)
5. At the end of a Leave of Absence (LOA)
5