Health and Dental Insurance

Upon hire, new employees have thirty one (31) days to enroll themselves and their eligible dependents in the health and or dental plan(s). Insurance becomes effective the 1st of the month following the employee’s hire date or date of eligibility. Thereafter, employees can add or change insurance during the annual open enrollment period. Open enrollment generally occurs during the month of May, and elections made at that time are effective July 1st. Look for announcements for specific dates and time during the spring each year.

 

Important Dates

The Comptroller’s Office has announced that the 2014 Health Insurance Open Enrollment period for state employees will be held from May 12, 2014 through June 6, 2014. Coverage selected during the open enrollment period will be effective July 1, 2014. The annual open enrollment period is the only time employees may change health plans, or add /drop coverage for existing dependents.

 

Plan Changes

The 2014 Health Care Options Planner can be found on the Comptroller’s Office website. One important change to note is that Cigna will be the dental carrier for all three State of Connecticut dental plans.

 

Health Enhancement Program (HEP)

Care Management Solutions, an affiliate of ConnectiCare, is the administrator for the HEP. You can visit www.cthep.com to:

  • View HEP requirements and download HEP forms
  • Check your HEP Compliance status
  • Exchange messages with HEP Nurse Case managers and professionals

Care Management Solutions representatives can be reached at (877) 687-1448, Monday – Friday, 8 a.m. to 5 p.m. If an individual is not already enrolled in HEP, and does not elect to enroll during this open enrollment, the next opportunity to join will be next year’s open enrollment period. If an individual does not participate in the Health Enhancement Program, the premiums will be $100 per month higher and there will be an annual $350 per individual ($1,400 per family) in-network medical deductible.

 

Enrollment Change Forms

Employees interested in making changes may request an enrollment change form from Beth Winiarski at (860) 906-5003. Any employee adding a dependent to his or her insurance must provide proof of relationship for the eligible dependent (i.e. marriage license, full-length birth certificate).

 

Affordable Care Act Notice

The Affordable Care Act requires us to inform all employees about the Health Insurance Marketplaces, which were set up to make it easier for consumers to compare plans and enroll in health insurance coverage. If you are eligible for employee health benefits through the State of Connecticut you will most likely not save money by purchasing coverage through the Marketplace. However, if you are not eligible for job-based health benefits, you may want to consider purchasing coverage through the Marketplace as explained here in the New Health Insurance Marketplace Coverage Options and Your Health Coverage notice.

 

Adding/Dropping Dependents Outside of the Open Enrollment Period

Once you choose your medical and dental plans, you cannot make changes during the plan year (July 1 to June 30) unless you experience a separate qualifying status change and contact Human Resources within 31 days of the event. Qualifying status changes include:

Legal Marital/Civil Union Status
Any event that changes your legal marital/civil union status, including marriage, civil union, divorce, death of a spouse, and legal separation.

The State and SEBAC have reached an agreement to clarify the allowable coverage in the event of legal separation, divorce and legal guardianship at age 18. When any of these events occur after July 1, 2012, an employee is required to notify the Benefits Unit within 31 days of the event.

  • Legal Separation
    An employee who is granted a legal separation can either terminate spousal coverage or will be permitted to provide spousal coverage, subject to the following:The employee must report the legal separation by submitting Comptroller’s Form CO-1319 to the Benefits Unit 31 days of the judgment;The employee must pay 100% of the cost of individual coverage for the spouse under the selected vendor and plan (includes both the employee and the state portion); and

    The spouse’s coverage will continue for three years or until either party remarries, whichever first occurs.

  • Divorce
    In general; entry of a divorce decree requires that the former spouse be removed as a dependent under the plan within 31 days from the effective date. However, the laws of some states and certain divorce decrees require an employee to continue group medical plan coverage for a former spouse.

Employees required by state law or divorce decree to provide health benefit coverage for an ex-spouse will be allowed to continue coverage for a former spouse under the state plan, provided:

The employee must report the legal separation by submitting Comptroller’s Form CO-1319 to the Benefits Unit 31 days of the judgment;

Coverage of the former spouse may continue for up to three years or until either party remarries, whichever comes earlier; and

The employee must pay 100% of the cost of individual coverage for the former spouse under the selected vendor and plan (includes both the employee and the state portion)

Where there is no court order or statute requiring continuation of coverage for a former spouse or member fails to provide timely notice of a marital status change, continuation coverage for the former spouse will be available under COBRA.

  • Legal Guardianship at Age 18
    Under our medical/dental plan, an employee who has been named by the court as legal guardian of a minor child is permitted to cover that child as a dependent while the guardianship is in place. Most legal guardianship ends at age 18.

Number of Dependents
Any event that changes your number of dependents, including birth, death, adoption, and legal guardianship.

Employment Status
Any event that changes your, your spouse/civil union partner’s, or another dependent’s employment status, resulting in gaining or losing eligibility for coverage such as:

  • Beginning or ending employment
  • Stating or returning from an unpaid leave of absence
  • Changing from part time to full time or vice versa

Dependent Status
Any event that causes your dependent to become eligible or ineligible for coverage under their current status as a dependent child, qualifying relative (child) or non-qualified child because of a change in age, student status, status as an IRS dependent, or similar circumstances.

Residence
A significant change in your plan of residence that affects your ability to access network providers (i.e., moving out of state).

All changes must be made within 31 days from the qualifying event. Employees must contact Beth Winiarski at 860-906-5003 within 31 days for the appropriate paperwork and for additional instructions for submitting required supporting documentation (i.e., marriage license or full-length birth certificate). The change made must be consistent with the qualifying status change (i.e., getting married would allow an employee to add a spouse, but would not allow an employee to change plans).

 

Insurance Options

For specific choices, coverage and rate information, please visit the following websites: