Common use of Health Benefits Eligibility Clause in Contracts

Health Benefits Eligibility. a. The State System shall provide an eligible permanent full-time active employee with health benefits. The State System shall provide permanent part-time employees who are expected to be in an active pay status at least fifty (50%) of the time every pay period with health benefits. b. The State System shall provide dependency coverage where the dependents of the employee qualify under such plan. c. Eligible employees shall be those determined by the health plans in accordance with the eligibility provisions of the STATE SYSTEM OF HIGHER EDUCATION Group Health Program (SSHEGHP). The choice among plans shall be operated as follows: (1) The option to elect the coverage in a plan shall be made available to those employees who reside within the service area of the plan. (2) The amount and kind of benefits available to the employees shall be those offered by the plan and contracted for by the State System. (3) The option to elect coverage under a plan shall be available during annual open enrollment periods designated by the State System and the plans. Employees who move into a plan’s service area may choose from available plans. d. Spouse Coverage Effective for employees hired on or after July 1, 2013, if an employee wishes to enroll his or her spouse in a State System health plan, and that spouse is eligible for coverage under his or her own employer’s plan, the spouse shall be required to enroll in that other employer’s plan (which shall be his or her primary coverage), as a condition of eligibility for secondary coverage under the State System plan, without regard to the amount of cost-sharing required under the spouse’s plan, and without regard to any incentive the spouse’s plan may offer the spouse not to enroll. In the event that the spouse loses coverage through his/her employer, the spouse’s coverage under the State System plan shall immediately become primary.

Health Benefits Eligibility. a. The State System shall provide an eligible permanent full-time active employee with health benefits. The State System shall provide permanent part-time employees who are expected to be in an active pay status at least fifty (50%) of the time every pay period with health benefits.benefits.‌‌ b. The State System shall provide dependency coverage where the dependents of the employee qualify under such plan.plan.‌ c. Eligible employees shall be those determined by the health plans in accordance with the eligibility provisions of the STATE SYSTEM OF HIGHER EDUCATION Group Health Program (SSHEGHP). The choice among plans shall be operated as follows:follows:‌ (1) The option to elect the coverage in a plan shall be made available to those employees who reside within the service area of the plan.plan.‌ (2) The amount and kind of benefits available to the employees shall be those offered by the plan and contracted for by the State System.System.‌ (3) The option to elect coverage under a plan shall be available during annual open enrollment periods designated by the State System and the plans. Employees who move into a plan’s service area may choose from available plans.plans.‌ d. Spouse Coverage Coverage‌ Effective for employees hired on or after July 1, 2013, if an employee wishes to enroll his or her spouse in a State System health plan, and that spouse is eligible for coverage under his or her own employer’s plan, the spouse shall be required to enroll in that other employer’s plan (which shall be his or her primary coverage), as a condition of eligibility for secondary coverage under the State System plan, without regard to the amount of cost-sharing required under the spouse’s plan, and without regard to any incentive the spouse’s plan may offer the spouse not to enroll. In the event that the spouse loses coverage through his/her employer, the spouse’s coverage under the State System plan shall immediately become primary.primary.‌