Eligibility & Enrollment Guidelines
Medical, Dental, and Reimbursement Accounts
| Eligible Faculty | Employed in a benefits-eligible position with an annual appointment of two-thirds time or more. |
| Eligible Staff | Employed in a benefits-eligible position of two-thirds time or more with a work schedule that is:
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| Eligible Participants | Eligible dependents include:
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| Coverage Effective Date | First of the month following date of hire or date of hire if it coincides with the university's first working day of the month. |
| Enrollment Deadlines | New hires and rehires: Up to 30 days from your date of hire Annual open enrollment: The one time during the year when you can join, change, or cancel your medical and dental coverage for the following year. During this time you can also enroll or re-enroll in the health- and dependent-care reimbursement accounts for the following year. Annual open enrollment is held in late fall to be effective for Jan. 1 of the following year. |
| Enrollment Changes | Because these benefits are paid for with pre-tax dollars, federal regulations restrict when you can make changes to your enrollment. Changes are not allowed unless they are made during the annual open enrollment or are classified as a qualifying event**. |
*Former Spouse
A faculty or staff member who covers a spouse on medical and/or dental plans must notify HRM Benefits of a divorce within 30 days. Supporting documentation will be required. In most cases, the former spouse would be offered continued coverage through COBRA.
It may be possible for the former spouse to remain on the family plan at no additional cost. At any time, a re-marriage by the faculty/staff member or by the former spouse will result in a loss of the former spouse’s eligibility as a dependent on the medical and/or dental plans. Therefore, a re-marriage by either party must also be reported to HRM Benefits by the faculty/staff member within 30 days and the former spouse will be removed from coverage. Any medical and/or dental claims after such loss of eligibility will become the responsibility of the patient.
**Qualifying Event
Federal regulations define a qualifying event as a change in family status, coverage eligibility or dependent eligibility, as outlined below.
- A family status change is defined as marriage, divorce, birth, adoption or death.
- A coverage eligibility status change is defined as either you, your spouse or same-sex spousal equivalent losing or gaining insurance coverage.
- A dependent eligibility status change is defined as an eligible dependent becoming an ineligible dependent.
If you or one of your covered dependents has a qualifying event, you must contact the HRM Benefits Office within 30 days of the event in order to change coverage. The coverage effective date will be retroactive to the date the qualifying event took place. If you do not change your coverage within 30 days of the event, you will not be able to change your coverage again until the annual open enrollment.