Health Insurance

Eligibility for Coverage When Working

 

Q: How many days must an employee work in a month to be eligible for benefits?

A: The “requisite amount of compensated service” is seven days. The seven days is determined by actual service rendered, vacation pay, or a combination of both.

 

Q: What if I don’t work enough in the month to be eligible for coverage?

A: If you don’t work the seven days in a month, there will be no coverage in the following month. For example, if you don’t work enough in January, there is no coverage for February. Seven days work in February will reestablish coverage, effective March 1.

 

Furlough & Dismissal

 

Q: How long does my insurance coverage last if I am furloughed?

A: Employee and eligible dependent coverage extends through the end of the fourth month following the month in which you last render compensated service. For example, an employee last rendering compensated service in January, who is then furloughed in February, will have coverage extended through the end of May.

 

Q: What if I am dismissed from service?

A: The coverage will be the same as above. The four months are measured from the date last worked, NOT the date of dismissal. For example, say an employee last worked in December, and an investigation is held in January and the employee is dismissed. Since December is the month last worked, coverage extends through the end of April.

 

Q: Will vacation pay extend coverage beyond four months in the above situations?

A: With regard to furlough – no. With regard to dismissal – yes, provided the vacation pay is received while the employee still has an employment relationship (vacation pay received in January prior to dismissal will extend coverage through May.)