[Faculty Handbook Category #4]
Faculty with an FTE of 0.50 or more are eligible to participate in the college health plan. Plan coverage is effective on the first of the month concurrent with or following the date of employment. The plan provides coverage for illness and injury as well as for diagnostic and preventive medical care.
New employees will have 30 days from the date of employment to elect health insurance. Employees who waive their right to enroll in the health plan will not be allowed to enroll at a later date unless they experience a family status change.[*] Changes in benefits must be made within 30 days of the qualifying status change.* New dependents must be added within 60 days for the birth or adoption of a child.
Once an employee elects coverage, he or she is required to keep the coverage for the entire plan year (September 1 – August 31) unless he or she experiences a status change.*
[*]A change in circumstances that qualifies as a status change under applicable regulations. These include:
· An event that changes your marital status, including marriage, death, divorce, legal separation or annulment.
· An event that changes your number of dependents, including birth, adoption, placement for adoption, or death of a dependent,
· Termination or commencement of employment by you, your spouse, or your dependent, which results in a gain or loss of eligibility,
· Change in employment status, such as reduction or increase in your hours of employment or those of your spouse or dependent, including a switch between part-time and full-time, a change in worksite, strike or lockout, which results in a gain or loss of eligibility,
· Commencement or return from an unpaid leave of absence or an FMLA leave on the part of you or your spouse,
· An event that causes your dependent to satisfy or cease to satisfy the requirements for coverage under the health plan, due to attainment of age, student status or any similar circumstance,
· Change in the place of your residence or that of your spouse or dependent, which affects eligibility for an underlying benefit, such as moving outside of an HMO service area,
· Change in coverage due to the spouse or dependent’s open enrollment.
· For health and accident plans, Status Change also includes:
· The exercise of a right under the special enrollment rights of the Health Insurance Portability and Accountability Act (HIPAA),
· Certain court orders related to health coverage of a dependent or former spouse,
· The entitlement (or loss of entitlement) to Medicare or Medicaid of you, your spouse, or your dependent.