Page 5 - Benefits Guide BICS 2020 Final

Enrollment Information

Who May Enroll
If you are a regular-status, full‐time employee working at least 30 hours per week, you and your eligible dependents may
participate in BICS’ benefits program. Your eligible dependents include:
• Legally married spouse.
• Registered domestic partner. If you live in a state where registration is not available, an affidavit is required. Please note
imputed income applies.
• Children under the age of 26, regardless of student or marital status. This includes stepchildren, legally adopted children,
foster children, your disabled children of any age if they became disabled before age 26.
 Dependent children are covered through the end of the month in which they turn 26. COBRA coverage may be
available for up to 36 months after their coverage ends.

When You Can Enroll
As an eligible employee, you may enroll at the following times:
• As a new hire, you may participate in the company’s benefit plans on your first day of employment.
• Each year during open enrollment.
• Within 30 days of a qualifying event as defined by the IRS. See Changes To Enrollment below.

Changes To Enrollment
Our benefit plans are effective January 1st through December 31st of each year (Plan Year). There is an annual Open Enrollment
period each year, during which you can make new benefit elections for the next Plan Year. Once you make your benefit elections,
you cannot change them during the year unless you experience a qualifying event as defined by the IRS.

If you do not enroll, you will waive coverage for medical (including prescription drugs), dental, vision and flexible spending
accounts (FSA). You will not have another opportunity to elect benefits for 2020 unless you have a qualifying event that impacts
your eligibility (i.e. a marriage or a new baby).

Coverage for a new dependent is not automatic. If you experience a qualifying event, you have 30 days to update your coverage.
Please initiate a qualifying event change online within the 30-day window to update your election, if necessary or desired. If you do
not update your coverage within 30 days from the qualifying event, you must wait until the next annual Open Enrollment or when
you have another qualifying event to update your coverage.

Qualified 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

Don’t forget to enroll by: _______________________________________

Online Enrollment

To enroll in your benefits, you must log into your UltiPro account by visiting TSSSO
• For New Hires or Qualifying Event Changes, please click “Life Events”
• When you enroll, be sure to have each dependent’s social security number available, you will need this information to
enroll.

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