Page 4 - Benefit Guide
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Eligibility
Employees who work at least 30 hours per week are eligible for the benefits described
in this guide.
Most benefits are effective on your date of hire as long as Spouses/domestic partners with access to
you enroll within 30 days. The following dependents are other employer coverage
also eligible:
We have a spousal surcharge that is intended to
΅΅ Your legal spouse encourage working spouses to review all medical
΅΅ Your domestic partner plan options available to them and to keep our costs
΅΅ Your children up to age 26 reasonable for everyone. If your spouse or domestic
partner is eligible for medical coverage through
Changes to your benefits their employer, and you cover them on our medical
plan, you will be required to pay a surcharge of
Generally, you may only make or change your existing $XX per month in addition to your regular medical
benefit elections as a new hire or during the annual premiums.
open enrollment period. However, you may change your
benefit elections during the year if you experience an Important notice if you use nicotine/tobacco
event such as:
Going nicotine- and tobacco-free is one of the most
΅΅ Marriage, divorce or legal separation important steps you can take to maintain good
΅΅ Birth or adoption of a child health. If you enroll in our medical plan and you use
΅΅ Loss or gain of other coverage by the employee or tobacco/nicotine or have used tobacco products
during the last six months, you will be required
dependent to pay a tobacco surcharge of $XX per month in
addition to your regular medical premiums. If you
΅΅ Eligibility for Medicare or Medicaid complete the tobacco cessation program through
XX, you can receive a refund of the surcharge.
You have 30 days from the qualified life event to make
changes to your coverage. Depending on the type of
event, you may need to provide proof of the event, such
as a marriage license. If you do not make the changes
within 30 days of the qualified event, you will have to wait
until the next open enrollment period to make changes
(unless you experience another qualified life event).
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