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Published byBelinda Peters Modified over 9 years ago
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Benefits Overview Rules of the Game 11
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Who is eligible for coverage? 1. Active employees 2. Full time (FT) Employees scheduled 32+ hours/week 3. Regular Part time (RPT) Employees scheduled between 20 and 31 hours/week 4. FT and RPT employees on approved Leaves of Absence (LOAs) 2
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When can coverage begin? 1. Upon hire 2. At open enrollment (in October/November to be effective the following January 1 st ) 3. Through a Qualifying Event (within 30 days) and with proper documentation a) Gain or loss of a dependent (birth, adoption, 26 th birthday of a child, marriage, divorce, death) b) Spouse/partner’s gain or loss of employment c) Spouse/partner’s open enrollment d) Medicare/Medicaid eligibility e) Change in Daycare charges 3
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When will coverage become effective? 1. New hires: Coverage is effective the first of the month after one month of FT/RPT employment 2. Open enrollment: Paperwork in October/November with coverage effective January 1 st. 3. 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
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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
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