Page 3 - Sumitomo EE Guide 06-20 Final English

ENROLLMENT INFORMATION

Who May Enroll
If you are a full-time (FT40) or a reduced full-time (FT30) employee, you and your eligible dependents may participate in SRNA’s
benefits program. Your eligible dependents include:
• Legally married spouse
• Domestic partner
• Children under the age of 26

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 benefits program on the first day of the month coinciding with or following
your date of hire - you must enroll in benefits within 15 days of your initial eligibility date
• Each year during open enrollment
• Within 30 days of a qualifying event as defined by the IRS (see Changes To Enrollment below)
• You may enroll in Supplemental Life and AD&D insurance at any time, subject to proof of good health and carrier approval

Paying For Your Coverage
The Basic Life/AD&D, Business Travel Accident, Travel Assistance Program, Short Term Disability, Long Term Disability, Employee
Assistance Program, Health Advocate, and Value-Added Programs are provided at no cost to you and are paid entirely by SRNA.
You and the company share in the cost of the Medical, Dental, and Vision benefits you elect. Any Supplemental Life/AD&D, and
Voluntary Benefits you elect will be paid by you at discounted group rates. Your Medical, Dental, and Vision contributions are
deducted before taxes are withheld. Paying for benefits before‐tax means your share of the costs are deducted before taxes
resulting in more take‐home pay for you. As a result, the IRS requires that your elections remain in effect for the entire year. You
cannot drop or change coverage unless you experience a qualifying event.

Changes To Enrollment
SRNA’s 2020/2021 benefit plans are effective June 1, 2020 through May 31, 2021. Open Enrollment happens once a year where
you can make new benefits elections. Once you make your benefits elections you cannot change them throughout the year unless
you experience a Qualifying Event as defined by the IRS.

Examples of a Qualifying Event 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.
You may log in to Paycom to update your dependent information as needed. Paycom login information is located on Page 4 of this
guide. If you do not update your coverage within 30 days of 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 6 of this guide.

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