Open Enrollment for Active Employees » New Eligibility Rules
Your medical plan options are no longer determined by your home zip code. This means that every employee, no matter what his/her place of residence, will be eligible for the National EPO, PPO, and CDHP plans. This will provide greater access to lower cost plans like the National EPO and National CDHP for employees formerly enrolled in the UHC Out-of‐Area PPO or the UHC National PPO.
The following changes to dependent eligibility requirements are effective January 1, 2010:
The Benefits Office wants to ensure coverage is accessible for all members of your immediate family. Requiring your stepchild to satisfy additional eligibility criteria for coverage under Laboratory benefits is not in keeping with that philosophy or the best practice standards of employer provided insurance. Therefore, the requirements of residency, financial dependency and tax dependency for step‐children have been removed.
Conversely, extending coverage to grandchildren as a stand‐alone class of dependents is not considered a best practice or in line with the standard offerings of most employers, and this dependent type will be eliminated. A disproportionate number of the grandchildren who were enrolled under Laboratory benefits did not meet plan eligibility requirements, and this created a liability for the Laboratory as well as the covering retiree. If you are currently covering a grandchild on your insurance, that coverage will cease on December 31st, 2009 and COBRA will be offered, as required.
If you decline enrollment in medical, dental, and/or vision coverage for yourself or your eligible dependents because you are currently enrolled in other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in medical, dental, and/or vision coverage if you or your dependents lose eligibility for that other coverage (or if the employer stopped contributing toward your or your dependents’ other coverage). However, you must request enrollment within 31 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. Your special enrollment request must be made within 31 days after the marriage, birth, adoption, or placement for adoption.
If an enrolled family member loses eligibility during the year, you are responsible for deenrolling that family member within 31 days of the change in eligibility. A natural, adopted or stepchild who reaches limiting age (25 for dental and/or vision; 23 for all other benefits) will automatically be de‐enrolled. Legal wards reach limiting age and are de‐enrolled at 18.
You are responsible for costs incurred in connection with the enrollment of ineligible family members and you could be subject to penalties associated with Misuse of Plan if you continue coverage for family members who no longer meet LANS eligibility rules. For more information, please reference the LANL Health and Welfare Benefit Plan for Retirees (pdf).
You may change your designated beneficiaries at any time through ORACLE Self-Service for basic life, supplemental life, AD&D and business travel accident insurance. Because you will be logged-in to the self-service application to make open enrollment changes, this is an ideal time to review your current beneficiaries and make any needed updates. Your most current designation will replace any previous designations on file. To designate a beneficiary for the LANS TCP1 or TCP2 401(k) plans, call Fidelity Investments at 1-800-835-5095 or go to the Fidelity NetBenefits website.
The new Mandatory Insurer Reporting Law (Section 111 of Public Law 110-173) requires group health plan insurers to report Social Security numbers in order for Medicare to coordinate payments with other insurance benefits. The law was enacted in late 2007 and became effective on January 1, 2009. As a subscriber (or spouse or family member of a subscriber) to a LANS Group Health Plan Arrangement, the Social Security numbers of enrolled retirees and dependents will be requested in order to meet the requirements of this law. Please make sure your information is up-to-date with Your Benefit Resources.
