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BENEFIT BASICS
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Eligibility
As a City of Raleigh employee your benefits are
effective on the first day of the month following your date of hire. You may enroll your eligible dependents for coverage once you are eligible.
A dependent child under the age of 26 consists of an employee’s unmarried children or the unmarried children of his/her spouse, including:
• Natural children
• Legally-adopted children
• Step children
• Children placed for adoption
• Children under legal guardianship by a court order and living with the employee and children who are entitled to coverage under a medical support order
A dependent spouse consists of an employees spouse under a legally valid existing marriage or court order.
Additional information regarding definitions and eligibility criteria is available in the City of Raleigh Carrier Policy Documents.
Once your benefit elections become effective, they will remain in effect until December 31, 2019. You may only change coverage within 30 days of a qualified life event.
Spousal Surcharge
Qualifying Life Events
Generally, you may only make or change your existing benefit elections during the open enrollment window each year. However, you may change your benefit elections during the year if you experience a Qualifying Life Event (QLE) such as:
• Marriage
• Divorce or legal separation
• Birth of your child
• Death of your spouse or dependent child
• Adoption of or placement for adoption of your child Change in employment status of employee, spouse/domestic partner or dependent child
• Qualification by the Plan Administrator of a child support order for medical coverage
• New entitlement to Medicare or Medicaid
Any QLE change should be made within 30 days of the event in PeopleSoft. You will need to provide proof of the event. If you do not enter your life event in PeopleSoft within 30 days of the qualified event, you will have to wait until the next open enrollment window to make changes (unless you experience another QLE.
The Surcharge applies to you (City of Raleigh employee) if your spouse is covered under the City of Raleigh healthcare plan and is eligible for healthcare coverage through his/her employer (whether enrolled in that coverage or not). For 2019, the Spousal Surcharge will be $50 monthly ($25 bi-weekly) and deducted automatically from your paycheck if your spouse is covered under your City of Raleigh healthcare plan, unless you are approved for a waiver. If your spouse is not eligible for healthcare coverage through his/her employer, or is retired or not working, you may be eligible for a waiver of the Spousal Surcharge.
Note: If you and your spouse work for the City of Raleigh, the Spousal Surcharge does not apply.
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