Insurance Benefits: Frequently Asked Questions
Who is eligible for insurance coverage?
In order to be eligible for insurance coverage the following criteria must be met: eligible to participate in the university retirement system, paid salary through local university payroll or the state comptroller, hired to work at least half-time or 50% (18.75 hours per week).
Can an employee waive insurance coverage?
Any full-time employee eligible for insurance coverage may, with proof of other comprehensive health coverage, elect to OPT OUT of the Program. Members who opt out will not be enrolled in health, dental or vision coverage through the Department of Central Management Services. The election to opt-out is entirely voluntary and there are no financial incentives or considerations available to those who opt out.
NOTE: Any full-time new hire, currently covered under their spouse’s state insurance program, will have to be dropped as a dependent and obtain their own State Insurance coverage with SIU School of Medicine. Only employees working less than 50% may remain covered under their spouse’s State Insurance coverage.
Any part-time employee eligible for insurance coverage may elect to WAIVE coverage and need not show proof of other comprehensive health coverage.
NOTE: Again, any part-time new hire, working 50% or more and currently covered under their spouse’s State Insurance program, will have to be dropped as a dependent and obtain their own State Insurance coverage with SIU School of Medicine. Employee’s hired as less than a 50% FTE may remain covered under their spouse’s State Insurance coverage. Part-time employees will be required to pay a portion of the State’s cost for health, dental and any dependent coverage. The portion the State contributes is the same percentage that the employee works. For example, for a 75% part-time employee, the State will contribute 75% of the State’s cost and the employee will be responsible for the remaining 25% of the State’s cost, in addition to the employee’s salary-based contribution.
If I am already covered under my spouse's state insurance program, can I continue as a dependent and waive coverage as an employee?
Only part-time employees may waive coverage. You can not be covered as an employee and a dependent on the state insurance program. Your spouse would need to contact their agency to terminate your coverage and should inform the employing agency that you will be covered as an employee on the state program and give your date of hire.
If I accept a position, how soon does insurance coverage begin?
New employees are covered effective the first day of employment.
Once hired, how long do I have to decide which insurance plan I want?
New employees have 30 calendar days from the initial employment date to make health, dental and life insurance coverage choices. If an employee fails to make the benefit elections within the 30 day period, coverage will automatically be enrolled in the Quality Care Health Plan and Quality Care Dental Plan and provided with basic life insurance coverage. New employees may enroll eligible dependents within the 30 calendar days of employment effective date. If dependent coverage is not elected during the first 10 days, the employee must wait until the next eligibility period to request dependent coverage. Annually there is a Benefit Choice Period during which time employees may make changes to their health insurance coverage.
Is there a pre-existing condition clause on the health plans?
No. Federal Healthcare Reform has eliminated any pre-existing conditions.