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Human Resources

College Policies I Health Insurance

**THIS POLICY IS UNDER REVISION**

Washington College offers all regular full-time employees and their dependents health insurance. Enrollment may be made during the initial orientation period, during the annual “open enrollment period” in April, and at other times of eligibility. All regular full-time employees are required to have health insurance and must either join a plan offered by the College or show evidence of coverage by another plan.

Eligibility

Full-time: Full-time regular employees and their dependents are eligible for health insurance.

Part-time: Part-time regular employees (who work at least 20 hours per week, have completed one year of service, and who began active employment by December 31, 2003) and their dependents are eligible for health insurance.  Part-time regular employees who begin active employment after December 31, 2003 and their dependents are not eligible for health insurance. This policy may be waived by the Vice President for Finance and Management in order to offer competitive compensation.

Dependent Coverage: Dependents eligible for enrollment include the employee’s legal spouse and may include unmarried dependent children who reside in the employee’s household and have not attained plan age limits. Dependents are eligible as long as the employee is in the plan. The employee must enroll an eligible dependent in order for him/her to receive benefits. It is important to report promptly any changes in family status such as marriage, divorce, a newborn child, an adoption, a child reaching the maximum age or a child leaving school.

Initial/Open Enrollment

Initial Enrollment: A newly eligible employee has an initial period of time in which he/she can enroll in a health plan offered by the College. The initial enrollment period begins on the later of the date that the employee begins active employment or the date the employee meets the eligibility criteria above. The enrollment form must be completed and returned to Human Resources within 30 days of the first day of the initial enrollment period.

Open Enrollment: During the “open enrollment” period in April, an eligible employee and his/her dependents (not previously covered) have the opportunity to enroll in a College- sponsored group health insurance plan. During the open enrollment period, a currently enrolled employee has the opportunity to select an alternative health insurance plan that is being offered by the College.

Late Enrollment: Under the late enrollment option, an employee may apply for coverage for him/herself or eligible dependents no later than 30 days following the first day of the initial enrollment period. Under the late enrollment option, an applicant is required to submit a certificate of coverage from his/her current insurer in order to apply for participation in the College- sponsored health plan.

Effective Date of Coverage

Initial Enrollment: Health insurance is effective the first day of the month following 30 days after the date of enrollment.

Open Enrollment: Effective date of coverage is May 1, following the open enrollment period in April.

Late Enrollment: Effective date of coverage is the first day of the month, following acceptance of the application by the insurance carrier.

Benefits

Information for each plan describing the benefits is available from Human Resources and the HR website (http://hr.washcoll.edu). Questions that are not addressed in the literature may be directed to Human Resources or the insurance company’s member services department.  In the event of a conflict, the insurance contract or plan documents will prevail over other documents.

Because of the nature of health care today, aspects of the College’s plans change from year to year. Human Resources will notify all employees of changes by distributing new information as it becomes available. Each employee should study the new information carefully, in order to have a full understanding of any changes from the previous plan(s).

Cost of Insurance

Washington College and the employee share the cost of Washington College’s health insurance premiums. With the employee’s written authorization, the employee’s portion will be deducted from his/her paycheck on a pre-tax basis.

An eligible part-time regular employee who has 15 years of regular service will be granted the same health premium benefit as full-time employees.

All other eligible regular part-time employees (see eligibility section above) may participate in the health insurance plan on a prorated basis, in proportion to the percentage of hours worked during the previous anniversary year.

Premiums and percentages of the contribution assumed by the College are subject to change. For current premiums, please see the Employee Benefits Booklet

Termination of Insurance and Continuation Privileges

Separation

Upon separation, an employee who has health insurance in one of the College’s plans will no longer be eligible for this benefit. The group health insurance will cease on the last day of the month in which the termination is effective. Coverage for any of the employee’s dependents will also be terminated.

COBRA Eligibility for Employee

Employees, and their dependents participating in the Company’s group health plan, may be eligible for eighteen (18) to thirty-six (36) months of benefits continuation. Eligibility for this benefit continuation under COBRA (Consolidated Omnibus Budget Reconciliation Act) is triggered by a “qualifying event” such as reduction in hours of employment, divorce, or termination of employment for reasons other than gross misconduct, and is subject to policy terms and conditions and applicable legal guidelines.

Should you, your spouse, or your dependent child covered under our group health plan become eligible for this continuation coverage, you must indicate to us whether you elect to participate in this plan within a certain amount of time from the date of the “qualifying event.” Otherwise, your group health benefits will end.  If you have any questions regarding your eligibility or how benefit continuation works, please see Human Resources.

COBRA continuation forms may be obtained from Human Resources, along with further details.

Health Insurance Portability and Accountability Act (HIPAA)

Under the federal HIPAA statute and regulations medical records pertaining to employee health plans enjoy certain privacy protections. To comply with HIPAA, Washington College has adopted a policy that states the College will no longer create or receive “Protected Health Information” in connection with employee health plans. Instead, Protected Health Information will be created or received by the College’s health insurance carriers. Therefore, any inquiries concerning Protected Health Information must be directed to the health insurance carriers. Of course, general inquiries about the College’s employee health plans that do not involve Protected Health Information issues should still be directed to Human Resources.