Page 9 - Franklin Madison 2022 Benefits Guide
P. 9
Benefits Eligibility
Eligibility at a Beneits Eligibility Start Date Please Bring This Documentation to
Glance Human Resources
Generally, irst day of
the month following
Full-time All Voluntary and date of hire. See the Please black out any personal (including social
security numbers) or inancial information.
Employees Company-paid Basic section for additional
Beneits Overview
Beneits
details. Note that dependent(s) will not be enrolled in
Medical, Dental, coverage until documentation is received and
Permanent Vision, Flexible First day of the approved. Suicient documentation must be
Part-time Spending Accounts, month following date
Employees* and Voluntary of hire. submitted for unveriied dependent(s) within 45
Beneits days of adding the dependent(s) to coverage. If
appropriate documentation is not received by the
* Employees regularly scheduled to work between 20 and 29 hours deadline, dependent(s) will not be approved for
each week.
coverage.
Dependent Eligibility If you and your spouse both work for the Company,
Eligible dependents for Medical, Dental and Vision you may enroll as individuals or as a dependent of
coverage include your: the other. Dependent children of married couples
who both work for the Company can be enrolled
y Lawfully married or state-recognized common- under one parent’s coverage. Rules for Voluntary
law spouse Life and AD&D are slightly diferent. Refer to pages
y Company-registered domestic partner* 26-28 for more information.
y Children under age 26, including stepchildren, * You must submit an Aidavit of Domestic Partnership and a
foster children and adopted children** Declaration of Tax Status. If your domestic partner does not
meet the IRS deinition of an eligible dependent, additional
y Grandchildren, if you are the court-appointed contributions for his/her coverage will be taken on an after-tax
basis. The Company’s portion of the cost is also considered taxable
guardian income and will be included in your W-2. Contact your local HR
y Disabled child of any age who lives with you and Representative for more information.
depends on you for support due to a mental or ** Employees enrolled in a Franklin Madison medical, dental or vision
plan can add or maintain coverage for an adult child until that child
physical disability turns 26 years old. Age will be the only criteria to determine a
child’s eligibility for coverage.
If you enroll your dependents for medical coverage,
you will be required to provide documentation to Benefits Online
support your dependent’s eligibility status (e.g., See your Beneit Summaries online at
birth certiicate, marriage license or any other access.paylocity.com.
applicable documentation).
9
Eligibility at a Beneits Eligibility Start Date Please Bring This Documentation to
Glance Human Resources
Generally, irst day of
the month following
Full-time All Voluntary and date of hire. See the Please black out any personal (including social
security numbers) or inancial information.
Employees Company-paid Basic section for additional
Beneits Overview
Beneits
details. Note that dependent(s) will not be enrolled in
Medical, Dental, coverage until documentation is received and
Permanent Vision, Flexible First day of the approved. Suicient documentation must be
Part-time Spending Accounts, month following date
Employees* and Voluntary of hire. submitted for unveriied dependent(s) within 45
Beneits days of adding the dependent(s) to coverage. If
appropriate documentation is not received by the
* Employees regularly scheduled to work between 20 and 29 hours deadline, dependent(s) will not be approved for
each week.
coverage.
Dependent Eligibility If you and your spouse both work for the Company,
Eligible dependents for Medical, Dental and Vision you may enroll as individuals or as a dependent of
coverage include your: the other. Dependent children of married couples
who both work for the Company can be enrolled
y Lawfully married or state-recognized common- under one parent’s coverage. Rules for Voluntary
law spouse Life and AD&D are slightly diferent. Refer to pages
y Company-registered domestic partner* 26-28 for more information.
y Children under age 26, including stepchildren, * You must submit an Aidavit of Domestic Partnership and a
foster children and adopted children** Declaration of Tax Status. If your domestic partner does not
meet the IRS deinition of an eligible dependent, additional
y Grandchildren, if you are the court-appointed contributions for his/her coverage will be taken on an after-tax
basis. The Company’s portion of the cost is also considered taxable
guardian income and will be included in your W-2. Contact your local HR
y Disabled child of any age who lives with you and Representative for more information.
depends on you for support due to a mental or ** Employees enrolled in a Franklin Madison medical, dental or vision
plan can add or maintain coverage for an adult child until that child
physical disability turns 26 years old. Age will be the only criteria to determine a
child’s eligibility for coverage.
If you enroll your dependents for medical coverage,
you will be required to provide documentation to Benefits Online
support your dependent’s eligibility status (e.g., See your Beneit Summaries online at
birth certiicate, marriage license or any other access.paylocity.com.
applicable documentation).
9
