Page 4 - QSC Benefits Guide 7-17 COLORADO

ENROLLMENT INFORMATION

Who May Enroll

You are eligible for QSC’s benefits on the first day of the month following one month of full-time employment if you are a
full-time employee scheduled to work 30 hours or more per week.

You may enroll your eligible dependents in the same plans you choose for yourself. Eligible dependents include your legal
spouse or registered domestic partner and your children up to age 26.

When You Can Enroll
Eligible employees may enroll at the following times:
• Annually, during open enrollment.
• As a new hire, you may enroll in the Medical, Vision, Dental and Flexible Spending Account within 30 days of your
eligibility date. If you do not enroll in coverage within 30 days of your eligibility date, you will not be allowed to enroll in
health coverage during the plan year unless you experience a qualifying event (see Changes To Enrollment for details).
• Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment for details).
• You may enroll in all Voluntary plans anytime during the year. Please note that you may be subject to evidence of
insurability for certain plans unless you are a new hire.

Paying For Your Coverage
The Basic Life and AD&D, Long Term Disability, Employee Assistance Program and Travel Assistance benefits are provided
at no cost to you and are paid entirely by QSC. You and the company share in the cost of the Medical, Vision and Dental
benefits you elect. Any Voluntary benefits you elect will be paid by you at group discounted rates.

You have the option for your Medical, HSA, Vision, Dental and Flexible Spending Account premiums to be deducted from
your paycheck on a pre-tax or post-tax basis. If you elect pre-tax, your premiums will be deducted from your paycheck
before federal (and in some cases, state) income and Social Security taxes are deducted, thereby lowering your taxes and
increasing the amount of your take-home pay.

Changes To Enrollment
The choices you make when you first become eligible will remain in effect for the entire plan year July 1, 2017 through June
30, 2018 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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