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Regular Employee Contingent II / Contractual Employees Eligibility

Employees
Any regular employee, working at least 50 percent of the time is eligible to participate in the University’s benefit programs. Retirees from such positions are also eligible. Contingent II employees, as well as graduate and research assistants are also eligible for most benefits with the exception of the state-sponsored retirement plans.

Eligible Dependents The spouse, domestic partner, and eligible children of employees and retirees qualify to enroll in coverage with the appropriate documentation. An “eligible child” is defined as a one of the following until the end of the month in which the child turns age 26:

  • A Biological Child
  • A Legally Adopted Child
  • A Step-child
  • Grandchild*
  • Legal ward*, Testamentary, or Court appointed guardian (not temporary for less than 12 months)
  • A Step-grandchild or other dependent child relative
  • A Child over the age of 26 and incapable of self-support due to mental or physical incapacity incurred prior to age 26*Please refer to important tax information.Note: A husband and wife who are both State employees may NOT have duplicate coverage under any plan by covering each other under separate enrollments. Also, children of a husband and wife who are both State employees may NOT be covered twice under both parents’ plans.

Same Sex Domestic Partner When to Enroll

As a new employee, you have 60 days from the date you begin employment to choose your benefit programs. However, it is advisable that you enroll as soon as possible, preferably before your start date. Coverage is effective when the first deduction is made. After the first deduction occurs, if you need coverage back to your original date of hire, please contact the University Office of Employee Benefits (301-405-5654). If you do not sign up for a benefit program within this 60 day period, you will NOT have another opportunity to enroll until the next open enrollment period. (Open enrollment is held once a year.)

Please note that you must choose one of the mandatory retirement programs before your pay check can be issued.

How to Enroll
Enrollment forms can be obtained from either the Office of Employee Benefits, online, or from your departmental Benefits Coordinator.

Regular Status Health Benefits Enrollment
Direct Pay Contingent II/COBRA Health Benefits Enrollment
Retiree Health Benefits Enrollment

The enrollment form allows you to make selections as to which benefits programs you want to participate in. It is a simple matter of marking which programs you want, the level of coverage you desire, and who is covered under the plan. Once the form is completed, it must be returned to the Office of Employee Benefits. While some departments will forward these forms for you, we recommend that the they be returned in person when possible.

Remember that you will not be able to cancel, change, or add to your coverage once you have made these decisions until the next open enrollment period. Exceptions to this rule are allowed only under select circumstances. Therefore, it is very important that you make careful and informed decisions regarding your benefits coverage.

Effective Dates for Coverage of New Employees

New Enrollments have an effective date of either the first or the sixteenth of the month, depending upon the pay period for which a deduction is taken form your paycheck. The state payroll system usually takes three pay cycles to begin premium deductions from your paycheck. The premiums deducted cover the two week period extending to your next paycheck.

Once you see a deduction from your paycheck, you will know that your coverage is in effect.

If you need medical care before deductions begin, use the health insurance program you selected. You may have to pay at the time of the doctor’s visit and then file a claim for reimbursement through the insurance company after your coverage becomes effective. In addition, you will have to make your effective coverage date retroactive to the date of your employment. You can do this by contacting the Office of Employee Benefits and making arrangements to pay your portion of the premium for this period.

When Can I Change My Coverage?

Open Enrollment
Once a year, there is an open enrollment period which allows all eligible employees to change, cancel or add to existing coverage. For example, you can change from one health insurance company to another during this time, or you can cancel coverage altogether.
Changes in Coverage Due to Qualifying Events
The State Health Benefits Program operates as a pre-tax cafeteria benefits program under Section 125 of the Internal Revenue Service (IRS) Code. The IRS regulations governing the program do not permit changes after open enrollment, except in very limited circumstances. Once you have elected a plan, you must stay in the selected plan, at the selected coverage level, for the full calendar year, unless there has been a qualifying event.

A qualifying event is a change in family status, such as the birth of a child, loss of a dependent, marriage, or divorce. A qualifying event can also occur in cases where your spouse’s employment is terminated. You have 60 days from the occurrence of the qualifying event to make changes to your benefits. The changes made, however, must be because of and consistent with the change in status that has occurred.

Limited changes may also be permitted for administrative error when it is demonstrated that a mistake has been made by a processing agency.

NOTE: Mistakes in completing the enrollment form and other errors made by the employee or retiree do not constitute administrative error under IRS regulations.

The penalty for non-compliance with the IRS regulations is the loss of tax-exempt status for both the State and the employees in the plan. Changes outside of the open enrollment period will be permitted only in accordance with the IRS regulations. For this reason, you are cautioned to be very careful in making your selections.

NOTE: To receive any applicable refunds, you must submit errors in writing to the State Employee Benefits Division within 60 days of an incorrect deduction from your check.

Retro Adjustments
Benefit Appeal Process
Continuation of Coverage