Active Employee Coverage. 1. The public entity must enroll or waive coverage for a new employee by submitting a form signed by the employee and the payroll representative within thirty-one (31) days of his/her eligibility date. A new employee’s coverage begins on the first day of the month after the hire date and the applicable waiting period.
2. An active employee may elect, change, or cancel coverage for the next plan year during the annual open enrollment peri- od.
3. An active employee may elect or change coverage for himself/herself and/or for his/her spouse/child(ren) if one (1) of the following occurs:
X. Xxxxxxxxxx of a life event, which includes marriage, birth, adoption, and placement of child(ren). A special enrollment period of thirty-one (31) days shall be avail- able beginning with the date of the life event. It is the employee’s responsibility to notify MCHCP of the life event.
(I) If paternity is necessary to establish the life event and was not estab- lished at birth, the date that paternity is estab- lished shall be the date of the life event; or
B. Employer-sponsored group cover- age loss. An employee and his/her spouse/child(ren) may enroll within sixty (60) days due to an involuntary loss of employer-sponsored coverage under one (1) of the following circumstances:
(I) Employer-sponsored medical, dental, or vision plan terminates;
(II) Eligibility for employer-spon- sored coverage ends;
(III) Employer contributions toward the premiums end; or
(IV) COBRA coverage ends; or
C. If an active employee or his/her spouse/child(xxx) loses MO HealthNet or Medicaid status, s/he may enroll in an MCHCP plan within sixty (60) days of the date of loss; or
D. If an active employee or active employee’s spouse receives a court order stat- ing s/he is responsible for covering a child(xxx), the active employee may enroll the child(ren) in an MCHCP plan within sixty (60) days of the court order; or
E. If an active employee submits an Open Enrollment Worksheet or an Enroll/Change/Cancel/Waive form that is incomplete or contains obvious errors, MCHCP will notify the public entity’s Human Resource Department of such by mail, phone, or secure message. The correct- ed form must be submitted to MCHCP by the date enrollment was originally due to MCHCP or ten (10) business days from the date the notice was mailed or sent by secure message or phone, whichever is later.
4. If an active employee is enrolled and does not complete enrollment during the open enrollment period, the employee and hi...
Active Employee Coverage. An active employee is one who is employed and meets the minimum number of hours worked per year as established by his/her employer.
1. If the public entity allows elected/appointed officials to participate in medical coverage, the definition of an employee includes elected/appointed officials where applicable.
2. The entity will determine the eligibil- ity requirements of waiting periods, required number of working hours, pay status, and contribution levels.
3. An active employee cannot be covered as an employee and as a dependent.
4. If an active employee has been enrolled as a dependent of another MCHCP subscriber as allowed by these rules, and the subscriber dies before coverage as a depen- dent goes into effect, the active employee may elect coverage as a subscriber within thirty-one (31) days of the date of death.
5. If one (1) spouse is an active state employee or retiree with MCHCP benefits and the other is an active public entity employee or retiree with MCHCP benefits, each spouse may enroll under his or her employer’s plan or together under one (1) employer’s plan. The spouses cannot have coverage in both places.
Active Employee Coverage. An active employee is one who is employed and meets the minimum number of hours worked per year as established by his/her employer.
1. If the public entity allows elected/appointed officials to participate in medical coverage, the definition of an employee includes elected/appointed officials where applicable.
2. The entity will determine the eligibil- ity requirements of waiting periods, required number of working hours, pay status, and contribution levels.
3. An active employee cannot be covered as an employee and as a dependent.
4. A subscriber may enroll eligible dependents as long as the employee is also enrolled subject to the provisions herein.
5. If an active employee has elected cov- erage as a dependent of another MCHCP sub- xxxxxxx as allowed by these rules, and the sub- xxxxxxx dies before coverage as a dependent goes into effect, the active employee may elect coverage as a subscriber within thirty- one (31) days of the date of death.
6. If one (1) spouse is an active state employee or retiree with MCHCP benefits and the other is an active public entity employee or retiree with MCHCP benefits, each spouse may enroll under his or her employer’s plan or together under one (1) employer’s plan. The spouses cannot have coverage in both places.
Active Employee Coverage. Medical coverage is provided through CalPERS under the Public Employees' Medical and Hospital Care Act (PEMHCA), also referred to as PERS Health. Employees can choose one of five medical options: Blue Shield Access HMO, Kaiser HMO, PERSCare PPO, PERSChoice PPO, and PERS Select PPO. The City sets its monthly contribution rates for health insurance on behalf of active employees according to the PEMHCA statutory minimum ($119.00/month for calendar 2014 and $122.00/month for calendar 2015.) These amounts are indexed (increased) in all future years according to the rate of medical inflation. The City pays a 0.33% of premium administrative charge for all active employees.
