Open enrollment for insurance benefits is held in August/September of each year. New employees have thirty days from the date of hire to enroll. Eligible dependent children can be covered until age 26 regardless of student status.
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The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Requires self-funded and fully insured group health plans to reduce any pre-existing condition (e.g. heart trouble, high blood pressure) limitation periods by days of prior creditable coverage. If coverage has been continuous for the last 12 months (and no break in coverage over 63 days) there will be no pre-existing condition limitation. Your former insurance carrier (e.g. if you leave WGSD, United HealthCare will be the issuer) will issue the HIPAA letter to you. It is important to keep this letter with your other important papers.
Under Federal law, if your group health benefits end due to a "qualifying event", you may elect to continue your coverage under the plan.
A qualifying event is any of the following:
- Termination of the employee's employment or reduction of hours worked which renders the employee ineligible for coverage
- death of the employee
- divorce or legal separation
- for a spouse and eligible dependents, loss of coverage due to the employee becoming eligible for Medicare, or
- for a dependent child, ceasing to qualify as a dependent under the plan
This coverage can be purchased through the District plan for a period of 18 months and/or 36 months depending upon the qualifying event. The COBRA premiums are the same as the current group insurance rate plus an additional administrative fee, and are quoted in the Cobra mailing. Medical and/or Dental can be continued. COBRA premiums are due from the date of the qualifying event.