Frequently Asked Questions (FAQ)

Insurance

Is enrollment automatic?

No. Enrollment forms must be completed within 60 days from the date of hire. The effective date for insurance coverage is the first day of the month following completion and submission of the enrollment forms and payroll deductions for a full month’s premium.


Is there a waiting period for insurance to begin?

No. Employees are eligible to begin insurance coverage on the first day of the month following their date of hire, subject to guidelines involving submission of enrollment forms and payroll deduction of premiums.


How long can I keep my children as dependents on my insurance?

Children may remain on the insurance plan without having to provide proof of dependency until age 19. From age 19 to 25, proof may be required each semester that the child is in school or living and home and financially dependent on the employee.


Does family health coverage cost the same with only one dependent?

Yes. Regardless of the number of dependents, the cost of family coverage is the same.


If I haven’t received or have lost my insurance card(s), what do I do?

Contact the insurance companies to request new cards and to verify your mailing address.


If I did not enroll in health insurance when I was hired, can I change my mind later?

Employees have 60 days from the date of hire to enroll. After that time period, employees may only enroll during the annual open enrollment unless they experience a qualifying status change.


What happens to my premium rates if I go from full-time to part-time employment?

The premiums are based on an employee’s percentage of full-time employment (FTE). Changes in FTE will result in either an increase or decrease in an employee’s premium amount. If you experience a change in employment status, contact your local Human Resource Benefits office for options and premium rates.


My spouse and I are going to have a baby soon. When should I add my child to coverage?

People First urges employees anticipating the birth of a child to change to family coverage as soon as they become aware of the pregnancy, but if individual coverage is in effect at the time of the baby’s birth, you have 31 days from the birth of the child to enroll in family coverage. The effective date of coverage will be retroactive to the beginning of the month in which the child is born and premiums will be due accordingly.


I’m not satisfied with my services. What can I do?

Contact the health plan’s member services area and voice your complaint. The insured may change primary care physicians or dentists at any time. If still not satisfied, be sure to follow proper grievance procedures as outlined by the insurance plan. Changing from one insurance plan to another may only occur during the annual open enrollment.


Can I cancel my insurance because I cannot afford it?

No. An employee must experience a qualifying status change (QSC) event in order to make a change during the plan year. Otherwise, the employee may cancel only during the annual open enrollment.


What happens to my insurance coverage if I decide to go on a leave of absence?

If you do not receive a paycheck, premiums for insurance coverage must be paid by personal check or money order. To prevent a lapse in coverage and since premiums are paid one month in advance, payments should be submitted to Payroll by the end of the month prior to the month of coverage. You do have the opportunity to change and/or your coverage due to a leave of absence. Please contact your local Human Resource Benefits Office for more details.


Can I keep my health insurance coverage after I leave the University?

Yes. COBRA allows you to continue your health, dental, and vision coverage for up to 18 months following termination for yourself and/or qualified dependents. Paperwork will be mailed directly from People First to your home address on file. To continue any other supplemental coverages, contact the company within 31 days of your termination to complete all appropriate forms. To continue your Medical Flexible Spending account, you need to contact your local Human Resource Benefits Office to complete the appropriate paperwork.


How do I get a prescription filled before I receive my I.D. card?

Contact the insurance company for your group number and identification number.


My statements from the Insurance carrier are going to the wrong address. What should I do?

Submit a new W-4 to Payroll. You can do this via the GEMS Self-Service website or via a paper form available in Payroll, SVC 0067.