Page 3 - 2018 USI Enrollment
P. 3
University of Southern Indiana
Benefits Eligibility
Eligible Employees
You may enroll in the beneits program if you are a regular employee working at least a
75 percent academic or iscal year schedule.
Eligible Dependents
Eligible dependents include your legal spouse and your children up to age 26 for
medical, dental, vision, and life plans (natural, stepchildren, foster children, adopted
children, or any child for which you have legal custody). Children may be covered on
the medical, dental, vision and life plans until the end of the month in which they turn
age 26. For life insurance, children must be unmarried.
SSN Required
You must provide a valid Social Security Number for yourself and each enrolled
dependent. Employers are required to provide names and Social Security Numbers to
the federal government for each individual enrolled for medical coverage.
Qualifying Life Event
If you experience a
Once you make your elections, you will not be able to make changes until the next qualiied family status
annual enrollment period unless you experience a qualifying life event. A qualifying life change, you must
event is a change in your personal life that may impact your eligibility or dependent’s notify the beneits
eligibility for beneits. Examples of some qualifying events include the following: team within 31
days of the change.
X Marriage, death of a spouse, divorce, legal separation, or annulment Depending on the
X Birth, placement for adoption, adoption of a child, or a court issued guardianship type of change,
you may need to
X Qualiied Medical Child Support order (QMCSO) requiring the plan to provide provide proof of the
medical coverage for your dependent child change. It is your
responsibility to notify
X Change in your spouse’s or dependent’s employment status including termination, the beneits team
change from full-time to part-time (or vice versa), or unpaid leave of absence when a dependent is
X Your dependent loses coverage under any group health plan no longer eligible for
coverage.
X Signiicant change in the cost of your current coverage or the options being offered
X Death of a covered dependent
X Your spouse’s employer’s medical plan, in which you are currently enrolled, ceases
its contributions to the plan’s cost or has a beneits enrollment (does not apply to
FSA)
X A dependent becomes eligible or ineligible for coverage, which could put you in a
different coverage category 3
Benefits Eligibility
Eligible Employees
You may enroll in the beneits program if you are a regular employee working at least a
75 percent academic or iscal year schedule.
Eligible Dependents
Eligible dependents include your legal spouse and your children up to age 26 for
medical, dental, vision, and life plans (natural, stepchildren, foster children, adopted
children, or any child for which you have legal custody). Children may be covered on
the medical, dental, vision and life plans until the end of the month in which they turn
age 26. For life insurance, children must be unmarried.
SSN Required
You must provide a valid Social Security Number for yourself and each enrolled
dependent. Employers are required to provide names and Social Security Numbers to
the federal government for each individual enrolled for medical coverage.
Qualifying Life Event
If you experience a
Once you make your elections, you will not be able to make changes until the next qualiied family status
annual enrollment period unless you experience a qualifying life event. A qualifying life change, you must
event is a change in your personal life that may impact your eligibility or dependent’s notify the beneits
eligibility for beneits. Examples of some qualifying events include the following: team within 31
days of the change.
X Marriage, death of a spouse, divorce, legal separation, or annulment Depending on the
X Birth, placement for adoption, adoption of a child, or a court issued guardianship type of change,
you may need to
X Qualiied Medical Child Support order (QMCSO) requiring the plan to provide provide proof of the
medical coverage for your dependent child change. It is your
responsibility to notify
X Change in your spouse’s or dependent’s employment status including termination, the beneits team
change from full-time to part-time (or vice versa), or unpaid leave of absence when a dependent is
X Your dependent loses coverage under any group health plan no longer eligible for
coverage.
X Signiicant change in the cost of your current coverage or the options being offered
X Death of a covered dependent
X Your spouse’s employer’s medical plan, in which you are currently enrolled, ceases
its contributions to the plan’s cost or has a beneits enrollment (does not apply to
FSA)
X A dependent becomes eligible or ineligible for coverage, which could put you in a
different coverage category 3
