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Benefit Comparison Summary: MEDICAL | DENTAL | VISION
Health Insurance Premiums: HEALTHCARE
| COBRA
COBRA | HIPAA | Care
Counsel | Employee Assistance
Program (EAP)
Eligibility | Open
Enrollment | Additional Info | Change
in Coverage
Waiver
of Coverage
Flexible Spending Accounts: Health | Dependent
Care | Transit
& Parking
Open Enrollment For All Medical/Dental Plans
Open
Enrollment
Each year the Court holds an open enrollment period during which employees and retirees may switch insurance plans, enroll (if coverage was initially waived or subsequently dropped) and add dependents.
To switch plans, your enrollment materials must be submitted to the Court’s Human Resources Department before the close of the open enrollment period (that date will be announced each year). Your coverage under the new plan selection will normally start at the beginning of the pay period that will be announced at the open enrollment period.
If you are adding dependents, obtain the appropriate change form and submit it as described above for enrollment materials.
- Eligible Employees
- You are eligible to enroll in a Court Medical or Dental Plan if:
- you are a regular, full-time or part-time employee of the Court, or
- you must also enroll in a medical plan offered by the Court to be eligible for dental coverage. You may not be covered by just a medical or dental plan offered by the Court. In order to have either type of coverage, you must be enrolled in both plans.
Change in Coverage Outside
Open Enrollment Period
You will not be allowed to change your plan selections or add dependents until the next benefit year unless you have a qualified “change in status”. The IRS regulations for these changes (i.e. outside of open enrollment period) restrict any changes to your plan or coverage unless you have a qualified “change in status.” The following are considered qualified changes in status by the IRS:
- Change in legal marital status, including marriage,
divorce, legal separation, annulment, and death of a spouse
- Change in number of dependents, including birth,
adoption, placement for adoption, or death of a dependent child
- Change in employment status, including the start
or termination of employment by you, your spouse, or your dependent
child
- Change in work schedule, including an increase
or decrease in hours of employment by you, your spouse, or your dependent
child, including a switch between part-time and full-time employment
that affects eligibility for benefits
- Change in a child’s dependent status, either
newly satisfying the requirements for dependent child status or ceasing
to satisfy them
- Change in place of residence or worksite, including
a change that affects the accessibility of network providers
- Change in your health coverage or your spouse’s coverage attributable
to your spouse’s employment
- Change in an individual’s eligibility for Medicare
or Medicaid
- A court order resulting from a divorce, legal
separation, annulment, or change in legal custody (including a Qualified
Medical Child Support Order) requiring coverage for your child or
dependent foster child
- An event that is a special enrollment event under HIPAA (the
Health Insurance Portability and Accountability Act), including acquisition
of a new dependent or spouse or loss of coverage under another health
insurance policy or plan if the coverage is terminated because of:
- Voluntary or involuntary termination of employment or reduction
in hours of employment or death, divorce, or legal separation,
- Termination of employer contributions toward the other coverage,
OR
- If the other coverage was COBRA Continuation Coverage, exhaustion
of the coverage
Two other rules apply to making changes to your benefits during the
year:
- Any changes you make must be consistent with the change in status,
AND
- You must make the changes within 31 days of the date the event
(marriage, birth, etc.) occurs.
* Contact Human Resources at (805) 882-4739 for the applicable enrollment
or change forms.
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