8.01 Medical Insurance

Effective Date: September 1, 2013 (revised)

Purpose:

Eligible employees may choose to enroll in a medical insurance plan offered by the College. Detailed information describing each of the plans currently available may be obtained from the Human Resources Department.

Procedure:

Eligibility/Enrollment

Enrollment is available to all continuing full-time employees with an FTE of .5 or more.

Eligibility starts on the first day of the month coinciding with or following employment.

Open Enrollment periods are held each November for coverage effective January 1st of the following year. This is the only time that employees may elect to add medical insurance, except for when originally employed or if an employee experiences a change in family status.

A change in family status is defined by the IRS as follows:

• Legal marital status changes, such as marriage, divorce, separation, or the death of a spouse.
• A change in the number of dependents such as birth, death or adoption.
• Changes in employment status of the employee, or of the employee’s spouse or dependents. This includes the beginning or ending of employment, new or different work hours, a change due to a strike, a change from full-time to part-time status or vice versa, the beginning or end of an unpaid leave of absence, or a change in work site. Also, if employment status affects eligibility under the plan, that is deemed to be an employment status change (e.g., salaried to hourly).
• A dependent becoming eligible or ceasing to be eligible for coverage due to age, student status, or any similar circumstance.
• A change in the residence of the participant, or the participant’s spouse or dependent.

Those who wish to enroll in a Trinity plan because of a change in family status may do so provided they enroll within 30 days following termination of previous coverage (as applicable). The Human Resources office will require proof of cancellation of coverage.

Family members may be enrolled at the time of hire, and thereafter, within 30 days of the time they become members of the family (i.e., as of the date of marriage, birth, adoption, etc.). Family members may also enroll during the open enrollment period.

Costs

For employees with an FTE of .75 or more, the cost of premiums for coverage available is shared by the College and the employee. Currently the College pays 75% of the premium of the lowest cost plan, and contributes the same dollar amount to the higher cost plan. For those employees eligible for part-time benefits, the College pays 50% of the premium of the lowest cost plan, and contributes the same dollar amount to the other plan.

The coverage categories are: employee only; employee plus spouse; employee plus dependent child or children; and employee plus spouse and dependent child or children. The employees share of monthly premium costs is deducted from paychecks. For employees not scheduled to work during certain periods of the year deductions owed for premiums will accrue until the first paycheck upon returning to work. Employees who do not return to work will be responsible for repaying the College.

Unless elected otherwise in writing, the employee contribution to group health insurance premiums is deducted from the individual’s paycheck on a pre-tax basis, which means that federal income and Social Security taxes are not withheld from these amounts. This salary reduction benefit is allowable under Section 125 of the Internal Revenue Code.

Termination of Coverage/COBRA

Health care coverage ceases either on the last day of the month in which termination of employment occurs, or on the last day of the month during which the employee no longer meets eligibility requirements for the plan. Coverage for employees on Military Service Leave ends as of the last day of active employment.

A group health insurance continuation privilege under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) is available for most employees and/or their dependents who are no longer eligible for group medical coverage, including those on Military Service Leave. It is the employee’s obligation to notify the Human Resources Department of any dependents who are no longer qualified under the group health plan. Specific guidelines for such extension or conversion will be provided by the Human Resources Department. Failure to properly notify Human Resources jeopardizes the rights of an employee or dependent to COBRA benefits.

Employees who are age 60 or older at the time of retirement are eligible for certain group medical insurance benefits with the College, provided they have worked a minimum of ten consecutive years on a full-time basis.

All information regarding rates, levels of coverage, comparison of benefits, enrollment and claims forms is available in the Human Resources Department and is subject to change without notice.

See the following policies for further relevant information:

4.05 Termination of Employment 62

6.51 Deductions from Pay and Pay Advices 170

7.13 Military Service Leave 227