PacificSource FAQ: Extension of Dependent Eligibility
|
|
- Basil Floyd
- 5 years ago
- Views:
Transcription
1 PacificSource FAQ: Extension of Dependent Eligibility Published: May 21, 2010 Updated: August 9, 2010 and November 19, 2010 General Information What is this about? Under the new federal Patient Protection and Affordable Care Act, known as the Affordable Care Act for short, dependents will be able to stay on their parents health plan to age 26. By law, this extension of dependent eligibility starts on September 23, 2010 and is effective on your health insurance policy s first renewal on or after that date. On May 10, 2010, the U.S. Department of Health and Human Services (HHS), the U.S. Department of Labor (DOL), and the U.S. Department of the Treasury published interim final rules on the dependent eligibility requirements of the Affordable Care Act. These interim final rules clarify the dependent eligibility requirements and create a special enrollment opportunity for adult children under the age of 26. The following questions and answers will provide more information about this early extension of dependent eligibility. Will PacificSource implement the dependent eligibility extension early? Yes and no. Effective May 1, 2010, PacificSource will extend coverage to dependents currently* covered on their parents individual or group policies up until age 26, regardless of full-time student status or parent support. Large employers had the option of opting out of this early extension of eligibility if they notified us in writing by May 14, Otherwise, they will have opted in to the extension by default. Dependents who terminated coverage on their parents policy prior to May 1, 2010 will not be able to re-enroll before the dependent eligibility provision of the Affordable Care Act takes effect on their policy renewal on or after September 23, We are also unable to extend coverage to those who don t meet the current dependent eligibility requirements outlined in their parents policies or benefit handbooks. *as of April 30, 2010 Information for Members Q1: Which of my dependent children are eligible to remain under my health plan as a result of the Affordable Care Act? A1: Your natural children, stepchildren, or adopted children (including a child placed for adoption) under the age of 26 are eligible. Q2: When do the changes in dependent eligibility go into effect under the Affordable Care Act? Q2: They are effective on the first day of the first plan year beginning on or after September 23, 2010 (e.g., January 1, 2011 for policies that renew on January 1). Q3: Are there any additional restrictions for children under the age of 26 to be eligible to enroll on my health plan under the Affordable Care Act? Q3: Yes, a plan may not define dependent other than in terms of a relationship between a child and the parent. A plan may not deny or restrict coverage for a child who is under age 26 based on any of the following: the child s marital status the child s financial dependency upon the parent or any other person the child s place of residence FAQ_DependentEligibility_ of 6
2 the child s employment status (unless the parent s health plan is a grandfathered group health plan for a definition of grandfathered group health plan, please see our General FAQ.) the child s student status If the parent s health plan is a grandfathered group health plan, the plan may exclude coverage to an adult child under the age of 26 only if the child is eligible to enroll in an eligible employersponsored health plan other than a group health plan of a parent. Q4: My child was dropped from coverage earlier this year due to no longer meeting the dependent eligibility requirements. Can he re-enroll early? Q4: (Updated November 19, 2010) In general, no; there is not an open enrollment period when dependents can resume coverage until the policy s renewal date on or after September 23, Dependents who lost coverage prior to May 1, 2010 may only re-enroll in their parents coverage when the dependent eligibility provision of the Affordable Care Act takes effect, which is on the policy s renewal date on or after September 23, At that time, a one-time special enrollment period will be offered to eligible children under age 26 who do not have healthcare coverage for one of the following reasons: their coverage ended because they reached the previous dependent age limit; they were denied coverage (or were not eligible for coverage) because they were over the previous age limit. The interim final rules require that this special enrollment period last for at least 30 days. Q5: My child transferred to a COBRA, state continuation, portability, or individual policy earlier this year due to no longer meeting the dependent eligibility requirements. Can she reenroll early? A5: (Updated November 19, 2010) In general, no; there is not an open enrollment period when dependents can resume coverage until the policy s renewal date on or after September 23, Dependents who lost coverage prior to May 1, 2010 may only re-enroll in their parents coverage when the dependent eligibility provision of the Affordable Care Act takes effect, which is on the policy s renewal date on or after September 23, At that time, a one-time special enrollment period will be offered to eligible children under age 26 who do not have healthcare coverage for one of the following reasons: their coverage ended because they reached the previous dependent age limit; they were denied coverage (or were not eligible for coverage) because they were over the previous age limit. The interim final rules require that this special enrollment period last for at least 30 days. Q6: My child is under age 26 and is getting married soon. Will he be able to remain on my policy? A6: In general, yes, as long as your child was enrolled on your policy as of April 30, 2010, and he will not have access to other group health insurance coverage after marriage. (Large employers have the ability to opt out of this early extension of eligibility.) Q7: Does my child have to be enrolled in college or pursuing some form of higher education? A7: No. There are no requirements related to education. Q8: Do I need to be providing a certain level of financial support for my child? A8: No. There are no requirements related to financial support. Q9: I received notice that my dependent child will be dropped from my policy effective May 1 or June 1, 2010 due to no longer meeting the dependent age or financial support requirements. How does this early extension of dependent eligibility affect that? FAQ_DependentEligibility_ of 6
3 A9: Unfortunately, our May and June 2010 dependent ineligibility notices mailed before we made the decision to extend eligibility. We are in the process of mailing updates to those who received that notice. Unless you are covered by a large employer that has chosen to opt out of this eligibility extension, or your dependent is reaching age 26, your dependent s coverage will not terminate and there will be no gap in coverage. If you have questions, please call our Membership Service Department at (866) (Oregon) or (888) (Idaho). Q10: What do I need to do to ensure that my dependent s coverage continues during this period? A10: You do not need to do anything. We are updating our systems to allow for coverage to continue without interruption until age 26 for everyone eligible. (Large employers have the ability to opt out of this early extension of eligibility; the extension will automatically happen for everyone else.) Q11: Will my premiums change if I keep my child on my policy during this time? A11: No, you will continue to pay the same amount you otherwise would for family or dependent coverage until your group renews. Q12: What if I don t want to keep my adult dependent children on my policy? A12: As always, you can remove dependents from your existing coverage at any time, effective the first of the month following the date PacificSource receives the request to drop your dependent. Q13: Does the special enrollment period under the Affordable Care Act apply only to group health plans, or to both group and individual health plans? A13: It applies to both group and individual health plans. Q14: Which of my family members are eligible to enroll during the special enrollment period under the Affordable Care Act? A14: (Updated November 19, 2010) Eligible family members are your adult children under the age of 26 who are not currently enrolled due to one of the following reasons: Their coverage ended because they reached the previous dependent age limit; or They were denied coverage (or were not eligible for coverage) on their parents plan because they were over the previous age limit. If you are not currently enrolled, you are also eligible if you are also enrolling your adult children described above at the same time. Your spouse, domestic partner, or any children who were still eligible under the previous dependent age limit are not eligible to enroll during this special enrollment period for adult children described above. Q15: Is the special enrollment period under the Affordable Care Act a one-time opportunity for an adult child to enroll, or will it be provided annually? A15: The special enrollment period created by the interim final rules is a one-time opportunity for an adult child to enroll. In subsequent years, dependent coverage may be elected for an eligible child in connection with normal enrollment opportunities outlined in the terms of the policy. Q16: If my employer offers more than one benefit package, is this special enrollment period under the Affordable Care Act also an opportunity for me to switch benefit packages? A16: (Updated November 19, 2010) Yes, but only if you are adding an adult child described in question Q14 above to your policy at that time. The interim final rules require that the plan must provide your child an opportunity to enroll in any benefit package available to similarly situated individuals who enroll when first eligible. Q17: My child is under age 26 and currently enrolled on COBRA. Can I add my child back under my coverage during the special enrollment period under the Affordable Care Act? A17: (Updated November 19, 2010) Yes. The interim final rules require that the plan must provide your adult child an opportunity to enroll on the plan as your dependent instead of as a COBRA qualified beneficiary. FAQ_DependentEligibility_ of 6
4 Q18: If my child who was previously enrolled on COBRA re-enrolls under my coverage, will she be eligible to elect COBRA continuation coverage due to aging out of the plan at age 26? A18: Yes, as long as your child meets the definition of a COBRA qualified beneficiary. If your child loses eligibility for coverage due to a COBRA qualifying event (including aging out of coverage at age 26), she has another opportunity to elect COBRA continuation coverage. If the qualifying event is aging out, your child s COBRA continuation coverage could last up to 36 months from the loss of eligibility that related to turning age 26. Q19: My child is under age 26 and has insurance through his employer, and I have a different employer. Can I also add him on my employer insurance policy under the Affordable Care Act? A19: (Updated August 9, 2010) Yes, if your employer s insurance policy is a nongrandfathered group health plan. If your employer s insurance policy is a grandfathered group health plan, the plan may deny coverage to a child who is eligible to enroll in an employer-sponsored health plan other than the parent s group health plan. Q20: Will I receive notice of the special enrollment opportunity under the Affordable Care Act closer to my plan s renewal date? A20: (Updated November 19, 2010) Yes. The interim final rules require that notice be provided to adult children under the age of 26 no later than the first day of the first plan year beginning on or after September 23, With group health plans, the notice must be provided by your employer. Your employer may provide the notice to you on behalf of your adult child. Your employer may also include the notice with other enrollment materials that it distributes to you. With individual health plans, the notice must be provided by your insurer, PacificSource. We may provide the notice to you on behalf of your adult child. Q21: (Added November 19, 2010) Can I add any eligible dependent child under age 26, or is it limited to just those that are newly eligible due to reform? A21: The interim final rules state that the special one-time enrollment is limited to just those that are newly eligible. As such, an eligible dependent child under age 26 can be added during the onetime special enrollment only if the child does not have healthcare coverage for one of the following reasons: Their coverage ended because they reached the previous dependent age limit They were denied coverage (or were not eligible for coverage) because they were over the previous age limit. Q22: (Added November 19, 2010) How long do I have to enroll my dependent child under age 26? A22: The interim final rules state that you have 30 days from the date on the special enrollment notice that your employer distributed to you. Your dependents effective date will then coincide with your plan s renewal date. Information for Employers Q23: I don t want to adopt this early extension of dependent eligibility under my policy. I would prefer to wait until the federal law goes into effect. Can I opt out? A23: If you are a small employer group of 50 or fewer employees as defined by ORS (30) in Oregon or IC (28) in Idaho, your group cannot opt out of this extension. The extension will automatically apply to any dependents under age 26 who are currently enrolled on your policy. If you are a large employer group of 51 or more employees, you may choose to opt out. This extension will automatically apply to any dependents under age 26 who are currently FAQ_DependentEligibility_ of 6
5 enrolled on your policy unless you opt out in writing by May 14, To exercise the opt-out provision, please contact your PacificSource Membership Service Representative by , mail, or fax and clearly indicate that you wish to opt out of the dependent eligibility extension until required by the Affordable Care Act. If you are a new large employer group moving to PacificSource between May and September 2010, you may choose to opt out at time of initial new group enrollment with PacificSource. If you are an employer group covered through an Association or MEWA, you cannot make this decision at the employer group level. Whatever decision the Association or MEWA makes applies to all employer groups under that entity. Q24: What do I need to do to ensure that my employees can participate in this early extension of dependent eligibility? A24: You do not need to do anything; no policy endorsement is required. We are updating our systems to allow for coverage to continue without interruption until age 26 for everyone eligible. Only large employer groups that notify us of their wish to opt out will be excluded. Q25: I d like to take the early extension of coverage a step further. Can I allow coverage of all dependents under 26, and give those newly eligible dependents an opportunity to re-enroll now? A25: If you are a small employer group of 50 or fewer employees as defined by ORS (30) in Oregon or IC (28) in Idaho, your group cannot make this change now. This provision will be automatically applied when your group policy renews for the first time after September 23, If you are a large employer group of 51 or more employees, and: o your policy renews in May, June, July, August, or September you can add such an endorsement to your policy at renewal. The endorsement will extend coverage to dependents under age 26 and provide a 31-day period for special enrollment of the newly eligible dependents. To do so, PacificSource must receive a written request to add such an endorsement prior to your renewal date. (Groups renewing May 1 have until May 14 to provide this notice.) Your group s premium rates will be increased up to 1% to allow for this endorsement in Oregon, or up to 0.25 percent in Idaho. o your policy s next renewal is October 1, 2010 or later - you cannot make this change now. This provision will be automatically applied when your group policy renews. Q26: My group renews sometime between May and September 2010 and we have an open enrollment provision. Our group has opted to accept the extension, but is not adding the endorsement. Since I have an open enrollment provision, can I allow parents to add their dependents under age 26? A26: No. Only those dependent children that meet the eligibility requirements outlined in your plan policy may elect open enrollment. If you do not add the endorsement at your 2010 renewal to expand adult dependent children ages to 26, they will not be able to enroll until the dependent eligibility provision of the Affordable Care Act takes effect, which is on the policy s renewal date on or after September 23, Q27: Do the changes in dependent eligibility requirements under the Affordable Care Act require an employee s grandchild to be covered if the employee s child is covered? A27: No. A plan does not need to make coverage available to a child of a child receiving dependent coverage. FAQ_DependentEligibility_ of 6
6 Q28: Do the changes in dependent eligibility requirements affect the provisions outlined in the policy for brothers, sisters, nieces, nephews, and grandchildren if the subscriber is designated as that person s legal guardian? A28: No. A plan does not need to make coverage available to them beyond the ages outlined in your policy. Q29: Do the changes in dependent eligibility requirements under the Affordable Care Act require an employee s son-in-law or daughter-in-law to be covered if the employee s child is covered? A29: No. A plan does not need to make coverage available to the spouse of a child receiving dependent coverage. Q30: If both parents have a grandfathered group health plan, can one of those grandfathered group health plans exclude an adult child from coverage based on the fact that the adult child is eligible to enroll in the other parent s plan? A30: No. Both parents grandfathered group health plans must make dependent coverage available to children under the age of 26 unless the child is eligible to enroll in an eligible employer-sponsored health plan other than the group health plan of either parent. Q31: If my company employs both the parent and the adult child and both are currently enrolled in our grandfathered group health plan as employees, can our grandfathered group health plan exclude the adult child from becoming a dependent under the parent s coverage based on the fact that the adult child is eligible for coverage as an active employee? A31: No. The grandfathered group health plan must make dependent coverage available to children under the age of 26 unless the child is eligible to enroll in an eligible employer-sponsored health plan other than the parent s group health plan. In this case, the parent and the child have the same employer-sponsored health plan. Q32: Can an insurer charge more premium for coverage of an adult child than it does for coverage of a minor child? A32: No. The terms of the plan providing dependent coverage of children cannot vary based on age for children under age 26. Q31: Can my company have separate, different benefit packages for adult children and minor children? A31: No. The terms of the plan providing dependent coverage of children cannot vary based on age for children under the age of 26. Q32: As an employer, am I required to notify my employee s adult children under age 26 of the special enrollment period under the Affordable Care Act? A32: (Updated November 19, 2010) Yes. The interim final rules required that notice be provided no later than the first day of the first plan year beginning on or after September 23, The notice may be provided to an employee on behalf of the employee s adult child. The notice may be included with other enrollment materials that you distribute to employees, provided the statement about this special enrollment period is prominent. Q33: Is the DOL developing a model notice employers can use to notify employees and their dependent children of the special enrollment period under the Affordable Care Act? A33: (Updated November 19, 2010) Yes, the DOL has created a model notice for this purpose. PacificSource, as a courtesy, has developed a template that employers may use to notify their employees based on the DOL s model notice. Our template is available on our Web site at Pacificsource.com/reform-notices. FAQ_DependentEligibility_ of 6
Q&A on US Health Reform: The Impact of National Health Reform and How it May Affect Your Business
Q&A on US Health Reform: The Impact of National Health Reform and How it May Affect Your Business Developed from Conner Strong s web briefing of April 8, 2010 On April 8, Conner Strong held a web briefing
More informationHIPAA Special Enrollment Rights
Provided by Clarke & Company Benefits, LLC HIPAA Special Enrollment Rights Group health plans often provide eligible employees with two regular opportunities to elect health coverage an initial enrollment
More information» 2009 Benefits Summary. for U.S. Full-Time Hourly & Salaried Associates
» 2009 Benefits Summary for U.S. Full-Time Hourly & Salaried Associates What s inside 1 Life Events 12 Eligibility and Enrollment 27 Benefits for Same-sex Domestic Partners 34 Medical 114 California Medical
More informationBOWDOIN COLLEGE FLEXIBLE BENEFITS PLAN HEALTH CARE REIMBURSEMENT PLAN DEPENDENT CARE REIMBURSEMENT PLAN SUMMARY PLAN DESCRIPTIONS
BOWDOIN COLLEGE FLEXIBLE BENEFITS PLAN HEALTH CARE REIMBURSEMENT PLAN DEPENDENT CARE REIMBURSEMENT PLAN SUMMARY PLAN DESCRIPTIONS Effective as of January 1, 2018 Bowdoin College One College Street Brunswick,
More informationIRS Clarifies Adult Child Dependent Coverage and Federal Healthcare Tax Credit for Small Employers
IRS Clarifies Adult Child Dependent Coverage and Federal Healthcare Tax Credit for Small Employers For additional information, please contact your Account Manager or Tony Sorrentino at 402.964.5470 or
More informationCity of New York Office of Labor Relations Health Benefits Program 40 Rector Street, 3 rd Floor New York, NY
City of New York Office of Labor Relations Health Benefits Program 40 Rector Street, 3 rd Floor New York, NY 10006 www.nyc.gov/olr Young Adult Coverage to Ag~ In accordance with the Federal Patient Protection
More informationSummary of Material Modifications and Summary Plan Description for the Retiree Dental Program
Summary of Material Modifications and Summary Plan Description for the Retiree Dental Program This notice serves as a Summary of Material Modifications (SMM) updating information in the 2011 Retiree Dental
More informationBlue Cross and Blue Shield of Minnesota Age 25 Mandate Common Questions and Answers. For Group Leaders
Blue Cross and Blue Shield of Minnesota Age 25 Mandate Common Questions and Answers For Group Leaders October 15, 2007 The following pages contain questions and answers to assist in communicating further
More informationClass No, Classification, or Plan Design. Enrollment Information
OSU Graduate Assistant Health Insurance ENROLLMENT APPLICATION Group Policy. G0021007 Subgroup. P001 Active P002 COBRA Class, Classification, or Plan Design PO Box 7068 Springfield, OR 97475 541.684.5583
More informationQuestions and Answers on the. Individual Shared Responsibility Provision. January 30, 2013
Questions and Answers on the Individual Shared Responsibility Provision January 30, 2013 Basic Information 1. What is the individual shared responsibility provision? Under the Affordable Care Act, the
More informationANSWERS TO QUESTIONS FROM THE HEALTH CARE LAW WEBINARS ON THINGS YOU NEED TO KNOW
ANSWERS TO QUESTIONS FROM THE HEALTH CARE LAW WEBINARS ON THINGS YOU NEED TO KNOW FOR PEOPLE WITH HEALTH INSURANCE PREVENTIVE SERVICES Question: If you have Medicare, will the office co-pay still be required
More informationGroup Insurance Eligibility Factsheet for Employees and Eligible Family Members
UNIVERSITY OF CALIFORNIA Group Insurance Eligibility Factsheet for Employees and Eligible Family Members This factsheet describes UC s general rules about: employee eligibility for health and welfare benefits
More informationGroup Health Plan For Insured Medical Programs
S U M M A R Y P L A N D E S C R I P T I O N L-3 Communications Corporation Group Health Plan For Insured Medical Programs Effective January 1, 2016 Table of Contents The L-3 Communications Group Health
More informationSelf-Compliance Tool for Part 7 of ERISA: Affordable Care Act Provisions
Self-Compliance Tool for Part 7 of ERISA: Affordable Care Act Provisions INTRODUCTION While this self-compliance tool does not necessarily cover all the specifics of these laws, it is intended to assist
More informationHealthcare Participation Section MMC Draft NA
March 17, 2009 Healthcare Participation Section MMC Draft NA Note to Reviewers: No notes at this time Date May 1, 2009 Participating in Healthcare Benefits MMC Participating in Healthcare Benefits This
More informationFrequently Asked Questions About Health Insurance
Frequently Asked Questions About Health Insurance Q #1: My employer doesn t offer health coverage. Where else can I get health insurance? A #1: A good place to start your research is www.healthinsuranceinfo.net,
More informationModel COBRA Continuation Coverage Election Notice (For use by single-employer group health plans)
Model COBRA Continuation Coverage Election Notice (For use by single-employer group health plans) IMPORTANT INFORMATION: COBRA Continuation Coverage and other Health Coverage Alternatives Date of notice:
More informationTAX, RETIREMENT & ESTATE PLANNING SERVICES. Registered Education Savings Plans (RESPs) THE FACTS
TAX, RETIREMENT & ESTATE PLANNING SERVICES Registered Education Savings Plans (RESPs) THE FACTS A Registered Education Savings Plan (RESP) is a tax-assisted plan that can help save money for post-secondary
More informationGroup Health Plan Enrollment Rules
Provided by Power Kunkle Benefits Consulting Group Health Plan Enrollment Rules Employers that sponsor group health plans have some different options available to them for designing their plans enrollment
More informationHealth Plan Enrollment Rules
Provided by Sullivan Benefits Health Plan Enrollment Rules Employers that sponsor group health plans have some different options available to them for designing their plans enrollment process. When it
More informationHealth Care Reform Overview
Published on : December 06, 2010 Health Care Reform Overview President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The law was almost immediately amended by
More informationELCA Benefit Program Description ELCA Pension and Other Benefits Program» Effective Jan. 1, 2014
ELCA Benefit Program Description 2014 ELCA Pension and Other Benefits Program» Effective Jan. 1, 2014 ELCA Benefit Program Description Effective Jan. 1, 2014 Revised Feb. 17, 2014 About This Document This
More informationHIPAA Special Enrollment Rights
Provided by Brown & Brown of Louisiana, LLC HIPAA Special Enrollment Rights Group health plans often provide eligible employees with two regular opportunities to elect health coverage an initial enrollment
More informationThe New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan
The New Jersey Individual Health Coverage Program Buyer s Guide How to Select a Health Plan Published by: New Jersey Individual Health Coverage Program Board P.O. Box 325 Trenton, NJ 08625-0325 Web Address:
More informationUNIVERSITY OF CALIFORNIA SECTION 125 PLAN. (Amended and Restated Effective as of January 1, 2014)
EXECUTION COPY UNIVERSITY OF CALIFORNIA SECTION 125 PLAN (Amended and Restated Effective as of January 1, 2014) TABLE OF CONTENTS INTRODUCTION...1 ARTICLE 1 DEFINITIONS...2 1.1 Benefit Program... 2 1.2
More informationSECTION 125 HEALTH AND WELFARE BENEFITS PLAN DOCUMENT PLAN YEAR 2019
SECTION 125 HEALTH AND WELFARE BENEFITS PLAN DOCUMENT PLAN YEAR 2019 (EFFECTIVE JULY 1, 2018) Public Employees Benefits Program 901 S. Stewart Street, Suite 1001 Carson City, Nevada 89701 (775) 684-7000
More informationIowa State University Flexible Spending Accounts Summary Plan Document
Iowa State University Flexible Spending Accounts Summary Plan Document Page 1-2 - Table of Contents Page 3 - FLEXIBLE SPENDING ACCOUNT PROGRAM DETAILS 3. What Is a Flexible Spending Account? 3. Who Can
More informationARTICLE 2. ELIGIBILITY FOR BENEFITS
basis must obtain Preadmission Review and Concurrent Review from the Professional Review Organization (PRO) under contract to the Fund as to the Medical Necessity of that confinement in order to receive
More informationHIPAA Portability and Accountability. How HIPAA Affects Individual Coverage
HIPAA Portability and Accountability How HIPAA Affects Individual Coverage The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, affects the way state and federal governments
More informationTHE WILKES UNIVERSITY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
THE WILKES UNIVERSITY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Introduction Wilkes University (the Employer ) sponsors the Wilkes University Cafeteria Plan (the Cafeteria Plan ) that allows eligible Employees
More informationEARLHAM COLLEGE FLEXIBLE BENEFIT PLAN SUMMARY PLAN DESCRIPTION. Benefit Planning Consultants, Inc. P. O. Box 7500 Champaign, IL
EARLHAM COLLEGE FLEXIBLE BENEFIT PLAN SUMMARY PLAN DESCRIPTION Benefit Planning Consultants, Inc. P. O. Box 7500 Champaign, IL 61826-7500 TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant
More informationSpecial Enrollment and Change of Status Event Provisions
1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 wespath.org Special Enrollment and Change of Status Event Provisions HealthFlex (the Plan) is designed to provide benefits in a tax effective
More informationSAINT LOUIS UNIVERSITY DEPENDENT CARE PLAN SUMMARY PLAN DESCRIPTION
SAINT LOUIS UNIVERSITY DEPENDENT CARE PLAN SUMMARY PLAN DESCRIPTION January 2017 INTRODUCTION Saint Louis University established the Saint Louis University Dependent Care Plan to be effective July 1, l99l.
More informationBORGWARNER FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION 2018
BORGWARNER FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION 2018 Table of Contents Pages INTRODUCTION...1 BENEFITS AND ELIGIBILITY...1 ENROLLMENT AND ELECTION OF BENEFITS...8 HEALTH CARE FLEXIBLE SPENDING
More informationGroup Insurance Eligibility Factsheet for Retirees and Eligible Family Members
UNIVERSITY OF CALIFORNIA Group Insurance Eligibility Factsheet for Retirees and Eligible Family Members This factsheet describes UC s general rules about enrollment of eligible family members in the UCsponsored
More informationROWAN-SALISBURY SCHOOLS FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION
ROWAN-SALISBURY SCHOOLS FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?...1 2. What are the eligibility requirements for
More information7/8/2015. HEALTH CARE REFORM AND ITS EFFECTS ON YOUR BUSINESS Presented by Ophelia Y., SPHR, GPHR, MBA AGENDA
HEALTH CARE REFORM AND ITS EFFECTS ON YOUR BUSINESS Presented by Ophelia Y., SPHR, GPHR, MBA AGENDA Background & History The Past: Previously Implemented HCR Provisions The Present: Current & Pending HCR
More informationInformation on COBRA, CDS and the Affordable Care Act
Information on COBRA, CDS and the Affordable Care Act 1. What is COBRA continuation coverage? COBRA is not an insurance company, nor is it health insurance. COBRA is an abbreviation for a federal regulation
More informationAll Active Plan A, B, Flat Rate and R Participants and their Dependents, including COBRA Beneficiaries
June 20, 2011 CARPENTER FUNDS ADMINISTRATIVE OFFICE OF NORTHERN CALIFORNIA, INC. 265 Hegenberger Road, Suite 100 P.O. Box 2280 Oakland, California 94621-0180 Tel. (510) 633-0333 (888) 547-2054 Fax (510)
More informationHandbook. TreeHouse Foods, Inc. Health and Welfare Benefits Plan. Non-union Employees. Effective January 1, 2017
Handbook TreeHouse Foods, Inc. Health and Welfare Benefits Plan Non-union Employees Effective January 1, 2017 This document, together with each of the benefits booklets and insurance contracts of coverage,
More informationQuick Reference Guide: Key Health Care Reform Requirements Affecting Plan Sponsors
Quick Reference Guide: Key Health Care Reform Requirements Affecting Plan Sponsors The following is a brief summary of some of the key requirements affecting group health plan sponsors. This is only a
More informationDiving Deep on Commonly Encountered Eligibility and Enrollment Issues
Diving Deep on Commonly Encountered Eligibility and Enrollment Issues Center on Budget and Policy Priorities February 26, 2014 2 Part I: COBRA COVERAGE OPTIONS 3 Open Enrollment: Annual Period When All
More informationSpecial Enrollment Periods in the Federally-facilitated Marketplace (FFM) April 29, 2015
Special Enrollment Periods in the Federally-facilitated Marketplace (FFM) April 29, 2015 Agenda Session Guidelines Webinar Objectives Review of Special Enrollment Period (SEP) Policies and Processes Question
More informationINTRODUCTION OVERVIEW OF BENEFITS...
Summary Plan Description Swift Transportation Company Medical, Dental and Vision Plan Effective January 1, 2015 Table of Contents INTRODUCTION... - 1 - OVERVIEW OF BENEFITS... - 1 - Medical & Prescription...
More informationAction Plan #1: Continuing Healthcare Under COBRA Action Plan #2: Continuing Life and Accidental Death & Dismemberment (AD&D) Insurance...
TABLE OF CONTENTS: Your LOA Benefi t Action Plans Action Plan #1: Continuing Healthcare Under COBRA... 4 TABLE OF CONTENTS Action Plan #2: Continuing Life and Accidental Death & Dismemberment (AD&D) Insurance...
More informationThe New Jersey Individual Health Coverage Program. Buyer s Guide. How to Select a Health Plan
The New Jersey Individual Health Coverage Program Buyer s Guide How to Select a Health Plan Published by: New Jersey Individual Health Coverage Program Board P.O. Box 325 Trenton, NJ 08625-0325 Web Address:
More informationFREQUENTLY ASKED QUESTIONS COBRA continuation premium reductions
FREQUENTLY ASKED QUESTIONS COBRA continuation premium reductions These FAQs are not intended as a substitute for legal or compliance advice, and employers and groups should consult legal counsel for specific
More informationBENEFIT ELIGIBILITY. (Effective July 1, 2017)
BENEFIT ELIGIBILITY (Effective July 1, 2017) A. General Eligibility An individual employed by the District in an introductory or regular position for 20 hours or more per week (or 0.5 FTE, in the case
More informationFlexible Spending Plan
St. Francis Health Services of Morris, Inc. Flexible Spending Plan Medical FSA, Dependent Care FSA, and Pre- Tax Premium Summary Table of Contents INTRODUCTION... 4 DETAILS REGARDING THE MEDICAL FSA BENEFIT...
More informationApril 28, 2015 JANE SAMPLE 1111 SW STREET CIR ANYTOWN OR 97000
April 28, 2015 JANE SAMPLE 1111 SW STREET CIR ANYTOWN OR 97000 Re: Your Coverage Options PacificSource Policy #: G0000000 PacificSource Member ID #: 200000000 We ve learned that you and/or your dependents
More informationCHILDREN EXEMPTIONS, CREDITS AND INCOME SHIFTING TECHNIQUES
CHILDREN EXEMPTIONS, CREDITS AND INCOME SHIFTING TECHNIQUES 2 STARTING A BUSINESS 3 CHILDREN: Exemptions, Credits And Income Shifting Techniques Children invariably mean making additional, often significant,
More informationCONEXIS P.O. Box Dallas, TX
CONEXIS P.O. Box 223684 Dallas, TX 75222-3684 Date: 5/24/2016 Form: CLC02-CXTEN Doc ID: Account #: To Participant Name: Employer: UNIVERSITY OF AKRON (THE) Election Deadline: 7/26/2016 Qualifying Event:
More informationFAQs For Employees About COBRA Premium Reduction Under ARRA (
FAQs For Employees About COBRA Premium Reduction Under ARRA (http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionee.html) CONTENTS General Information... 1 Q1: I have heard that the stimulus package
More informationHealth Care Reform Template Language for Employers
Health Care Reform Template Language for Employers The health care reform law requires health insurance issuers and sponsors to provide certain notices to employees, either as a separate notice or as part
More informationThis document printed in April, 2017 takes the place of any documents previously issued to you which described your benefits.
Westminster College FLEXIBLE SPENDING ACCOUNT SAMPLE SUMMARY PLAN DESCRIPTION * Dependent Care EFFECTIVE DATE: July 1, 2017 FSA005 3338819 This document printed in April, 2017 takes the place of any documents
More informationTHE LINDSEY WILSON COLLEGE CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
THE LINDSEY WILSON COLLEGE CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Introduction Lindsey Wilson College (the Employer ) sponsors the Lindsey Wilson College Cafeteria Plan (the Cafeteria Plan ) that allows
More informationSAMPLE CAFETERIA PLAN
HR COMPLIANCE CENTER Cafeteria plans are governed by Internal Revenue Code 125 requiring employees to make irrevocable elections before the start of the plan year. Midyear changes are prohibited except
More informationEMERITI RETIREE HEALTH PLAN FOR GETTYSBURG COLLEGE
EMERITI RETIREE HEALTH PLAN FOR GETTYSBURG COLLEGE SUMMARY PLAN DESCRIPTION JULY 1, 2005 ALL OF THE INVESTMENT OPTIONS IN THE PLAN ARE MUTUAL FUNDS REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED
More informationChapter 2 Changes to Your Benefits
Chapter 2 Fast Facts You should take a fresh look at your benefits whenever you experience a major life event such as marriage or having a baby to be sure that what s in place still meets your needs. You
More informationGeneral Notice. COBRA Continuation Coverage Notice (and Addendum)
University Human Resources Benefits Office 3810 Beardshear Hall Ames, Iowa 50011-2033 515-294-4800 / 1-877-477-7485 Phone 515-294-8226 FAX General Notice And COBRA Continuation Coverage Notice (and Addendum)
More informationSUMMARY PLAN DESCRIPTION. for the CRETE CARRIER CORPORATION FLEXIBLE BENEFITS PLAN, DEPENDENT CARE ASSISTANCE PLAN & FLEXIBLE SPENDING ACCOUNT PLAN
SUMMARY PLAN DESCRIPTION for the CRETE CARRIER CORPORATION FLEXIBLE BENEFITS PLAN, DEPENDENT CARE ASSISTANCE PLAN & FLEXIBLE SPENDING ACCOUNT PLAN SUMMARY PLAN DESCRIPTION Introduction Crete Carrier Corporation
More informationTHE CAFETERIA PLAN SUMMARY PLAN DESCRIPTION FOR WHEELING JESUIT UNIVERSITY
THE CAFETERIA PLAN SUMMARY PLAN DESCRIPTION FOR WHEELING JESUIT UNIVERSITY Page 1 of 42 Introduction Wheeling Jesuit University (the Employer ) sponsors the Wheeling Jesuit University Cafeteria Plan (the
More informationRUSK INDEPENDENT SCHOOL DISTRICT FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION
RUSK INDEPENDENT SCHOOL DISTRICT FLEXIBLE BENEFITS PLAN SUMMARY PLAN DESCRIPTION Updated September 18, 2012 TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What
More informationGroup Health Benefit
Group Health Benefit Benefits Handbook IMPORTANT DO NOT THROW AWAY Contents INTRODUCTION... 3 General Overview... 3 Benefit Plan Options in Brief... 4 Contact Information... 4 ELIGIBILITY REQUIREMENTS...
More informationSummary Plan Description and Plan Document for the MEIJER HEALTH BENEFITS PLAN. (Restated as of the first day of the 2017 Plan Year)
Summary Plan Description and Plan Document for the MEIJER HEALTH BENEFITS PLAN (Restated as of the first day of the 2017 Plan Year) TABLE OF CONTENTS INTRODUCTION... 1 ELIGIBILITY AND PARTICIPATION...
More informationFORT BEND INDEPENDENT SCHOOL DISTRICT CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
FORT BEND INDEPENDENT SCHOOL DISTRICT CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements
More informationFLYERS ENERGY LLC INSURANCE PREMIUM PRE-TAX PAYMENT PLAN SUMMARY
FLYERS ENERGY LLC INSURANCE PREMIUM PRE-TAX PAYMENT PLAN SUMMARY FLYERS ENERGY LLC INSURANCE PREMIUM PRE-TAX PAYMENT PLAN SUMMARY Flyers Energy LLC maintains an Insurance Premium Pre-tax Payment Plan (the
More information2018 Medicare Fact Sheet
2018 Medicare Fact Sheet L O C K T O N C O M P A N I E S MEDICARE COVERAGES Part A Part B Part C Part D Coverage for hospital Coverage for other Part C is called the Part D is an stays, skilled nursing
More informationHealth Care FSA COBRA ELECTION NOTICE for the Health Care FSA offered through the Office of Group Benefits
Health Care FSA COBRA ELECTION NOTICE for the Health Care FSA offered through the Office of Group Benefits Date July 4, 2014 Dear: DEPENDENT OF NAME ADDRESS ANY CITY, LA 99999 Introduction This notice
More informationHealth Care Plans A14742W. Health Care Plans 2009 Edition
Health Care Plans Summary Plan Description 2009 Edition/Union-Represented Employees IBCJA 721; IBEW 2295; IBPATA 36; IBT 578 and 952; UAW 864, 887, 952, 1519, and 1558; SMWIA 461 The summary plan description
More informationHEALTH CARE REFORM: WHAT EMPLOYERS NEED TO KNOW
HEALTH CARE REFORM: WHAT EMPLOYERS NEED TO KNOW RESOURCE LINKS Senate Reform Bill http://docs.house.gov/ru les/hr4872/111_hr3590_ engrossed.pdf http://docs.house.gov/ru les/hr4872/111_hr4872_ amndsub.pdf
More informationSection 125 Plan Election Change Matrix
This diagram represents NEO Administration's interpretation of the current Section 125 regulations regarding election changes. By plan design, plan sponsors may elect to impose more restrictive rules,
More informationTW Ventures Inc. Flexible Spending Account Plan
TW Ventures Inc. Flexible Spending Account Plan SUMMARY PLAN DESCRIPTION For Tier 1 and Tier 2 Employees Effective January 1, 2016 Contents Introduction... 4 About This Summary Plan Description... 4 Overview...
More informationCONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA)
Office of Employee Benefits Administrative Manual CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) 250 INITIAL EFFECTIVE DATE: SEPTEMBER 1, 2005 LATEST REVISION DATE: AUGUST 1, 2013 PURPOSE: To provide
More informationModel COBRA Continuation Coverage Election Notice Instructions
Model COBRA Continuation Coverage Election Notice Instructions The Department of Labor has developed a model Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) continuation coverage election
More informationCOBRA Rules for Medicare Beneficiaries
Provided by Sullivan Benefits COBRA Rules for Medicare Beneficiaries As older Americans those who are age 65 and older continue to stay in the workforce, employers will need to understand how an employee
More informationGeneral Information Book for active employees of the State of New York, their enrolled dependents, COBRA enrollees and Young Adult Option enrollees
2017 NY Active Employees New York State Health Insurance Program for active employees of the State of New York, their enrolled dependents, COBRA enrollees and Young Adult Option enrollees New York State
More informationHealth Care Reform Health Plans Overview
Health Care Reform Health Plans Overview Topics Status of health care reform Grandfathered plans Timeline for compliance Health Care Reform What is It? Patient Protection and Affordable Care Act (PPACA)
More informationEL PASO COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
EL PASO COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?...1 2. What are the eligibility requirements for our Plan?...2 3.
More informationTHE CENTRAL METHODIST UNIVERSITY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
THE CENTRAL METHODIST UNIVERSITY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Introduction Central Methodist University (the Employer ) sponsors the Central Methodist University Cafeteria Plan (the Cafeteria
More informationCESAs Coverdell Education Savings Accounts. Questions & Answers
CESAs Coverdell Education Savings Accounts Questions & Answers What is a Coverdell Education Savings Account? A Coverdell Education Savings Account is a type of tax-preferred savings and investment account
More informationNCFlex FREQUENTLY ASKED QUESTIONS
NCFlex FREQUENTLY ASKED QUESTIONS BENEFITS How often can I go to the dentist for a routine cleaning/check-up? Twice a year. How do I know if a service is covered or not? Visit the NCFlex website at www.ncflex.org
More informationBOX ELDER COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
BOX ELDER COUNTY CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Restatement TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements for our
More informationIMPORTANT INFORMATION ABOUT COBRA CONTINUATION COVERAGE RIGHTS FOR SILVER AND GOLD PARTICIPANTS
IMPORTANT INFORMATION ABOUT COBRA CONTINUATION COVERAGE RIGHTS FOR SILVER AND GOLD PARTICIPANTS 1. What is COBRA Continuation Coverage? COBRA Continuation Coverage ( COBRA Coverage ) is a continuation
More informationNCFlex Frequently Asked questions
NCFlex NCFlex Frequently Asked questions BENEFITS How often can I go to the dentist for a routine cleaning/check-up? Twice a year. How do I know if a service is covered or not? Visit the NCFlex website
More informationYour Benefit Program. Highlights
Your Benefit Program Highlights At Turner, we value your hard work, and we believe you deserve a high-quality, comprehensive benefit program. Turner Benefits offers you and your family the opportunity
More informationWASHINGTON AND LEE UNIVERSITY EMPLOYEE HEALTH AND WELFARE PLAN PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION
WASHINGTON AND LEE UNIVERSITY EMPLOYEE HEALTH AND WELFARE PLAN PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION This document is provided for informational purposes and to comply with certain requirements of
More informationHow will this Fact Sheet help me?
FACT SHEET: Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65 How will this Fact Sheet help me? As you near age 65, you have to make several important decisions about your Medicare
More informationGroup Benefits Package for Professional Employees Represented by SPEEA. Retiree Medical Plan Attachment B (Professional Unit) January 1, 2018
Group Benefits Package for Professional Employees Represented by SPEEA Retiree Medical Plan Attachment B (Professional Unit) January 1, 2018 ATTACHMENT B Attachment B Table of Contents ELIGIBILITY... 1
More informationHealth Coverage Options Guide
Health Coverage Options Guide Overview At Fresenius Kidney Care, we know that providing superior patient care goes beyond delivering industry leading dialysis services. We also strive to help patients
More informationCOBRA Procedures and Basic Compliance Rules for Employers
COBRA Procedures and Basic Compliance Rules for Employers Allied National is pleased to provide your group with medical and/or dental benefits. This guide is intended to assist you with managing your COBRA
More information1/5/16. Provided by: The Lank Group Winterthur Close Kennesaw, GA Tel: Design 2015 Zywave, Inc. All rights reserved.
1/5/16 Provided by: The Lank Group 2971 Winterthur Close Kennesaw, GA 30144 Tel: 770-683-6423 Design 2015 Zywave, Inc. All rights reserved. Table of Contents Introduction... 3 Plan Design and Coverage
More informationHIPAA Special Enrollment Rights Legislative Alert June 9, 2015
Provided by BB&T Insurance Services, Inc., McGriff, Seibels & Williams, Inc., BB&T Insurance Services of California, Inc., and Precept Insurance Solutions, LLC HIPAA Special Enrollment Rights Legislative
More informationImportant Health Benefit Continuation Information
CHIEF EXECUTIVE OFFICE Risk Management Division Employee Benefits 1010 10 TH Street, Suite 5900, Modesto, CA 95354 Phone: 209.525.5717 Fax: 209.567.4367 Important Health Benefit Continuation Information
More informationELCA Health Benefits Plan ELCA-Primary Health Benefits
SUMMARY PLAN DESCRIPTION» Effective Jan. 1, 2014 ELCA Health Benefits Plan ELCA-Primary Health Benefits ELCA Benefit Program Description and ELCA-Primary Health Benefits Summary Plan Description Effective
More informationFAQs. General Questions on Domestic Partnership. 1. What is a domestic partnership?
FAQs General Questions on Domestic Partnership 1. What is a domestic partnership? As defined by the CHEIBA Trust, a domestic partnership is one that meets the criteria outlined in the "Affidavit of Domestic
More informationK E L L E Y D R Y E. Final Department of Labor Regulations On COBRA Requirements
Client Advisory June 14, 2004 Final Department of Labor Regulations On COBRA Requirements The Department of Labor (the DOL ) recently issued final regulations (the Regulations ) setting forth new notice
More informationNew Health Insurance Marketplace Coverage Options and Your Health Coverage
New Health Insurance Marketplace Coverage Options and Your Health Coverage Form Approved OMB No. PART A: General Information When key parts of the health care law take effect in 2014, there will be a new
More informationGRANVILLE EXEMPTED VILLAGE SCHOOLS CAFETERIA PLAN SUMMARY PLAN DESCRIPTION
GRANVILLE EXEMPTED VILLAGE SCHOOLS CAFETERIA PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS I ELIGIBILITY 1. When can I become a participant in the Plan?... 1 2. What are the eligibility requirements
More informationDefined Contribution What s Legal, What s Not?
Finally, some answers Defined Contribution What s Legal, What s Not? PURPOSE AND OVERVIEW Eric Johnson 817-366-7536 eric@comedyce.com PURPOSE AND OVERVIEW Working Together This Technical Release provides
More information