Benefits Eligibility and Enrollment

• Employee and Research Associate Eligibility
• Family Member Eligibility
• Selecting Medical and Dental Benefits
• How to Enroll
• Making Changes
• Waiving Benefits

Employee and Research Associate Eligibility

You are eligible for medical and dental benefits if you are:

• An active ongoing salaried employee regularly scheduled to work a minimum of 20 hours a week paid either wages or a stipend on a regular basis
  
  
• A post-doctoral research associate (including Research Associate, Post-doctoral Research Fellow, and Senior Fellow) whose primary benefits are through this organization

Graduate students who have insurance available through their sponsoring institution are not eligible for benefits.

You may cover your family members in the same medical and dental plans you select.

You are eligible for life, AD&D and LTD insurance if you are:

• An active ongoing salaried employee regularly scheduled to work a minimum of 30 hours a week (20 hours for supplemental life)
  
  
• A post-doctoral research associate (including Research Associate, Post-doctoral Research Fellow, and Senior Fellow) regularly scheduled to work a minimum of 30 hours a week.

Post-doctoral research associates receiving a training stipend that provides at least 50% of total compensation are not eligible to contribute to flexible spending accounts.

Family Member Eligibility

You may cover your family members in the same medical and dental plans you select. To be eligible, the family member must be:

• Your legal spouse.
  
  
• Your domestic partner, if all requirements are met as stated in the signed affidavit of domestic partnership (on the back of the enrollment form).
• You, your spouse's or your domestic partner's:
  • Natural child
  • Adopted child
  • Foster child
  • Stepchild
  • Child legally placed for adoption
  • Child placed with you as legal guardian
  • Child for whom you, your spouse or your domestic partner has responsibility to provide medical coverage under a QMCSO.

Children are eligible until they turn 25, as long as they are unmarried and primarily dependent on you for support. A disabled child who continues to be dependent on you may be eligible to continue coverage after age 25.

To be eligible for Supplemental Life Insurance, your family member must be:

• Your legal spouse.
  
  
• Your domestic partner, if all requirements are met as stated in the signed affidavit of domestic partnership (on the back of the enrollment form).
  
  
• Your, your spouse's or your domestic partner's dependent child from birth to age 25, including:
  • Natural child
  • Adopted child
  • Stepchild living in your home

Deductions for domestic partner coverage are post tax; please contact Employee Services for more information.

Selecting Medical and Dental Benefits

You must enroll in a medical and dental plan unless you have coverage under another group health care plan. (Government-sponsored health care and health assistance plans such as Medicaid and the Basic Health Plan are not group health care plans.) Here are several other important facts to keep in mind:

• You may also enroll your family members in the same medical and dental plans you select.
  
  
• You don't need to enroll the same family members in the medical and dental plans. For example, you may enroll yourself and your spouse only in the dental plan while enrolling yourself and your children only in the medical plan.
  
  
• Any family members you enroll will be covered by the same plan or plans you select. For example, you can't enroll yourself in the Premera Blue Cross plan and your spouse in Alliant Plus.

How to Enroll

You must either enroll in these plans or waive participation when you are first eligible. Eligible employees and post-doctoral research associates receiving on-site training are eligible for coverage through some or all of the employee benefit plans. You'll need to complete an enrollment form for yourself and any dependents you choose to cover.

Each year there is an open enrollment period during which you may change your health care and flexible spending account benefits. You cannot make changes during the year unless you have a qualifying change in status.

You're eligible to enroll on the date you begin work as an eligible employee, and your coverage is effective on the first day of the calendar month coincident with or next following the date you begin work. For example: if you begin work August 5, your coverage is effective September 1; if you begin work September 1, your coverage also would be effective September 1. If you're eligible to participate, you'll have the opportunity to:

1. Select health care benefits (medical and dental)
   
   
2. Create flexible spending accounts for reimbursement of qualifying health care and dependent care expenses
   
   
3. Elect coverage in the Supplemental and Dependent Life Insurance Plan

If you don't submit an enrollment form within 30 days of your eligibility date, you'll automatically be enrolled in the Alliant Plus medical plan and Washington Dental Service Plan B. None of your dependents, if any, will be enrolled in the health care benefits. You can't change these default elections until the next open enrollment period.

Making Changes

Once you've made your elections (according to IRS rules), you cannot change them until the next open enrollment unless you (or a family member) gain or lose plan eligibility due to one of the following types of events — a change in:

• Legal marital status such as marriage or divorce
  
  
• The number of your dependents, for instance due to birth, death or adoption
  
  
• Employment status, such as being hired, terminating employment, taking a leave of absence, or changing from part-time to full-time status (or vice versa)
  
  
• A dependent's status as a dependent, for example due to age or beginning or ending a qualifying domestic partnership
  
  
• Residence (moving out of the coverage area)

Any change you make must be on account of the event that gives you the election change opportunity, and must correspond with that event. In addition, election changes will also be allowed when consistent with:

• You or a family member gaining or losing coverage under Medicare or Medicaid
  
  
• An official order, judgement or decree, such as a qualified medical child support order
  
  
• An election change by a family member under that family member's plan

Several years ago the Department of Labor passed legislation that allowed employers to offer even more flexibility with regard to life changing events. You may be eligible to change your election mid-year for yourself and certain family members under these circumstances:

• If you waive medical coverage for yourself or your family members because of other health care coverage and you lose that coverage for certain reasons
  
  
• If you have new family members due to a marriage, birth, adoption or placement for adoption.

Any change in your participation must be consistent with the change in status. You must make any change in your elections within 31 days following a qualified status change (60 days for newborns and adoptions). Please contact Human Resources for more information.

Waiving Coverage

If you're covered by another group plan, you may waive medical and/or dental coverage and be eligible to receive taxable cash each month:

• $85 for medical
  
  
• $15 for dental

You may be asked to submit proof of this other coverage to Employee Services along with your enrollment form when you are initially eligible to enroll, and on additional occasions. You may have this amount paid as additional compensation, as a contribution to a flexible spending account, or divided between additional cash and flexible spending accounts. To waive coverage, you must complete the waiver of coverage on the back of the enrollment form.