Page 4 - QSC Benefit Guide 7-18 SLO

ENROLLMENT INFORMATION

Who May Enroll Paying For Your Coverage

You are eligible for QSC’s benefits on the first day of the The Basic Life and AD&D, Long Term Disability, Employee
month following one month of full-time employment if you Assistance Program and Travel Assistance benefits are
are a full-time employee scheduled to work 30 hours or provided at no cost to you and are paid entirely by QSC.
more per week. You and the company share in the cost of the Medical, Vision
and Dental benefits you elect. Any Voluntary benefits you
You may enroll your eligible dependents in the same plans elect will be paid by you at group discounted rates.
you choose for yourself. Eligible dependents include your
legal spouse or registered domestic partner and your children You have the option for your Medical, HSA, Vision, Dental
up to age 26. and Flexible Spending Account premiums to be deducted
from your paycheck on a pre-tax or post-tax basis. If you
When You Can Enroll elect pre-tax, your premiums will be deducted from your

Eligible employees may enroll at the following times: paycheck before federal (and in some cases, state) income
• Annually, during open enrollment. and Social Security taxes are deducted, thereby lowering
• As a new hire, you may enroll in the Medical, Vision, your taxes and increasing the amount of your take-home pay.
Dental and Flexible Spending Account within 30 days
of your eligibility date. If you do not enroll in coverage Please note that unless your domestic partner qualifies as
within 30 days of your eligibility date, you will not be your tax dependent for health care purposes under the
allowed to enroll in health coverage during the plan year Internal Revenue Code, Federal Tax Law requires that the
unless you experience a qualifying event (see Changes premium cost for your domestic partner and his/her children
To Enrollment for details). will be deducted from your paycheck on an after-tax basis.
• Within 30 days of a qualifying event as defined by the The value of QSC’s portion of the premium will result in
IRS (see Changes To Enrollment for details). “Imputed Income” to you. This amount will be included as
• You may enroll in all Voluntary plans anytime during the an additional wage paid to you on your pay stub for the
year. Please note that you may be subject to evidence of cost of the domestic partner’s premium on which you will
insurability for certain plans unless you are a new hire. pay Federal Taxes.

Changes To Enrollment
The choices you make when you first become eligible will remain in effect for the entire plan year July 1, 2018 through June
30, 2019 unless you are a new hire during the plan year. Once you are enrolled, you must wait until the next Open Enrollment
period to change your benefits or add or remove coverage for dependents, unless you experience a qualifying event as
defined by the IRS. Examples of qualifying events include, but are not limited to the following:
• Marriage, divorce, legal separation or annulment
• Birth or adoption of a child
• A qualified medical child support order
• Death of a spouse or child
• A change in your dependent’s eligibility status
• Gain or loss of coverage from another health plan
• Change in your residence or workplace (if your benefit options change)
• Loss of coverage through Medicaid or Children’s Health Insurance Program (CHIP)
• Becoming eligible for a state’s premium assistance program under Medicaid or CHIP

Please note that coverage for a new spouse or newborn child is not automatic. If you experience a qualifying
event, you have 30 days to update your coverage. Please contact the Human Resources Department
immediately or make a life event change in UltiPro. 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.

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