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Points To Consider
YOUR
SPOUSE HAS BENEFIT COVERAGE | YOU
ARE A NEW EMPLOYEE |
WHEN YOUR SPOUSE WORKS FOR THE STATE
PLEASE NOTE
Benefit Options Administrtive Fees
Beginning with the December, 2007 reductions/ deductions for January 1, 2008 coverage,
the 30¢ administrative fee will be added to each premium with the exception of Spending Accounts.
Spending Account participants are assessed the following fees:
General Purpose/Limited Purpose Health Care Spending Accounts....$2.00
Dependent Care Spending Accounts...................................................$1.00
Total, if employee has
both...................................................................$3.00
The HSA is subject to a separate fee schedule.
YOUR SPOUSE HAS BENEFIT COVERAGE
Spending Accounts
If your spouse's plan offers spending accounts, you can each have a Health Care Spending Account at
the maximum allowed. For Dependent (Child) Care Spending Accounts, however, IRS laws restrict your
total family contributions to $5,000 per year. For the 2008 Plan Year (January - December 31)
contributions will be limited to $4,992.
Health Savings Accounts
If your spouse's plan offers spending accounts and your spouse is enrolled in a Health Care Flexible
Spending Account or another non-HDHP plan, you are deemed 'covered' by a non-qualified Health Plan,
and are thus ineligible from participating in the Health Savings Account.
You Are A New Employee
Dental
There is a much shorter waiting period in the Regular and PPO options if you sign up immediately.
Late enrollment penalties will apply to the Regular and PPO options if you do not enroll now, but
elect to do so in the future. The Prepaid Option does not have waiting periods or late enrollment
penalties.
Spending Accounts
If you are hired by the State after October 1, your paycheck reductions for the spending accounts
will start the 15th of your first full calendar month of employment. Your total contributions to
each account are prorated by the number of months you participate in these options up to the maximum
monthly amount allowed for each account.
Once you enroll, you may submit claims for services incurred on or after the first of the month after
you have completed one full calendar month of employment. If, for example, you are hired July 8 and
sign up for a spending account, reductions will start on August 15. You can begin submitting claims
for services that you incur on or after September 1.
Health Savings Account
If you are hired by the State after January 1 and elect to participate in the State Health Benefit
Plan (SHBP) High Deductible Health Plan, you are not eligible to enroll in the Health Savings
Account until the first of the month coinciding with or after your effective date of the High
Deductible Health Plan. To determine your maximum contribution amount, please refer to the Health
Savings Account section of this booklet.
Long-Term Care
You have a one-time opportunity to sign up for long-term care insurance without providing
medical underwriting.
FOR THE PY 2008 OPEN ENROLLMENT PERIOD ONLY - Current employees may select Long-Term Care with no medical underwriting required
Employee Life, Spouse Life and Child Life
You have a one-time opportunity to choose some employee, spouse and child life insurance coverage
without providing medical underwriting. The chart on page 9 lists medical underwriting
requirements
Specified Illness
You have a one-time opportunity to sign up for the Specified Illness guaranteed levels
($5,000 and $10,000) without providing medical underwriting
FOR THE PY 2008 OPEN ENROLLMENT PERIOD ONLY - Current employees may select up to $10,000 of Specified Illness coverage with no medical underwriting required.
Disability
- There is a one-time opportunity to sign up for long-term disability coverage without providing medical underwriting during your new hire eligibility period. If you did not sign up then, you will need to complete an Evidence of Insurability Form.
- There is a one-time opportunity to sign up for
short-term disability without being subject to a late entrant waiting period
during your new hire eligibility period. If you did not sign up then, you will
be subject to the Late Enrollment Penalty.
Other Coverage
There are no medical underwriting requirements at any time for legal insurance, AD&D, spending accounts, or vision benefits.
Be sure to consider your options carefully when you first enroll. If you decline or drop some of your State coverages and want to pick them up again another year, you may have to prove insurability through medical underwriting to be covered again, or have longer waiting periods to receive full benefits.
>
WHEN YOUR SPOUSE WORKS FOR THE STATE
Dental
Each of you may take single coverage and enroll in
different options if you choose, but your children will
not be covered. As an alternative, one of you may
take family coverage and cover your spouse and
children. If you both take family coverage, the most
the plan will pay is 100% of the allowable expenses.
Spending Accounts
Health Care Spending Account (HCSA)- Each of you may have a Health Care
Spending Account for the maximum allowed ($5,040).
Dependent (Child) Care Spending Account (DCSA) - the
family maximum allowed is $4,992.
Health Savings Account
If one of you has a Health Care Spending Account, the spouse cannot enroll in the Health
Savings Account option. The spouse who has the High Deductible Health Plan coverage will be
the individual entitled to opening the HSA account and have payroll deductions taken
Long-Term Care
Each of you may enroll for the coverage you need.
> If you are married to a State employee covered by the Flexible Benefits Program,
make sure you understand how your coverage works together. You may have some advantages
Legal Services Insurance
Each of you may take single coverage; in this case, your children will not be covered and some
benefits may overlap. Or, one of you may take family coverage, which will cover the other spouse
and your children. Coordination of Benefit Rules may apply.
Employee Life and AD&D
Each of you may enroll for the coverage you need.
Spouse Life
Each of you may provide Spouse Life insurance for the other. Or, if you wish, one spouse may take coverage and the other spouse could choose "no coverage."
Specified Illness
Each of you may enroll for the coverage you need.
Child Life
Each of you may provide Child Life insurance for your eligible children. Or, if you wish, one spouse may take coverage and the other spouse could choose "no coverage."
Disability
Each of you may enroll for the coverage you need.
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