When is our "open enrollment"?

Open enrollment is usually around the months of October and November with all changes taking effect on January 1st of the following year. An official notice is e-mailed to employees before open enrollment begins.

What types of health cover ages are available to me?

Depending on your appointment with the Foundation, we offer medical coverage through CalPERS or Kaiser. Our dental coverage is offered through Delta and vision coverage is through Vision Service Provider (VSP).

Do I have to enroll in Health Insurance to obtain dental and /or vision?

No, dental and vision coverage’s are offered independently, on a completely voluntary basis. Dependent coverage’s are also voluntary, and do not need to mirror other enrollments.

Can my dependent parents be covered?

No. Parents are not eligible for coverage under the Foundation’s health plans.

Can my grandchild or niece/nephew be covered under my health plan?

If a grandchild is under the age of 18, unmarried, living in a parent-child relationship with a grandparent (in absence of their natural parents) and economically dependent upon the employee, they may be covered under the employee’s health plan. However, if the child related to employee is not a grandchild or is of no relation biologically, the employee must be the court appointed guardian of the child and legal proof of guardianship must be provided in order for the child to be covered by the employee’s health plan. The dependent must be enrolled within 60 days from the date of custody. After 60 days, “special enrollment” or “late enrollment” criteria may apply for health and vision coverage, and late enrollees (after 31 days of event date). Dental coverage may be subject to a waiting period. Please note this rule does not apply to stepchildren who automatically become eligible dependents at the time their parent becomes an employee’s spouse.

I am getting married soon. Can I add my new spouse and/or stepchildren to my coverage, or do I have to wait until there is an open enrollment period?

You do have 60 days from the date of marriage to add your spouse and/or stepchildren to your health, dental and vision coverage. After 60 days, “special enrollment” or “late enrollment” criteria may apply for health coverage and late enrollee (after 31 days of event date). Dental coverage may be subject to a waiting period. You must contact the Director of Human Resources to complete the appropriate documents and be able to provide a marriage certificate.

I am expecting a baby soon. Can I add my newborn to my coverage?

You have 60 days from the date of birth or adoption placement (under age 18) to add a child to your health, dental and vision coverage. After 60 days, “special enrollment” or “late enrollment” criteria may apply for medical coverage and late enrollees (after 31 days of event date). Dental coverage may be subject to a waiting period. You must contact the Director of Human Resources to complete the appropriate documents and be able to provide proof of birth or adoption.

My dependent child just turned age 19. Is he/she still covered?

Dependent children may be covered to age 23 under the Foundation’s medical policy through CalPERS/Kaiser as long as they are unmarried, have never been married, and are economically dependent upon the employee. Dependent children may be covered to age 23 under the Foundation’s dental policy through Delta if they are unmarried, have never been married, are economically dependent upon the employee and between the age of 20 and 23, are enrolled as full-time students at an accredited school. Dependent children may be covered to age 23 under the Foundation’s vision policy through VSP if they are unmarried, have never been married, are economically dependent upon the employee and between the age of 19 and 23, are enrolled as full-time students at an accredited school. For all policies, there are exceptions for dependent who are mentally and/or physically disabled.

I am resigning, or my project ends at the end of the month. How long will be my covergae be in effect?

Medical, dental and vision coverage is effective through the end of the following month after the date of your resignation or termination of employment (if your termination date is September 15, 2010, coverage is effective through October 31, 2010).

Can I continue my health benefits if I resign or when my project ends?

Yes. COBRA Continuation Coverage provides you the option of continuing your medical, dental and/or vision plans for up to 18 months (or longer in specific cases). You would become responsible for paying the entire premium amount to the carriers, plus a 2% administration fee. The provisions of COBRA also apply to dependents that lose coverage due to legal separation, divorce, or age eligibility. Please contact the Director of Human Resources for further information.

Do I have the option of selecting a different plan when I move to COBRA coverage?

Normally COBRA coverage must be the exact same plan you had as an active employee. The only exception would be those qualifying for the ARRA subsidy. This law allows those who qualify for subsidized COBRA coverage to also choose a less expensive plan at the time they move to COBRA in order to further reduce their premium cost

Is there an opportunity to change my COBRA plan elections at some time in the future (for instance, Open Enrollment)?

Yes, COBRA participants are allowed the same Open Enrollment options as they would have had were they still an active employee. Available options and the associated premium costs for COBRA participants are distributed by ADP each October. Depending on the timeliness of the communications, COBRA participants may have a later enrollment period than active employees, although the goal is that they coincide with the actives.

When I am choosing a health carrier for medical coverage, are there restrictions for pre-existing conditions?

When an employee becomes eligible to enroll in the group medical coverage through CalPERS, there are no restrictions for enrollment with a pre-existing conditions with a carrier available to the organization within the service area. There are also no restrictions for enrollment with a pre-existing condition with a health carrier during open enrollment.

When I was originally hired with the Foundation, I had health coverage with my spouse. But we have just lost that coverage, am I eligible to enroll in the Foundation’s health plans?

Yes, you do have 60 days from the date of loss of coverage to add you and your spouse and/or stepchildren to your health, dental and vision coverage. After 60 days, “special enrollment” or “late enrollment” criteria may apply for health coverage and late enrollee (after 31 days of event date). Dental coverage may be subject to a waiting period. You must contact the Director of Human Resources to complete the appropriate documents and be able to provide proof of loss of coverage from a prior plan.

I lost my ID card. How do I get a replacement?

Contact the insurance carrier or Human Resources if you need an additional or replacement card.

What is Co-Insurance?

Co-Insurance is the percentage of your care for which the medical plan pays. For example, if your co-insurance is 100%, then the plan pays 100% after any deductible and co-pays. If it is 80% co-insurance, the plan pays 80% after deductible and co-pays and the remaining 20% would be the member’s responsibility.

What is an EAP?

An EAP (Employee Assistance Program) offers free counseling to full-time employees and their household members to help them resolve personal matters which may affect their work performance or quality of life.

How many counseling sessions may I attend?

EAP will provide five free counseling sessions per person per issue, unlimited issues, per year.

Are there services other than counseling?

Yes, EAP also provides one free consultation with an attorney per year, and offers counseling for financial and debt management issues.

Are the sessions confidential?

Yes, all sessions are confidential.

What are some topics that are covered under short-term counseling?

Examples would include family problems, marital problems, drug and/or alcohol and dependency, depression, compulsive gambling, anger management, eating disorders, financial mismanagement, legal problems, anxiety, stress, tension, grief, child and adolescent problems, interpersonal problems with co-workers and supervisors, and parenting problems.

Who can I contact to schedule an appointment?

Contact EAP at 1-800-234-5465 or you can visit the website at www.liveandworkwell.com to schedule an appointment.