Medical Insurance

Purpose: To provide eligible faculty and staff with medical insurance.

Policy Statement: Staff who work at least 20 hours per week on a regular (not temporary) basis and faculty with at least .50 FTE are eligible to enroll in medical insurance plans sponsored by the College. Employees enrolled in medical insurance plans are subject to eligibility rules and benefits outlined in each medical insurance plan document and are required to pay a portion of the premium. Medical insurance plans and premiums are subject to change each year on April 1. Applicable premium adjustments occur on the March payroll.

Employees who are eligible for, but choose not to enroll in, a medical insurance plan due to other coverage are eligible for $50/month medical waiver stipend.

If an employee’s spouse/domestic partner is eligible for health coverage through their own employer and doesn’t enroll in those benefits, but elects to enroll in Lewis & Clark’s health benefits, a monthly spousal surcharge will be deducted from their paycheck. The monthly spousal surcharge is $50.00. If an employee enrolls a spouse/domestic partner in Lewis & Clark’s health benefits but fails to complete the Spouse/Domestic Partner Surcharge Affidavit the $50 surcharge will be deducted from their paycheck until such time as the form is completed and supports that the surcharge would not be applicable.

Procedures:

1. Upon hire, benefit eligible faculty and staff will receive a benefits summary containing information about premiums and benefit coverage of available medical plans, the applicable enrollment deadline, and information on how to get assistance.
2. New employees will be provided with an opportunity to attend a benefits orientation session in which medical insurance plan options, enrollment procedures, deadlines, and other related information will be presented. Benefit enrollments are completed within Workday.
3. Employees have 30 days from their start date to submit their benefits elections in Workday. Coverage begins on the first day of the month following date of hire. If an employee does not enroll in coverage through their initial benefits enrollment, the only other opportunity to enroll is during the annual open enrollment period unless there is a qualifying event. Open enrollment elections take effect on April 1.
4. Employees are required to pay a portion of the medical insurance premiums. Employee contributions are deducted from the paycheck at the end of the month for the next month’s coverage. Employee medical insurance premiums are withheld on a pre-tax basis. Premiums are subject to change each year on April 1.
5. In some instances of unpaid leave employees may be allowed to continue their coverage for a period of time by paying their premiums outside of the monthly paycheck cycle on an after-tax basis. Employees who pay their premiums on an after-tax basis may choose to discontinue their medical insurance at any time by contacting the HR office for assistance. These same employees may also choose to discontinue coverage for one or more dependents at any time while keeping coverage for themselves by contacting the HR office for assistance. Employees whose premiums are deducted on a pre-tax basis are subject to IRS regulations regarding mid-year election changes, which require a qualifying event in order to make changes such as canceling coverage or deleting dependents.
6. Each year employees will be notified of the annual open enrollment period. Employees may switch medical insurance plans, add or delete dependents, cancel coverage or begin coverage during the annual open enrollment period. Employees who anticipate being absent during the open enrollment period are advised to contact Human Resources no later than February 15 to request open enrollment assistance.
7. If there is a qualifying event as described in the applicable Summary Plan Description, employees and their dependents or Spouse/Domestic Partners may enroll in medical coverage outside of open enrollment. Employees are required to submit their change request and provide supporting documentation within 30 days of the qualifying event.
8. Employees who take an unpaid leave of absence or who work less than 12 months per year must make arrangements in advance with the Office of Human Resources to pay for benefit premiums or insurance coverage will be discontinued.
9. Covered employees and their dependents who lose insurance coverage for any of the following reasons are eligible to continue medical insurance through COBRA: termination, reduction in hours, divorce or legal separation, death of the employee, eligibility for Medicare, or dependent loss of qualification due to age. Please refer to the COBRA policy.

 

Approved by the Executive Council, June 24, 1992.

Revised on April 12, 2023.