Health Benefits & Pensions

Upper Arlington Crew Mobile Logo

"CHILDREN COME FIRST, LOS NIÑOS SON PRIMERO"

Health Benefits & Pensions

Health Benefits & Pensions


 
 

Employee Benefits Basics


SPECIAL ENROLLMENT: WHEN OPEN ENROLLMENT ENDS AND I EXPERIENCE A MAJOR LIFE EVENT…

=       Q: What is a qualifying event?

A: A qualifying event is a special enrollment that allows an employee to change an enrollment election (i.e. add or delete dependents, change level of coverage) for yourself and/or your dependents. You will be required to provide proof of the life event and the date it occurred.

 

=       Q: What types of actions would be considered a qualifying event?

 ü Marriage/Divorce

 ü Birth or Adoption of a child by the employee

 ü Termination of employment (or commencement of employment) of the employee’s spouse

 ü The spouse has a significant change in employment status (i.e. full-time status to part-time status, etc…)

 ü Death of the enrolled family member

 ü You waive medical coverage for yourself/family because of other health-care coverage…and you lose that other coverage for special reasons

 ü Your dependent child ‘aged-out’ of the plan and/or obtains their own plan (refer to your contract as applicable)

 

=       QHow much time do I have to notify Human Resources that I have experienced a qualifying event for a special enrollment?

A: You must request enrollment within 31 days after your or your dependents’ other coverage ends. You must request enrollment within 31 days after the marriage, birth, adoption, death, etc…

 

=       Q: Beyond benefit enrollment changes…would there be any other changes that I need to consider?

A: Don’t forget that you may also need to change your marital status, address, beneficiary(ries), tax withholding, direct deposit, and/or name change for payroll/pensions.

Change of name/address/phone number forms may be obtained online in the HR Forms link or at the Human Resources counter. Payroll/tax forms are available from the payroll office. Beneficiaries can be changed via the NJ Pensions and Benefits website via MBOS.

 

Contacts

Horizon Membership Services: 1-800-355-2583; Medical Group number: 86002

Horizon Dental: 17-86002

Link: https://www.horizonblue.com/

 

Eastern Dental: 1-800-982-5529; Group number: 85a108

Link: https://www.easterndental.com/

 

Delta Dental: 1-800-452-9310; Group number: 07078

Link: https://www.deltadentalnj.com/members/members.aspx

 

Vision Service Plan (VSP): 1-800-516-6268; Group number: 12150434

Link: https://www.vsp.com/


Resources

View text-based website