How and when may I add a new employee to our municipality's health coverage? How and when may I delete an employee from our municipality's health coverage?
To add an employee, the employee must complete a CIGNA Enrollment/Change Form. Coverage will begin the first day of the month after the probationary period ends. If your group has no probationary period, coverage begins the first of the month after the date of hire. Each employer's probationary period is different.
To delete an employee, please complete a CIGNA Enrollment/Change Form. Coverage will end as of the last day of the month an employee works. For example, if an employee terminates as of May 15th, coverage will end on May 31st.
Is our municipality allowed to offer more than one health plan?
Yes. Municipalities are allowed to offer more than one health plan. However, if a municipality wishes to offer more than two plans, it must obtain approval from the VLCT Health Trust Board of Directors.
How and when may an employee change health insurance plans?
Employees may change plans during the January open enrollment period.
Who qualifies for Consolidated Omnibus Budget Reconciliation Act (COBRA) and how long does the coverage last?
The following individuals may qualify for COBRA:
* An employee (for example, an employee who reduced working hours and lost coverage)
* A former employee
* A retired employee
* The spouse of any of the above
* The dependent children of any of the above
* Children born to, adopted by or placed for adoption during the period of COBRA coverage with a qualified beneficiary who was once the covered employee
* Other individuals such as self-employed individuals, agents and independent contractors and their employees who are on your plan
Coverage under COBRA has the following duration:
| Qualifying Event | Individuals Affected | Coverage Duration |
|---|
| Termination of employment | Employees and beneficiaries without disability | 18 months |
| Reduction in hours of employment | Employees and beneficiaries without disability | 18 months |
| Termination of employment | Disabled employees and their dependent qualified beneficiaries | 29 months |
| Reduction in hours | Disabled employees | 29 months |
| Bankruptcy | Active employees | 18 months |
| Bankruptcy | Retirees | Life |
| Bankruptcy | Dependents of retirees | 36 months after retiree dies |
| All other events | Usually dependents | 36 months |
When can an employee enroll or add dependents?
Employees can enroll or add dependents either January 1 or July 1 of each year, during open enrollment periods.
What happens when an active employee turns age 65?
For groups of 20 or more employees, the active employee (including dependents) will remain on the CIGNA active plan and there will be no change in coverage.
For groups of 19 or less employees, Medicare will become primary and CIGNA will become secondary for the employee over 65, so the employee needs to move to a Medicare carveout plan (at a reduced monthly premium rate), effective the first of the month of the employee's birthdate. The dependent for this employee would remain on the active plan if under age 65.
For more information on carveouts or procedures for employees turning age 65, please call the VLCT Member Relations staff at 800-649-7915.
