Health Care Options for Employees

Employees eligible for medical and dental insurance enroll at the time of initial employment. Thereafter, employees can add or change insurance during the annual open enrollment period. Open enrollment generally occurs during May, and elections made at that time are effective July 1. Look for announcements for specific dates and times during the spring of each year.

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.

Child Eligibility Rules

In accordance with the “Affordable Care Act” medical/prescription drug eligibility rules are revised to allow enrollment of the subscriber's natural, adopted child, or stepchild who are:

1. Up to age 26;

2. Any age if permanently and totally disabled, and who are enrolled as a dependent in the state plan or an equivalent plan at the time the disability occurred;

3. And, whether or not they are:

a. Married (a dependent's spouse or the employee's grandchildren are still not eligible for coverage);
b. Living in Connecticut;
c. Living with the employee;
d. In school;
e. Financially dependent on the employee; or
f. Eligible to enroll in their employer's health coverage.

Health Enhancement Program Compliance

Quantum Health is the administrator for the Health Enhancement Program. You can visit https://carecompass.ct.gov/hep/ to:

View HEP requirements and download HEP forms
Check your HEP compliance status
Exchange messages with Care Coordinators

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. All changes must be made within 31 days from the qualifying event. Employees must contact the HR Employee Resource Center at 860-679-2426 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).

Qualifying status changes include, but are not limited to:

Legal Marital/Civil Union Status
Divorce/Legal Separation
Legal Guardianship at Age 18
Number of Dependents
Employment Status
Dependent Status
Residence

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.

Divorce/Legal Separation

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. An employee who is granted a legal separation can either terminate spousal coverage or will be permitted to provide spousal coverage under certain circumstances.

Employees required by state law or divorce decree to provide health benefit coverage for an ex-spouse, or employees granted a legal separation who choose to continue to provide spousal coverage, will be allowed to continue coverage under the state plan, subject to the following:

The employee must pay 100% of the cost of individual coverage for the spouse/ex-spouse under the selected vendor and plan (including both the employee and the state portion).
The spouse/ex-spouse's coverage will continue for three years or until either party remarries, whichever occurs first.

Where there is no court order or statute requiring continuation of coverage for a former spouse, or the employee 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 the 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.

An employee who wishes to provide health insurance benefits to a child for whom he or she is the legal guardian must submit a copy of the legal guardianship order and a CO-1318 form to the Benefits Unit within 31 days of the order date.

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).

Special Payroll Insurance Rates

Effective July 1, 2024

Contact

For questions, contact Human Resources.

HR Employee Resource Center:

Phone: 860-679-2426
Email: HR Resource Center

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