Page 3 - CHI 2022 Benefits Guide
P. 3
2022
Benefits Guide
Plan Eligibility
Eligibility
You may enroll if you are a full-time, active employee, working a minimum of 30 hours or more per week on
average.
Eligible dependents include your legal spouse, and your children up to age 26 for the medical, dental, and
vision plans. Children (natural, stepchildren, foster children, adopted children, or any child you have legal
custody of) will be covered on the medical plan until the end of the month in which they turn 26.
It is your responsibility to notify Human Resources when a dependent is no longer eligible for coverage. C.H.I.
reserves the right to request proper documentation in order to verify dependent eligibility. Failure to provide
proper documentation may result in your dependent being terminated from the plan.
Qualified Family Status Change
You may only make changes to your elections during the calendar year if you have a qualifying family status
change. The following list includes qualiied family status changes:
z Marriage, death of a spouse, divorce, legal z Your dependent loses coverage under any
separation, or annulment group health plan
z Birth, placement for adoption, adoption of a z Signiicant changes in the cost of your current
child, or a court issued qualiied medical child coverage, or the options being ofered
support order (QMCSO) requiring the plan to z Death of a covered dependent
provide medical coverage for your dependent z
child Your spouse’s employer’s medical plan in
which you are currently enrolled ceases its
z Change in your spouse’s or dependent’s contributions to the plan’s cost, or has a
employment status including termination, beneits enrollment (does not apply to FSA)
change from full-time to part-time (or vice z
versa), or unpaid leave of absence A dependent becomes eligible or ineligible for
coverage, which could put you in a diferent
coverage category
If you experience a qualiied family status change, you must notify Human Resources within 31 days of
the change. Depending on the type of change, you may need to provide proof of the change.
3
Benefits Guide
Plan Eligibility
Eligibility
You may enroll if you are a full-time, active employee, working a minimum of 30 hours or more per week on
average.
Eligible dependents include your legal spouse, and your children up to age 26 for the medical, dental, and
vision plans. Children (natural, stepchildren, foster children, adopted children, or any child you have legal
custody of) will be covered on the medical plan until the end of the month in which they turn 26.
It is your responsibility to notify Human Resources when a dependent is no longer eligible for coverage. C.H.I.
reserves the right to request proper documentation in order to verify dependent eligibility. Failure to provide
proper documentation may result in your dependent being terminated from the plan.
Qualified Family Status Change
You may only make changes to your elections during the calendar year if you have a qualifying family status
change. The following list includes qualiied family status changes:
z Marriage, death of a spouse, divorce, legal z Your dependent loses coverage under any
separation, or annulment group health plan
z Birth, placement for adoption, adoption of a z Signiicant changes in the cost of your current
child, or a court issued qualiied medical child coverage, or the options being ofered
support order (QMCSO) requiring the plan to z Death of a covered dependent
provide medical coverage for your dependent z
child Your spouse’s employer’s medical plan in
which you are currently enrolled ceases its
z Change in your spouse’s or dependent’s contributions to the plan’s cost, or has a
employment status including termination, beneits enrollment (does not apply to FSA)
change from full-time to part-time (or vice z
versa), or unpaid leave of absence A dependent becomes eligible or ineligible for
coverage, which could put you in a diferent
coverage category
If you experience a qualiied family status change, you must notify Human Resources within 31 days of
the change. Depending on the type of change, you may need to provide proof of the change.
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