Page 3 - Pathway EE Guide OOS 06-17

ENROLLMENT INFORMATION

Who May Enroll
If you are a regular full‐time employee working at least 30 hours per week, you and your eligible dependents may participate in
Pathway’s benefits program. Your eligible dependents include:
• Legally married spouse (marriage certificate may be required)
• California state registered domestic partner (Proof of registration may be required)
• Children:
• Medical, Dental and Vision: To age 26, regardless of student or marital status
• Voluntary Life/AD&D: To age 25 with proof of full-time student status
• Court Appointed children who live with you

When You Can Enroll
As an eligible employee, you may enroll at the following times:
• You may participate in the company’s Medical, Dental, and Vision program on the first day of the month following your date of hire
• You may participate in the company’s Flexible Spending Accounts after 12 months of continuous active employment
• You may participate in the company’s 401(k) plan on the first day of the month following 3 months of continuous active
employment
• You may enroll in Voluntary Life/AD&D insurance at any time, subject to proof of good health and carrier approval
• Each year, during open enrollment
• Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment below)

Paying For Your Coverage
All of employee insurance coverage is provided at no cost to you and is paid entirely by Pathway, with the exception of Voluntary
Life/AD&D, Voluntary Hospital or Accident, and Flexible Spending Accounts. There is a $25 per patcheck contribution for your
dependents for medical plan coverage.

Changes To Enrollment

Our benefit plans are effective June 1st through May 31st of each year. There is an annual open enrollment period each year,
during which you can make new benefit elections for the following June 1st effective date. Once you make your benefit elections,
you cannot change them during the year unless you experience a qualifying event as defined by the IRS. Examples include, but are
not limited to the following:

• Marriage, divorce, legal separation or annulment • Change in your residence or workplace (if your benefit
• Birth or adoption of a child options change)
• A qualified medical child support order • Loss of coverage through Medicaid or Children’s Health
• Death of a spouse or child Insurance Program (CHIP)
• A change in your dependent’s eligibility status • Becoming eligible for a state’s premium assistance
• Loss of coverage from another health plan program under Medicaid or CHIP

Coverage for a new dependent is not automatic. If you experience a qualifying event, you have 30 days to update your coverage.
Please contact the Human Resources Department immediately following a qualifying event to complete the appropriate election
forms as needed. If you do not update your coverage within 30 days from the qualifying event, you must wait until the next annual
open enrollment period to update your coverage.

Online Carrier Resources

Take advantage of the online resources available through our insurance carriers. You can
locate network providers, manage your claims, obtain health and wellness information, and
much more!

Insurance carrier website addresses are located on page 4 of this guide.

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